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George flies a kite

Health minister George Freeman has called for an end to the “apartheid” between the public and private sectors in the funding and provision of health and care services.

The life sciences minister, whose brief spans the health and business departments, also said there needed to be “a debate about how we fund healthcare” in the 21st century, and argued that patients should be allowed to take more “responsibility” for their care.

He said in a speech on Tuesday: “In my party, we have to end the apartheid that suggests the private sector does all the innovation and entrepreneurship and the public sector just treats people… The NHS is the great engine of innovation that can drive that partnership.”

Giving the political sensitivity around any suggestion, justified or erroneous, of the NHS, or any part of it, being privatised, a government minister’s decision to set out such an agenda in such stark language is significant.

It is hard to imagine Jeremy Hunt giving a speech with a central theme of blurring the divisions betwwen public and private sector provision.

As kite flying exercises go, this was impressive, with Mr Freeman also floating the idea that local areas could be allowed to retain a share of savings they deliver to re-invest in services.

Keep an eye on Birmingham

Earlier this week we ran an editorial suggesting that CCGs should be allowed to reconfigure themselves where it made sense to do so.

We have learned that moves are under way in Birmingham to do just that: the three CCGs covering Birmingham and Solihull are considering either a full merger or a major step in that direction.

The CCGs’ governing bodies will be asked to consider adopting a single management team, a federation structure or a “single commissioning function” – an ambiguous phrase that might mean a full merger, but doesn’t necessarily have to.

The intention is to de-fragment NHS commissioning across the Birmingham and Solihull STP footprint.

In turn, this could develop into a broader coalition of health and care commissioners, including NHS England and Birmingham City Council.

Expect the full story soon on

Treading on NICE’s toes

NHS Improvement has been accused of “undermining and dismantling” official safe staffing guidance after HSJ learned it is revisiting work already completed by NICE.

Senior sources close to the work at the regulator have told HSJ it is planning to publish safe staffing guidance for acute inpatient wards and maternity services – despite a pledge by NHS England’s chief nursing officer last year that this would not happen.

HSJ was told the action risks confusing hospitals and undermining the guidance published by the National Institute for Health and Care Excellence following the Mid Staffordshire Foundation Trust public inquiry.

One senior source close to the work said: “The goal is no longer to think about safe staffing but safe and sustainable staffing, in other words only what can be done within budget, as if that is acceptable.”

HSJ has also learned NHS Improvement has established eight committees to draw up new staffing guidance under the title of “safe and sustainable staffing”. The groups have met a handful of times since the start of the year.