Towards a consumer-facing National Health Service
While the NHS is special, going forward, there is an increasingly urgent need for it to be 'untrapped' to achieve a step change in the cost-effectiveness of healthcare. This can be done by carefully and sympathetically applying the best principles of the private sector, to achieve efficiency, effectiveness and genuine value for citizens, taxpayers and patients.
Resolving the flaw in the architecture of NHS foundation trusts
Form follows function? Function follows form? With NHS foundation trusts both propositions are true. Their purpose has a profound influence on what they physically look like and what it is like to work and be treated in them - form follows function. The level of their performance is strongly influenced by their architectural and organizational design - function follows form. Leadership and staff quality are also critical to performance but best results cannot be extracted from an imperfectly designed system.
Two changes to drive value in health
Under the headline "An overdose of health reform?" the Financial Times' leader recently stated "the NHS vision is right, but not the manner or pace of change". I would agree that for the time being "the model for the new NHS is the right one, a universal health service, free at the point of delivery, which allows the market to increase efficiency", and that "the substance of the reforms - choice, competition and diversity - are all welcome". I do not, however, agree with the Government's chosen primary drivers of change in the NHS - getting GPs to manage most of the NHS budget and buy care, and relying on an unchanged foundation trust model as the main provider of care.