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    The notion that localism can be compatible with a National Health Service is, on the face of it, absurd. By definition, localism must mean a postcode service, or what is the point of it? The real questions, therefore, are firstly whether it matters and secondly, whether it can lead to improved services for patients. I would strongly argue that with the right safeguards, localism is not only beneficial, but essential under this criteria. That being said, how can I, a GP, former Labour MP, and a passionate believer in the NHS, make this case with any credibility? I currently Chair […]
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    From its very beginnings, there has always been an ambiguity about the precise relationship between centre and periphery in the National Health Service. Even Aneurin Bevan, its founder, spoke with a forked tongue.  On the one hand, there was the Bevan who insisted that his aim of “universalising the best” required planning on “a broad national scale”. The logic of both equity and parliamentary accountability for public money led to the much quoted bedpan doctrine: “When a bedpan is dropped in a hospital, I want the noise to reverberate through the corridors of Westminster”. Yet there was another Bevan, the […]
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    Health inequalities are one of the most pernicious and tenacious challenges that any government, and wider society, has to address. And judged by the coalition government’s own commitment “to increase the health of the poorest, fastest”, there are good reasons to be critical of its track record on health inequalities. Various institutional tweaks and changes have led to a plethora of disconnected strategies in the approach to health inequalities. New central bodies such as NHS England and Public Health England have been created, while the Department of Health has seemingly lost its strong oversight function and the public health subcommittee […]
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    To succeed over the next 10 years,the National Health Service must also be a local health service. A public service dedicated to the health and wellbeing of every person in England cannot be run as a bureaucratic offshoot of Whitehall. Instead, success will depend on power and trust cascading downwards to local areas, NHS institutions, teams of professionals and to citizens. Autonomy matters because good services adapt, innovate and set their own direction, rather than just implementing instructions from elsewhere: achieving excellence is an intrinsic, internal process of learning and experimentation. And autonomy enables institutions and individuals to collaborate in […]
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