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Author Archives: Karin Smyth

The antecedents of the NHS are to be found in Tredegar and in the Beveridge report, which preceded it. Disease was one of Beveridge’s five great evils. Infectious diseases such as polio, diphtheria and tuberculosis caused people to die in their early and mid-50s on average. The need for a sufficient and healthy labour force to rebuild the economy necessitated combating those diseases, which also caused a high rate of infant mortality. The need for a better, longer-living workforce drove much of what Beveridge looked at. There was in fact a good deal of state funding provision before 1948 to […]
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The Department of Health (DH) is to create a new property company to replace the two that currently exist1 nearly four years after the intention was first announced. The move is understood to be one of the recommendations of Sir Robert Naylor’s forthcoming report on the NHS estate. The current position came into being as an afterthought to the now much derided Health and Social Care Act 2012 “reforms”, with a new DH owned company, Propco, solving the problem of who took over billions of pounds of property (such as primary care centres, clinics, community hospitals and offices) after Primary […]
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With Sustainability and Transformation Plans (STPs) aimed at delivering multi-billion savings, being carried out secretly in 44 areas nationwide, this is a seminal moment for the NHS. Leaders need to engage the public in addressing the country’s health and social care crisis; come clean about what STPs can realistically deliver; and acknowledge that in some areas STPs could actually be asking the wrong questions. Nine months ago NHS England announced that every health and social care system would produce a STP, the first drafts of which have now been submitted to NHS England. On one of August’s quieter news days […]
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Jeremy Hunt had one job since his appointment as the Secretary of State for Health – to make sure the NHS was not an election issue.  He almost succeeded. Despite the Tories recognition that the 2012 Act was their biggest mistake it is only in the last year that the chaos, fragmentation and lack of accountability has really impacted on the frontline – on the availability and waiting times for  patient services. It is clear that the NHS will only just survive this coalition government. It needs rebuilding. Labour’s Shadow Health Team has worked doggedly to learn lessons from our […]
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The NHS has finally made the front pages and will now undoubtedly be a key part of the election debate.  Despite the Tories best efforts to keep the NHS out of the news the pressure from increasing demand, reduced supply, cuts in training and workforce, cuts to local authorities and of course the devastation of the Health and Social Care Act has resulted, as widely predicted, in another NHS ‘crisis’. Pressure on A&E is indicative of wider pressures on GPs, community services, the voluntary sector and social care. A&E should be just that – for accidents and emergencies.  Such departments […]
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The recent Festival of Ideas on Health at Bristol’s Watershed gave an opportunity to consider potential sources of change in the health and care system.  Given that much of the political debate about the NHS involves more platitudes than facts or first hand experience it was a good debate and I was glad to be able to take part.  What follows are my thoughts as presented on Saturday. Our discussion needs placing in the context of the first 60 years of the NHS and the failure of both state planning and the market to achieve the change we need. My […]
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