Health Service Journal
Richard Vize

NHS medics must face the issue of productivity

15 April 2010
Trusts are taking tentative steps into the landmine riddled territory of their consultants’ productivity.
Alternative providers: a good idea is a good idea, whoever had it

15 April 2010
After three years editing HSJ I am still struck by the NHS’s antediluvian attitudes to the private and voluntary sectors. It does not want this mirror held in front of it.
Hospital closures: the taboo has been broken

15 April 2010
At the first whisper of a service or hospital closing, local campaigners and politicians launch vociferous protests. But despite this opposition the idea that we need fewer hospitals and beds is gathering momentum, writes Richard Vize
Flimsy electoral one-liners must make way for realistic policies

8 April 2010
Now the general election has been called, the NHS can finally start crossing off the days until some honesty returns to the debate about the future of healthcare.
After two decades of wandering, commissioning has a destination

1-Apr-2010
The report on commissioning from the Commons health select committee is both insightful and flawed.
We need to face up to tough choices on social care – fast

1-Apr-2010
The social care white paper unveiled on Tuesday is an important step on the way to getting politicians and voters to face difficult choices.
It may not have been pretty, but Labour gave new life to the NHS

25 March 2010
This week leading commentators give their verdict on Labour’s 13 year stewardship of the NHS.
Steve Bundred is stepping up at a pivotal time

25 March 2010
The appointment of Steve Bundred as chair of Monitor is a shrewd choice.
Preferred provider policy: unions jilted, Burnham jolted, competition wins the day

11 March 2010
Andy Burnham’s “preferred provider” policy is now in its death throes. What began as a speech aimed at ingratiating the health secretary with the unions ended in a put-down from the prime minister.
At last – your chance to write a manifesto

10-Mar-2010
Have you ever felt so frustrated with the political parties’ health policies that you wished you could write your own? Now your chance has come.
Gordon Brown’s knee-jerk reaction to Mid Staffs is doomed to failure

4 March 2010
Gordon Brown wants the power to strike you off.
Dream of taking on ailing trusts founders on rocks of Good Hope

25 February 2010
With just five weeks to go before non-foundation trusts have to outline their plans for joining the elite, there are severe doubts about the government’s aspiration for foundation trusts to rescue weaker hospitals.
Foundation independence is on a knife edge

24-Feb-2010
Foundation trusts are undermining their autonomy through poor governance and accountability.
Burying the NHS mortality row will clear the way for quality push

18 February 2010
The Department of Health is trying to get a grip on the toxic issue of hospital standardised mortality ratios.
Royal Surrey has some explaining to do

18 February 2010
HSJ’s revelation that Royal Surrey County Hospital was the foundation trust selling millions of pounds of drugs on the export market requires some answers from its board.
Regulation must boost NHS managers’ reputation, not voters’ blood lust

28 January 2010
Plans to regulate NHS managers are gathering pace. This creates both risks and opportunities.
Urgent care: confusing jargon – we’ve got your number

28 January 2010
The NHS is constructing its own tower of Babel.
CQC SOS: high stakes mean it is essential registration succeeds

13-Jan-2010
The Care Quality Commission is in difficulty.
Put the brakes on NHS car park consultation

7 January 2010
If ever there was an example of pointless Department of Health micromanagement it is the launch of the consultation paper on car parking.
Tories’ tempered pledges show the effect of political realities

7 January 2010
The Conservatives’ draft manifesto on health offers subtle changes to the party’s health policies.
Review of 2009: a swine of a year for Mid Staffs, Rose Gibb and the public purse

17 December 2009
It had it all: an inspiring comeback at Brent, a bruising scandal at Mid Staffordshire, a constitution, a pandemic, financial collapse, a war of words with some meddling Republicans and rather a lot of departures. Ah, 2009: Richard Vize is missing it already
Irrational optimism is the best prescription for NHS managers

16-Dec-2009
Monitor’s outgoing executive chair Bill Moyes delivered a typically pugnacious valedictory address.
Unions and NHS employers team up to negotiate for a better future

16-Dec-2009
A tough year has ended with news that is no less painful for being inevitable - there are likely to be thousands of job losses in 2010. But despite the implosion of public finances the omens are not all bad.
NHS regulatory turmoil distracts from the real business of care

10 December 2009
Regulation has become politically dangerous territory for health secretary Andy Burnham. Just at the moment when the recent furore over death rates and patient safety has shaken public confidence in the NHS, the two regulators at the centre of the storm are about to be left leaderless.
Populist blame culture stifles openness

10 December 2009
The introduction of mandatory safety breach reporting has superficial voter appeal, but problems lurk beneath.
Unison furious over pay and pension caps

9-Dec-2009
Unison has condemned Alistair Darling’s pay controls as a betrayal of public sector workers.
Successful trusts must not let their stories be overshadowed

3 December 2009
The past week has seen the NHS endure its worst reputational battering since the Mid Staffordshire scandal in March.
Pragmatism versus populism will prove a tough test for the Tories

26 November 2009
Adjudicating on service reconfigurations will prove a tough test for an incoming Tory government.
NHS boards are still not getting the message

26 November 2009
The latest Dr Foster Intelligence analysis of trusts’ mortality rates contains both good and baffling news.
Overspends are another reason to move care away from hospital

19 November 2009
The revelation in HSJ this week of significant overspends in 33 primary care trusts is a worrying indicator of problems ahead.
Don’t apologise for executive pay – but you must explain it

19 November 2009
Managers’ pay is now under continual scrutiny. This week’s contribution comes from consultancy Hay Group, which has given HSJ an analysis of salary data which it says shows there is no link between pay rises and performance for foundation trust chief executives.
HSJ50 2009 - Major Shifts of Power

12-Nov-2009
This year’s HSJ50, the ranking of the 50 most powerful people in NHS management policy and practice in England, again reveals major shifts in who is wielding power.
NHS managers are used to abuse but Mike O’Brien’s attack is a new low

12 November 2009
The government is attempting to gag NHS managers, to hide from the electorate the true scale of cuts about to hit the health service.
Hospitals are blocking stroke care progress, and patients are bearing the cost

5 November 2009
HSJ’s analysis of trusts’ performance on stroke care shows there is a long, long way to go.
FT governance enthusiasm has given way to indifference

5 November 2009
The boards of governors for foundation trusts are ailing. HSJ reveals this week that the turnout for governor elections has halved in five years - it started below 50 per cent - and many are uncontested.
Andy Burnham stands ground after taking fire on competition rules

29 October 2009
Health secretary Andy Burnham has insisted to HSJ that his rewriting of the competition rules will accelerate, not slow, the pace of NHS reform.
Andy Burnham’s flawed NHS regime will stifle commissioning ambitions

29 October 2009
The row over NHS competition policy played out over the pages of this week’s HSJ goes to the heart of Labour’s leadership of the NHS.
Hard cash makes Tory policy a soft target

22 October 2009
As the Conservatives’ policy of handing commissioning cash to GP consortia comes under closer scrutiny, the lack of detailed thinking about how it will work becomes increasingly apparent.
Tariff cap may limit some trusts’ ability to survive the recession

22 October 2009
Concrete evidence of the impact of the collapse of public finances on the health service is beginning to emerge.
GP commissioning is turning in its grave

15 October 2009
Practice based commissioning is dead. Primary care tsar David Colin-Thomé, unable to find signs of life, has written its death certificate.
Stars of the health check ratings must not be eclipsed by failures

15 October 2009
The annual health check reveals a stronger performance by primary care trusts, but provides worrying signs that improvement in acute trusts has stalled.
Andrew Lansley and NHS managers must face hard truths about cuts

8 October 2009
The policies which shadow health secretary Andrew Lansley outlined to this week’s Conservative conference are not the answer to the exam question he will be set - save £20bn.
Can the Conservatives mix cutting and caring?

1 October 2009
Editor Richard Vize discusses whether the health policies of a Conservative government would deliver the right improvements for the NHS long after the applause of the voters has faded away
SHAs face an uncertain destiny as political friends desert them

1 October 2009
Are strategic health authorities staring into the abyss?
Andy Burnham’s ideas may be more about his future

1 October 2009
Health secretary Andy Burnham has come under fire from two of his predecessors in two weeks.
Andy Burnham speech delivers body blow to NHS competition and choice

24 September 2009
The government’s commitment to choice and competition is unravelling.
NHS pay freezes move up management agenda

24 September 2009
The recession is coming for Agenda for Change.
A shot in the arm for GPs as they eye swine flu profits

17 September 2009
Why is the government shovelling yet more money to GPs?
Firing squads won’t solve trusts’ problems

17 September 2009
The naming of 34 trusts as poor performers will strike fear into the managers in charge.
McKinsey report was no fiendish plot, just an attempt to grasp the reality

10 September 2009
Last week’s revelation by HSJ of the pain the NHS might have to endure to achieve savings in the order of £20bn by 2014 dominated the national media.
McKinsey have plotted a course, NHS managers must lead through it

2-Sep-2009
The report by consultancy McKinsey revealed in this week’s HSJ spells out the pain of cuts and change the NHS needs to endure to find £20bn of savings.
High death rates or just more data headaches: it’s no contest

20 August 2009
The health service has taken a brave step on the quality road this week with the publication of the names of trusts over the last two years where unusually high death rates triggered alerts with the regulator.
Too many NHS staff in sickness and in health

20 August 2009
The NHS is doing too little to address the annual loss of 10.3 million working days through sickness.
Community services: get off your bikes

13 August 2009
Community services need to raise their sights if they are to be ready for the funding squeeze.
NHS patient safety hotline may just be a solution looking for a problem

13 August 2009
Is the government in danger of trying too hard on patient safety?
Panicky response to Mid Staffs scandal could erode FT freedoms

6-Aug-2009
The government is threatening the independence of foundation trusts.
NHS workforce: is your senior manager a psychopath?

6-Aug-2009
Are you a psychopath? Warning signs include being manipulative, bullying your staff, spreading rumours about colleagues, believing rules are for others, feeling the end justifies the means and being turned on by risk.
DH must act decisively over bully claim

30 July 2009
The implosion of relations between the leadership of United Lincolnshire Hospitals and NHS East Midlands is damaging the reputation of the NHS.
No time for complacency with the shape of the system at stake

30 July 2009
The disagreement between the National Institute for Health and Clinical Excellence and primary care trusts over guidance on saving money presages a big debate facing the NHS over the balance between central and local power in the recession.
Patients don't care who provides GP services as long as they work

16 July 2009
Why does the public have to endure antiquated GP services?
The tripartite leadership must be debated

16 July 2009
This week the Cabinet Office is finally unveiling its report on the progress the Department of Health has made since an excoriating “capability review” two years ago.
Our mission is clear: to help our readers

9 July 2009
Last weekend the Mail on Sunday ran a full page article claiming an HSJ reporter (Sally Gainsbury) wrote a news story in the magazine as part of a Labour “sting” to undermine Conservative health policy.
Pay freeze is warmer prospect than thousands of job losses

9 July 2009
HSJ’s interviews with a panel of finance directors have begun to flush out where managers are planning to make savings as the financial noose tightens.
Targets’ rebirth as NHS constitution rights will not ensure a cultural shift

2 July 2009
Labour claims it is planning another healthcare revolution.
One year down Darzi’s road the way ahead looks a lot tougher

25 June 2009
A year on from the launch of Lord Darzi’s next stage review, both the progress and the huge distance still to travel are clear.
Don’t hide the truth about Mid Staffordshire: publish or be damned

25 June 2009
Mid Staffordshire foundation trust has shown contempt for its dead patients, the bereaved and local people by refusing to publish the report into the conduct of its former chief executive.
Flu pandemic could kill off a generation of local managers

18 June 2009
The fear in the Department of Health over swine flu is palpable.
Limits on Monitor should not threaten foundation trusts

18 June 2009
The Department of Health is moving to weaken the power of foundation trust regulator Monitor.
Barbara Hakin and Andrew Cash top health honours list

15-Jun-2009
East Midlands strategic health authority chief executive Dr Barbara Hakin has been made a dame in the Queen’s birthday honours.
Mark Britnell quits NHS for private sector

11-Jun-2009
HSJ has learned Mark Britnell, NHS director general for commissioning and system management, is to join consultancy KPMG.
Time is short but the chance to make a difference is real

11 June 2009
New health secretary Andy Burnham’s second stint in the Department of Health is, like the first, defined by financial crisis.
NHS cuts will be chance for staff to be new radicals

4 June 2009
Existing NHS systems will not cope with the financial crisis enveloping the public sector.
Safe, streamlined services give the best – and cheapest – care

28 May 2009
There are signs of rancour in the NHS over how best to address the forthcoming funding squeeze.
Takeover is a test-run for nervous bidders

28 May 2009
The NHS has entered the world of competitive trust takeovers. In the first process of its kind, NHS East of England has invited bids to takeover Bedfordshire and Luton Mental Health and Social Care Partnership trust, after its chair and non-executive directors resigned in February. This act of governance harakiri was prompted by the realisation it was never going to win foundation status.
NHS should not be out of pocket when doctors trouser extra cash

21 May 2009
HSJ’s revelation that the NHS is spending in the region of £2m a year subsidising private patients raises serious questions about how some trusts manage them.
Ben Bradshaw hunts down scandal-hit NHS chiefs

21 May 2009
The Department of Health has scented blood over blocking pay-offs for chief executives quitting in the wake of a scandal.
Rose Gibb case underlines cost of failure for NHS managers

30 April 2009
The judgement against Rose Gibb in her claim for breach of contract reinforces the accountability of senior managers for service failures, and slashes the chances of pay-offs.
NHS boards ignorant of brewing danger and scandal

30 April 2009
If a major problem is brewing in your hospital, don’t bank on the board spotting it before it becomes a scandal.
Foundation trusts running out of time to meet Monitor standards

23 April 2009
The challenges are piling up for trusts yet to clear the hurdle of achieving foundation status
Budget confirms that clinicians must accept responsibility for managing money

23 April 2009
The arid financial landscape for the health service confirmed in yesterday’s Budget means the days of clinicians avoiding responsibility for managing money are over.
Budget 2009: funding squeeze looms in 2011, says David Nicholson

22-Apr-2009
NHS chief executive David Nicholson has not ruled out a cash cut in NHS funding from 2011.
Prospect of serious competition rattles foundation trusts

16 April 2009
As the era of competition starts to take hold in the NHS, foundation trusts are getting jittery.
Care is still a long way from the community

15-Apr-2009
This week’s HSJ revelation of the huge scale of primary care trusts’ overspend on acute care exposes the distance between the desire to move more care into the community and delivering it.
NHS commissioners hold the secret to thriving beyond the recession

9 April 2009
With even the chancellor having to admit his forecast was woefully wide of the mark, the NHS could be forgiven for basing its financial planning on sunny spells rather than torrential rain.
New look hsj.co.uk will give you much more

9 April 2009
HSJ’s website has relaunched. The new service at hsj.co.uk features simpler navigation, a more powerful search engine and vastly more links to related articles.
Time to regulate GPs

3-Apr-2009
Last week I had two conversations which highlighted the need for GPs to be properly regulated.
David Nicholson talks to HSJ about foundation trusts on their fifth anniversary

2 April 2009
As the new financial year begins, NHS chief executive David Nicholson talks to HSJ about the first five years of foundation trusts, the national quality board, and how managers should respond to the gathering financial storm
Foundations are older and wiser, but have they flown the cage yet?

2 April 2009
This week marks five years since the launch of foundation trusts.
Resource centre: a commitment to helping you be the best

2 April 2009
This week HSJ launches a new five page section - Resource Centre - offering managers practical advice for your personal development and to help you do your job even better.
Boldly forth into the blogosphere

31-Mar-2009
As part of the new hsj.co.uk I have decided to stumble into the blogosphere.
Managers must fight to win back the trust of the public

19 March 2009
As well as damaging the reputation of the NHS as a whole, the scandal of Mid Staffordshire foundation trust’s emergency services has piled more opprobrium on the reputation of NHS managers.
Stay of execution will draw out the agony

19 March 2009
Strategic health authorities grappling with trusts that will fail to make foundation status face opposition whichever way they turn.
Is your employer in the Healthcare 100 club?

5-Mar-2009
Do you work for one of the best health employers in the country?
Spectre of more competition haunts NHS

29-Jan-2009
A new beast is unleashed onto the healthcare world tomorrow which could change the landscape on everything from pensions to private practice.
Stop at red: study shows PCTs have a long road ahead of them

29-Jan-2009
Around 18 months after the Department of Health began outlining its vision for world class commissioning, we have the first tangible measure of how well primary care trusts have prepared.
Darzi review: MPs' shallow analysis sheds no light

15-Jan-2009
The Commons health committee has delivered a devastating critique of primary care trusts.
NHS history tells us we've been in this tough spot before

15-Jan-2009
The NHS is reliving its own history. Government papers released to the National Archives reveal that 30 years ago ministers were facing eerily familiar pressures: a recession, plunging support, rising unemployment and demand, the need to improve the NHS with little or no new cash, and a big idea about making the service more patient centred.
NHS Confederation: stop dithering or start shedding members

18-Dec-2008
More than 10 months after Gill Morgan quit as NHS Confederation chief executive, it has failed to appoint a successor.
Taxpayers deserve a say over NHS, but there is a less disruptive way

18-Dec-2008
Disputes at opposite ends of the UK highlight the complexities of introducing democracy into the health service.
HSJ's review of 2008: diamonds, debt and Darzi

18-Dec-2008
The NHS’s diamond anniversary year began with Gordon Brown’s relaunch and ended with the health service paying the price for the banking sector’s profligacy. Richard Vize looks back over an eventful 12 months
NHS surplus robbery risks a return to financial instability

11-Dec-2008
This week the NHS was told part of the price it will have to pay for the collapse of the economy, as it bid a fond farewell to £1bn of its £1.8bn surplus.
Baby P: beware the mob gathering outside your gates

4-Dec-2008
Anyone working in the health service should fear the implications of the public baying for the blood of social workers and health staff in the wake of the death of Baby P.
Drive down NHS costs, raise quality: just a normal day at the office

27-Nov-2008
While Alistair Darling's speech in the Commons on Monday barely mentioned the NHS, the small print of the chancellor's pre-Budget report spells the end of the era of rapid funding growth and big surpluses.
Data tsunami will swamp trusts unless commissioners get a say

20-Nov-2008
The clinical data revolution came closer this week with the unveiling of the approach for improving quality and a survey on what to include in quality accounts.
Why are so many NHS influencers white men?

20-Nov-2008
The HSJ50 - the ranking of the 50 most powerful people in English health management policy and practice, published in last week's magazine - is very male and very white.
Ethnic minority board quotas are off target

6-Nov-2008
HSJ's nationwide survey on the experiences of black and minority ethnic staff in the NHS shows the service has a long way to go to make its worthy platitudes on equality and diversity a reality.
NHS's irrational pay constraints are derailing the drive for quality

6-Nov-2008
There is one aspect of competition the Department of Health has yet to grasp - the competition for management talent.
Hold your nerve - equality is not an expensive indulgence

30-Oct-2008
This week's HSJ special edition on health inequalities looks at the causes, complexities, arguments and options that underpin this most intractable of policy issues.
Annual health check: pedantry gets the better of common sense

23-Oct-2008
The Healthcare Commission is under attack. In the aftermath of the annual health check, its data has been fired on by trusts and the Department of Health.
Constitutional rights in danger of smothering local NHS values

23-Oct-2008
The proposed NHS constitution is drowning in a sea of indifference.
Annual check finds trusts in rude health

16-Oct-2008
Among the talk of recessions, crunches and squeezes, there is some good news - the Healthcare Commission's valedictory annual health check again reveals substantial improvement.
Good times set to end as health pays price for squirrelling cash

16-Oct-2008
The credit crunch is heading your way. While the government has so far rejected the idea of revisiting its health spending plans up to 2011, there are numerous other ways it can get its hands on trust cash.
Calm before the storm as PCTs prepare to flex their muscles

9-Oct-2008
This week's HSJ survey of the extent to which primary care trusts have been decommissioning services represents the calm before the storm of world class commissioning.
Edwina Hart's new system has a whiff of Stalinism

9-Oct-2008
Just as the government’s fingers are finally being prised off the throat of the NHS in England, Welsh health minister Edwina Hart has put her own service in a stranglehold.
Tory blueprint is light on detail as Lansley prepares for power

2-Oct-2008
As the party conference season draws to a close, it is the similarities rather than the contrasts between the two main parties which shine through.
DH faces turmoil over tariff regime

25-Sep-2008
Is there going to be tariff turmoil for the second time in three years?
Time to get facts straight on NHS failure rates

25-Sep-2008
Following HSJ's revelation last week that the Department of Health is projecting 2.1 per cent of trusts will fail each year for the next 20 years, we have been accused of misrepresenting policy.
Lib Dems take a cheap shot at managers

18-Sep-2008
Any public sector manager thinking of voting for the Liberal Democrats at the next election might wish to reconsider after the ill-judged rant by Treasury spokesman Vince Cable at the party conference.
NHS centralism is in the small print

18-Sep-2008
Buried within the 59 pages of brittle-dry prose of an ‘impact assessment’ on the failure regime for foundering trusts are extraordinary assumptions by the Department of Health about how many providers will go to the wall.
No amount of health funding will be an antidote to poverty

11-Sep-2008
As the political parties mobilise for the conference season it is tempting to believe there is broad consensus about the future of the NHS. But three debates that go to its heart are raging.
Pick and mix accounting clouds surplus predictions

11-Sep-2008
The NHS year-end surplus may not be quite as easy to predict as you might think.
HSJ bloggers promise the insider's view

4-Sep-2008
This week this website plunges into the blogosphere. Five readers are charting their highs and lows, frustrations and triumphs working in the health service.
Trusts survey the wreckage as PFI hospitals begin to crumble

4-Sep-2008
Arcane accountancy rules are in danger of costing the NHS control of some of its buildings. As HSJ reveals this week, the Treasury's decision to adopt new international accountancy standards is pushing trusts with ...
Clinical code-breaking jeopardises safety

28-Aug-2008
The Audit Commission's exposure of a high error rate in clinical coding has an impact far beyond payment by results.
Divide and rule: time for the UK to debate its four health systems

28-Aug-2008
Among the oceans of data washing around the NHS, it is striking that government has avoided collecting one of the most illuminating sets of figures - comparisons between England, Scotland, Wales and Northern Ireland.
Beleaguered NICE is powerless to call off postcode lottery

21-Aug-2008
The NHS is caught in a media storm over access to drugs, with NICE at the centre.
Patients have a right to know about mortality rates

21-Aug-2008
The argument in the West Midlands over interpreting mortality rates is just a taste of the rows that will ensue once the Department of Health starts publishing outcomes data.
Carbon emmissions need central steering

14-Aug-2008
When it comes to reducing carbon emissions, it is difficult to conceive of an industry that faces a more complex challenge than the health service.
Young promises new regime will deliver speed and independence

14-Aug-2008
The language used by the chair of the Care Quality Commission in her interview with HSJ was typically clear, robust and ambitious.
Management must do more to ensure the NHS is free of racism

7-Aug-2008
Apart from legal and moral obligations to its own staff, there is an even more powerful reason why the NHS needs to be sure it is free of discrimination.
Venomous rhetoric blocks better services

31-Jul-2008
The row in Cornwall over plans to move a cancer service out of the county encapsulates the struggles primary care trust managers face when trying to improve services.
Workforce strategy should be driven by trusts, not regions

31-Jul-2008
Among the wild cheering that accompanied most of Lord Darzi’s next stage review plans, there was a markedly more muted response to the workforce strategy.
Mental health training shortage hits progress on safety

24-Jul-2008
The Healthcare Commission's investigation into mental health inpatient services paints a troubling picture.
Opening the door to clinical innovation

24-Jul-2008
The medical world is looking to managers and surgeons to unlock the benefits of clinical innovation - and training is again the key.
Healthcare 100: staff's chance to vote for top employers

17-Jul-2008
Health service staff have the chance to rate their employer in a major new set of awards launched this week.
The size of the mountain PCTs must climb is becoming clear

17-Jul-2008
With only a few months to go before primary care trusts have to submit their strategic plans, the scale of the world class commissioning challenge is becoming clear.
Will you be in the Healthcare 100 club?

17-Jul-2008
This week HSJ, with our sister title Nursing Times and NHS Employers, launches the Healthcare 100, which aims to identify the 100 best healthcare employers in the country.
Darzi review will be a success when it causes managers grief

3-Jul-2008
Lord Darzi’s next stage review has been met with a remarkable degree of support. The few critics have failed to shoot any substantial holes in it.
HSJ talks to Gordon Brown and Lord Darzi

3-Jul-2008
While the past 10 years of NHS reform were designed to increase capacity, the next task is to increase quality and personalisation and give more power to clinicians and patients. Gordon Brown and Lord Darzi explain their plans to Richard Vize
Acute's leftovers won't feed public health

26-Jun-2008
At the NHS Confederation conference, Nuffield Trust director Jennifer Dixon offered the heretical view that the policy of tilting NHS spending towards public health is a mistake.
Door slams shut on targets and opens on a world of outcomes

26-Jun-2008
In the corridors of health policy there is now an unseemly rush to be the first through the door marked 'outcomes'.
BMA campaign trades on fear and ignorance

19-Jun-2008
One has to admire the British Medical Association. Getting people to campaign against health service closures is easy, but it takes a particular talent to get the public to campaign against service openings.
Updating top-up rules need not be a dagger to the heart of NHS

19-Jun-2008
Just days before its 60th birthday the NHS is being forced to re-evaluate its founding principle - that treatment is based on clinical need not the ability to pay.
Ambitious plan will require innovation

12-Jun-2008
The evaluation by the Audit Commission and the Healthcare Commission of the progress of NHS reforms is a wake-up call for foundation trust managers.
Sacking managers may attract headlines but won't fix problems

12-Jun-2008
After 11 years of public service reform, the government's record is still dogged by poor performance. The failure regime unveiled last week shows ministers are running out of patience.
DH must step in to protect the vulnerable

5-Jun-2008
The government needs to rethink its plan to exclude sectioned mental health patients from the protection of the Corporate Manslaughter Act for up to five years.
Monitor survey shows distance still to travel on FT governance

5-Jun-2008
A survey of foundation trust governors by regulator Monitor reveals the distance still to travel to develop effective governance.
Drugs' benefits go further than the patient

29-May-2008
The vertiginous rise in mental health costs predicted in a King's Fund report this week should trigger debate about which drugs are approved for use.
Vulnerable people's fate must not fall to faceless bureaucracy

29-May-2008
Health secretary Alan Johnson has called for a 'national debate' on how we will meet the needs and costs of an ageing population.
King's puts smart money on private sector

22-May-2008
The decision of King's College Hospital foundation trust to appoint corporate big-hitter Tim Smart to its top job will provide a fascinating trial for private sector management techniques at the highest levels of the NHS.
Safety demands leaders at the top and power at the bottom

22-May-2008
This week's HSJ survey on patient safety exposes a substantial perception gap between chief executives and senior managers.
Darzi review: SHAs must not take over role of centraliser

15-May-2008
The wraps are finally coming off - region by region, details are emerging of what the review spearheaded by Lord Darzi will mean for patients and the balance of power in the NHS.
Post-operative care: help patients on the road to recovery

15-May-2008
The Healthcare Commission's survey of inpatients' experiences, published today, reveals a need for more management focus on the part of the hospital journey that is often neglected - what happens after the operation.
Darzi review kicks central control out of the frame

8-May-2008
Tomorrow junior health minister Lord Darzi releases another part of his next stage review. It demonstrates some deft political footwork.
Independent sector sceptics must be won over

8-May-2008
This week's interview with Channing Wheeler, commercial director general at the Department of Health, highlights the complexity of the relationship between the NHS and the independent sector.
BMA staff survey: excoriating verdict on out-of-touch union

1-May-2008
It is not just the government that finds the British Medical Association out of touch and stuck in its ways.
PCTs that venture into NICE's territory face dangers

1-May-2008
The move by public health directors to play a lead role in advising on new treatments puts primary care trusts squarely on territory that was previously dominated by NICE.
Fines could turn access screw - if they do not scare off GPs

17-Apr-2008
The plans being discussed by junior health minister Lord Darzi to effectively fine GPs when patients inappropriately use walk-in centres, accident and emergency departments and minor injury units, illuminate some ...
Introducing Board Talk, the new voice for non-execs

17-Apr-2008
Today HSJ is launching Board Talk, a free service on hsj.co.uk for trust non-executive directors.
HSJ Awards: give your team something to celebrate

10-Apr-2008
This week we launch the health service's annual celebration of excellence - the HSJ Awards.
If it is this bad for staff, it is no wonder that patients complain

10-Apr-2008
The annual Healthcare Commission staff survey has revealed a communication chasm between senior managers and staff.
PCTs must take action to tackle quality framework disparities

3-Apr-2008
The data HSJ reveals today on the patients GPs exempt under the quality and outcomes framework raises questions about whether the system is being abused.
Care Quality Commission: open your wallet and pay for real talent

20-Mar-2008
For a department renowned for its largesse when it comes to remuneration, it is difficult to understand why the Department of Health is being so parsimonious when it comes to the salary for the chair ...
Darzi's national blueprint must leave room for local innovation

20-Mar-2008
The King's Fund's response to the consultation on reforming London's healthcare following Lord Darzi's landmark report is a scene-setter for the debate that will follow the publication of his national strategy ...
PCT rebrand will help end identity crisis

13-Mar-2008
Public sector rebranding exercises are often seen as a costly and pointless distraction. But the proposal to rebrand primary care trusts - so Oldham PCT would become NHS Oldham, for example - makes a great deal of sense ...
Use it or lose it: freedom from Whitehall is a two-way street

13-Mar-2008
At last week's Primary Care Trust Network conference, the discussion with NHS chief executive David Nicholson revealed how hard it is for the centre to let go - especially when local health services won't ...
NHS pyramid scheme remains unchanged

6-Mar-2008
This week's report by HSJ shows that progress on driving up the lamentable levels of black and minority ethnic representation in NHS management ranks has stalled.
Premises buy-back is yet more ammo for anti-private brigade

6-Mar-2008
Our revelation this week that the government made deals with the providers of the independent sector treatment centres to buy back their premises is another blow to a controversial policy. According to a document unearthed in ...
Is government taking liberties with the foundation principle?

21-Feb-2008
The argument between the foundation trust lobby and the Department of Health over foundations’ freedoms goes to the heart of the debate about the role of politics in health policy.
Find the funds to keep violence in check

14-Feb-2008
Uniquely among the main care disciplines, mental health services routinely have to manage a triangle of potentially violent relationships: patients attacking staff, patients attacking each other and - when it comes to restraining aggression - staff using force on patients.
The BMA is standing between patients and a better service

14-Feb-2008
Not content with grossly misrepresenting the government's position on opening hours, the British Medical Association has now resorted to sabotage to block modernisation of our primary care services.
Help us identify the NHS's biggest figures

7-Feb-2008
In the first week of July, when the NHS will celebrate its diamond jubilee, HSJ will be publishing the names of the 60 most influential figures in the service's history, and we would like your help in drawing up the roll of honour.
NHS 60: help mark the birth of an institution

10-Jan-2008
This week HSJ launches six months of coverage marking the 60th anniversary of the founding of the NHS on 5 July 1948.
Preventive care rhetoric could become reality

10-Jan-2008
Gordon Brown's keynote health speech was not just a crucial moment in the bid to relaunch his premiership (for more details, click here). As the NHS heads towards its 60th anniversary, his government's ability to deliver ...
HSJ review of the year: jobless doctors, lethal bugs and a £1.8bn pile of unspent cash

20-Dec-2007
A year with more than its fair share of drama saw medics on the streets, C difficile in the wards, Blair and Hewitt on the way out - and an embarrassing surplus in the bank. By Richard Vize
Operating framework's localist spin unravels

20-Dec-2007
Will NHS chief executive David Nicholson be eating words as well as turkey this Christmas?
The curious incident of the missing £870m

20-Dec-2007
The fine print of the coming year's funding settlement indicates that, in contrast to NHS chief executive David Nicholson's protestations, the Department of Health will indeed have a significant sum - up to £870m - locked away in its Richmond House safe next year (for more background,
Private sector sceptics take on foundation freedom-fighters

13-Dec-2007
The deal the government carved out with Labour backbenchers to get the foundation trust legislation through Parliament has precipitated a battle between the trusts and Unison over the limits of their freedoms (for more background, click ...
Sir Liam's patient safety spotlight shines on PCTs

13-Dec-2007
Chief medical officer Sir Liam Donaldson is pushing primary care trusts to put his crusade on patient safety at the centre of their work (for more details, click here).
Don't lose sight of the threat of HIV/AIDS

6-Dec-2007
Last week the Terrence Higgins Trust marked its 25th anniversary with a Downing Street reception. Gordon Brown used the occasion to become the first prime minister in 15 years to talk about the severity of HIV rates in Britain.
Some great work, but PCTs are still a long way off 'world class'

6-Dec-2007
The Healthcare Commission's State of Healthcare report, published on Tuesday, reveals much to celebrate (for more background, click here).
Management training push for doctors

29-Nov-2007
The momentum for management training for doctors has received a further boost this week with moves by the King's Fund to establish an MBA for doctors (for more details, click here).
What is behind the NHS surplus?

29-Nov-2007
Last week’s revelation by HSJ that the NHS is heading for a 1.8bn underspend raises the spectre of renewed financial turbulence.
Minority report: shameful race record harms staff and patients

22-Nov-2007
A Healthcare Commission survey has revealed scandalously poor compliance with race equality legislation (for more on the survey, click here).
Patients are driven to distraction by parking fees

22-Nov-2007
Are hospital car park charges becoming a tax on patients and carers?
Give heart and soul for organ donation

15-Nov-2007
With managers relentlessly focused on keeping patients alive, they could be forgiven for taking their eye off the ball once someone is dead. But, as so often, there is still one more thing to do.
Local blueprint for primary care revolution kickstarts GP reform

15-Nov-2007
Heart of Birmingham primary care trust has placed itself in the vanguard of the drive to modernise primary care.
Chief executive pay-offs raise doubts about local control

8-Nov-2007
Don't be taken in by ministerial hot air on their belief in local decision-making. The latest move after the Clostridium difficile deaths at Maidstone and Tunbridge Wells trust demonstrates that soundbites, press releases and the irresistible urge to be seen to be doing something still take precedence over sensible government.
Payment by results: top-up scheme clears the way for back-door reconfiguration

8-Nov-2007
The changes to the tariff for specialist services revealed in this week's HSJ risk inflaming public opinion just as Lord Darzi's review is supposed to be restoring confidence in how reconfigurations are managed.
GP access dispute reveals holes in Darzi's rushed report

1-Nov-2007
Does the Department of Health know what it is doing on GP access?
Overseas workers are getting a raw deal

1-Nov-2007
The Local Government Association's report on the impact of migration presents a powerful case for more funding of public services in areas experiencing the sharpest increases in demand.
Health check: does the NHS want for good management?

18-Oct-2007
It is the struggle to shift the trusts hanging around near the centre of the annual health check which is most perplexing the Healthcare Commission.
Health check: Foundations lead the pack but PCTs still fighting in the rear

18-Oct-2007
The wealth of data unveiled today by the Healthcare Commission in its annual trust health check reveals foundation trusts are thriving, primary care trusts are struggling, and the best are leaving the rest behind.
Darzi report message is clear: reform faster

11-Oct-2007
Lord Darzi's interim report for his review of the NHS clears the way for private sector providers to break the logjam over GP access.
Infection control: we are here for the patients, not targets

11-Oct-2007
The Healthcare Commission's damning investigation into outbreaks of Clostridium difficile at Maidstone and Tunbridge Wells trust drives home the message of its report last week on the lack of engagement of some acute trust boards with what is happening on their wards.
Hygiene: staff won't follow where they are not led

4-Oct-2007
After the years of media scrutiny, policy statements, regulations, inspections and public outcry - not to mention the avoidable deaths and illnesses - it is hard to comprehend why many acute trust boards are failing to make hygiene standards a priority.
Tories struggle to make their own room in the centre ground

4-Oct-2007
This week in Blackpool the Conservative Party conference promised to scrap top-down targets - and end the postcode lottery.
Department should explain itself on race

27-Sep-2007
The new health secretary is passionate about tackling health inequalities. With race a central factor, he will be appalled at the catalogue of race equality failures at the Department of Health that the Commission for Racial Equality claims to have unearthed.
Labour conference: localist messages do not cover a nasty whiff of central control

27-Sep-2007
The speeches at Labour's annual conference mapping out the principles for Gordon Brown's stewardship of the NHS highlighted the tensions with which the new ministerial team is grappling.
Old-style GPs may go the same way as Britain's motor industry

20-Sep-2007
‘Dr Buckman is in danger of doing for primary care what Derek ‘Red Robbo’ Robinson did for the British motor industry in the 1970s’
Time to come clean on the private sector

20-Sep-2007
‘The role of independent providers under Gordon Brown is one of the most opaque areas of health policy’
Herts bags early winner with stadium bid

20-Sep-2007
As the football season cranks into action, Watford have scored an early goal in a PFI partnership with West Hertfordshire Hospitals trust.
High Court drugs ruling marks latest skirmish in war of words

20-Sep-2007
The High Court ruling upholding the National Institute for Health and Clinical Excellence's decision over medication for Alzheimer's is just the latest skirmish in what promises to be protracted manoeuvring over drug use and pricing.
Medic's freedoms will reveal commitment to NHS autonomy

20-Sep-2007
'The arrival of another world-class surgeon at Richmond House is a significant coup for NHS chief executive David Nicholson'
Patient involvement can help siphon control from the centre

13-Sep-2007
The government has raised the question of the health service's democratic deficit.
Your chance to tell us who has the power

13-Sep-2007
In a few weeks, HSJ, recruitment consultancy Harvey Nash and management consultants Ernst & Young will be collaborating with a panel of experts to decide the HSJ50 for 2007 - the definitive list of the 50 most influential people in healthcare.
Bring community medics in from the cold

6-Sep-2007
'The culture shock of moving from the intensity of a hospital to community work is profound'
Bring community medics in from the cold

6-Sep-2007
'The culture shock of moving from the intensity of a hospital to community work is profound'
SHA shrinkage drives questions on the future of a regional role

6-Sep-2007
'The greatest concern is that SHA shrinkage is outstripping the growth in capacity and expertise among PCTs'
SHA shrinkage drives questions on the future of a regional role

6-Sep-2007
'The greatest concern is that SHA shrinkage is outstripping the growth in capacity and expertise among PCTs'
Misleading forecasts could spell disaster

31-Aug-2007
'Chief executives and others must encourage openness and transparency in financial reporting'
Timely action will save lives and restore public confidence

31-Aug-2007
'Media coverage of mental health killings obliterates shades of grey'
GPs' fading popularity could hurt Tories

23-Aug-2007
'Not so long ago, local family doctors were running a close third to apple pie and motherhood in the list of safe things for politicians to support'
Herts bags early winner with stadium bid

16-Aug-2007
As the football season cranks into action, Watford have scored an early goal in a PFI partnership with West Hertfordshire Hospitals trust.
High Court drugs ruling marks latest skirmish in war of words

16-Aug-2007
The High Court ruling upholding the National Institute for Health and Clinical Excellence's decision over medication for Alzheimer's is just the latest skirmish in what promises to be protracted manoeuvring over drug use and pricing.
Herts bags early winner with stadium bid

15-Aug-2007
As the football season cranks into action, Watford have scored an early goal in a PFI partnership with West Hertfordshire Hospitals trust.
Darzi takes the blows as review develops

9-Aug-2007
'Darzi says his rapid consultations around the country, as he prepares his interim report for October's comprehensive spending review, demonstrate widespread support for the current direction of reform'
Established GPs prepare to feel the heat of big business

9-Aug-2007
'Running a practice may not be a huge money-spinner for commercial firms, but the rewards from a greater role in commissioning could be considerable'
Target-driven department is off the mark

2-Aug-2007
'Reforming the DoH to make it an effective and respected department is an important step on the road to rebuilding NHS confidence in the government'
The public needs reassurance that it is in the safest hands

2-Aug-2007
'Such big jumps need analysis. Are employers becoming more lax in their approach? Or is it just a statistical anomaly?'
Fewer targets means more accountability

26-Jul-2007
'The reduction in targets does not mean data collection will be weakened. For example, health inequalities cannot be monitored without understanding smoking cessation, obesity and infant mortality'
Ministers must win battle on provision to fulfil early promise

26-Jul-2007
'While other parts of the public sector have learned to work with a mixed economy, the NHS still flinches at the idea of private involvement'
It's a question of trust: will the new ministers devolve power?

19-Jul-2007
'Central control is a far more natural response from Brown than trusting local freedom and competition'
Ringfencing is only a short-term cash fix

19-Jul-2007
'Local flexibility is a principle that needs defending. Ringfencing is only convenient so long as the political wind is blowing in your direction'
Darzi's review shows who has the power in the new top team

12-Jul-2007
'Most ministers can be brought to heel by threat of the sack, but not one with a global reputation well beyond politics'
London review: everyday problems at heart of proposals

12-Jul-2007
'Darzi argues that his approach to this study - listening to Londoners, building a clinical consensus, providing evidence for the recommendations, working with the mayor and London boroughs - provides the foundations for success'
Johnson leads Brown's charm team as ministers start to listen

5-Jul-2007
'Sir Ara keeping one foot in the operating theatre should encourage clinicians to have confidence that their views are listened to'
Frank message in Whitehall report card: must try harder

28-Jun-2007
'That three people signed off the DoH's response to a report highlighting poor leadership has caused much merriment in Whitehall'
Nicholson: let local managers drive health service reforms

28-Jun-2007
The NHS chief executive's advice to any incoming health secretary is to steer clear of further structural upheaval and allow managers to drive reform locally.
BMA must engage, not take cheap shots

21-Jun-2007
'Shouting from the sidelines will secure more newspaper column inches than engagement, but it will achieve less'
NHS Confederation rolling news: SNP stance on reconfiguration condemned

21-Jun-2007
One of the architects of the modernisation of Scotland's health service has attacked the Scottish National Party's opposition to reconfiguring services.
Report points to NHS culture of bullying and bureaucracy

21-Jun-2007
'Middle managers need more support to survive in the treacherous terrain between their bosses and clinicians'
Bill exposes flaws in plans for greater patient involvement

14-Jun-2007
'One of the strengths of the local involvement networks was supposed to be that, rather than examining the services in a particular institution, they could range across a whole area to gain a rounded view of all aspects of services users' experiences'
Independent treatment centre move redefines choice

14-Jun-2007
'The DoH appears to be considering pushing PCTs to use independent sector treatment centres.- even to the extent of trying to steer patient choice'
Ofcare: 'Ambitions and metrics' mark launch of a new regulatory era

7-Jun-2007
'Ofcare's performance framework commences with mea culpa, admitting what healthcare professionals have been telling the Department of Health for years - top-down targets undermine innovation, motivation and accountability to communities'
Deficit crisis: ground won for training must be held in face of cash battles

31-May-2007
'The government's service-level agreement - a response to criticism of the 10 per cent cut in training by SHAs last year - looks to be a dead letter within days of being published'
Partnership working needs financial conviction

31-May-2007
'Anxious to move on from rows over cost-shunting, the Association of Directors of Adult Social Services has pledged to champion partnership working, pooled budgets and joint commissioning'
Back innovation and good judgement in primary care

17-May-2007
Primary care trusts.are bound to weigh proposals fairly, but they cannot be compelled by entrepreneurs to make reckless decisions.
Commissioning: Practices may need a fairy godmother to make PBC work

17-May-2007
Practice-based commissioning is the 'Cinderella' policy reform of the NHS.

Alastair McLellan

Health Service JournalRichard Vize

Health Service Journal
Richard Vize