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Let's be clear about this. Mark Britnell does raise some interesting points, but his argument is a bit like decorations on a Christmas tree; look pretty but don't really hang together. Couple of examples:
- endlessly banging on about productivity is meaningless unless its given a proper menaning and context. Do we want more activity or do we want a different type of activity (with maybe less throughput) ? This is one in a whole load of comments in which he's flung the P word around without any real context and it's a far too one-dimensional approach to the challenges wer're facing
- Britnell acknowledges the importance of long term conditions (and I agree), but this is reall an argument for difficult descisions and service-reshaping, not modes of funding. Try and match the answer to the question
- his quote on 'equivalent services' shows also that he's missing this trick
- mark Britnell may have been an NHS manager (and from what I hear, a pretty darn good one). But let's not pretend he's representative or symptomatic of what NHS managers currently think. He's not - he's working in the private healthcare sector and if I was doing his job, that's the audience I would be plyaing to and that's what his article reads like. Nothing wrong with that, but no one voice speaks for all of managers
- he's right to question the reforms; it could be argued they aim to tackle a current acute elective agenda, but fail to think coherently about long term conditions and the need for service change. Unfortunately, I feel that Mark's solution tends to do the same.