The must-read stories and debate in health policy and leadership.

Capital conversations

While MPs and the media worked themselves up into a frenzy about the latest Brexit vote yesterday in the Commons, Daily Insight’s eyes were fixed on events in another part of the Palace of Westminster.

Over in Committee Room 8 a rather sparse Commons health and social care committee took evidence on NHS capital from Simon Stevens and Matt Hancock, as well as a smattering of health policy experts.

The session’s most eyebrow-raising comment came from Mr Stevens, who admitted the recent capital process for the NHS effectively amounted to “implicit rationing”. He is spot on, though Daily Insight feels it would have had more impact had he acknowledged that publicly a few years ago.

Mr Stevens stressed the need to take “delays” out of the capital process, and he appeared confident the measures outlined in the Health Infrastructure Plan would assist with this.

He also agreed with comments by NHS Providers chief Chris Hopson that an asset transfer scheme between NHS Property Services and trusts needed some fine-tuning, though Mr Hancock subsequently argued trusts weren’t submitting enough business cases.

Mr Hancock – after a brief argument with committee chair Sarah Wollaston over the newness of the £1.8bn of capital announced in summer – went on to hint further about well-performing foundation trusts losing the ability to spend the capital they want.

He criticised the current system which – he said – meant his department is forced to clamp down on capital spending by non-FTs to offset the amounts spent by FTs over which his team has little control.

How many warning signs are needed for a commissioner to properly scrutinise a service? So asks Rebecca Thomas in this week’s Mental Health Matters column.

She writes: ”Yesterday HSJ reported how repeated concerns over the safety of children’s autism services across South Staffordshire, over several years, were given “minimal” attention due to the small size of the contract.

“While minimal attention would have been justifiable if the service was performing well, local leaders had been sent serious complaints by families since at least 2013 — essentially saying children in crisis were not getting specialist help and were repeatedly passed between different services.”

On the wider national picture: ”This month has seen a big spotlight shone on children’s inpatient mental health services, with the launch of a new independent taskforce by NHS England.

”It appears to have been set up in response to increasing reports of poor quality inpatient CAMHS services. However, problems such as those experienced in Staffordshire are rooted within community services.

“We don’t yet know what the new taskforce will look into, but it would be a missed opportunity if children’s autism and learning disability services within the community were not also scrutinised.

“Another suggestion for the new taskforce? To scrutinise the role of commissioners, both in terms of how they monitor services and the quality of what is commissioned in the first place.”