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Author Archives: Herbert C Agnew

Background The NHS Executive outlined eight groups of suggested legislative changes in the NHS Long Term Plan and, as promised in the Plan, these have now been set out in further detail in Implementing the NHS Long Term Plan: Proposals for possible changes to legislation [1]. The intention is to make it easier for NHS organisations to work together. Ostensibly these proposals are supposed to help the NHS improve its delivery of services but we see real problems here. Principal objection The Health and Social Care Act 2012 was a package promoting a range of checks and balances on the […]
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Introduction  The Labour Party Conference have rejected Sustainability and Transformation Partnerships and American style Accountable Care Organisations and John Ashworth has declared his wish to work with campaigners , trade unions and Labour Party members to review the funding of the NHS and to work on a future Labour policy for the NHS. This paper takes up that challenge and proposes looking at the issues according to these headings: Immediate priorities Provision of funding and funding principles The question of Integration of healthcare and social care. The question of managing complexity and sub-contracting management to the private sector. The question […]
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I’m going to talk about Accountable Care Systems/Accountable Care Organisations today. My thesis is a simple one: that ACSs/ACOs are not new and they don’t work. They promise 20-30% savings but they cost at least an extra 15-20%. There are better ways of saving money and improving quality. I will look at them from two different perspectives: a commercial perspective and a scientific perspective. I will ask can Accountable Care Systems work in theory and have they worked in practice. I will leave you with what I believe are the lessons for the UK (and the USA) and where I […]
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Corbyns’ Health Policy- Problems from a different  perspective I provide some commentary in bold under the details of Jeremy Corbyns’ recently announced health policies. These represent a different perspective from those of most commentators. Secure our NHS and social care “We will end health service privatisation and bring services into a secure, publicly-provided NHS. We will integrate the NHS and social care for older and disabled people, funding dignity across the board and ensure parity for mental health services.”  Jeremy Corbyn’s vision for the NHS will reverse the marketisation of health, integrate social care and improve staff morale to build […]
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This is a curious document and it gets a mixed blessing. First: on the form of the document. It is an 18 pager addressing the priorities of the incoming Labour government for healthcare and health more generally. Although it references other documents that have clearly influenced it, it remains a surprisingly light read. There is no attempt to compare healthcare provision with the EU or the world in general or to describe the rapidly increasing needs for healthcare as a result of immigration, a baby boom and the needs of a more elderly population. It is not based on an […]
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  For years Tesco has been held up as a model to be emulated by the NHS. Sir Gerry Robinson: “I, for one, would like to see the NHS learn from and copy working practices from Tesco, in particular, which has constantly modernised to better meet the needs of its customers. Our health service could be vastly improved, made more efficient, more innovative and, crucially – in the light of what has happened at Mid Staffs and Barrow-in-Furness hospitals – safer.” Sir Paul Corrigan: “…health service should learn from supermarket chains such as Tesco, by mirroring its business model of […]
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A review of the Independent Commission on Whole-Person Care commissioned by Andy Burnham. “One Person supported by people acting as One Team from Organisations behaving as One System” This report is intended as supporting documentation to the Labour Party policy review consultation document “Health and Care” published in March 2014. It provides an insight into what may happen if there is a Labour Victory in the General Election in 2015, and indicates some of the thinking behind the proposals. The driver for the report seems to this commentator to be a desire to draw a clear line between the approach […]
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Polly Toynbee in her Guardian column of 25th October draws attention to “an emergency extra law …. rushed through the Lords this week to give NHS bankruptcy administrators power over surrounding viable hospitals” (1). This means that the Government , having been told by Mr Justice Silber that the action of its appointed ‘special administrator’ to close the Lewisham  A&E department was unlawful, is attempting to change the law to allow special administrators a free hand to close facilities and move services without any real public consultation. This at a time when the Government has been heralding patient and GP […]
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1          Introduction Although HS2 may at first seem unrelated, it possesses many of the features of the NHS reconfiguration debate: strong vested interests; a lot of money at stake; many people sympathetic to the vague goals of the project but without a clear idea of the costs, benefits or alternative options. Additional common features are the tendencies of the powers that be to seek to commit at an early stage; to pursue “aspiration-based planning techniques” that respond to uncertainty by the clever device of making it up or as it is called ‘adjusting to circumstances’ as the project proceeds. This […]
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