The must read stories and debate in health policy

Wrong questions and no answers from Hunt

Health secretary Jeremy Hunt had little to offer delegates at the NHS Confederation conference on Thursday in terms of new policy or interventions to help the service tackle its burgeoning problems.

Instead Mr Hunt, constrained by purdah and the EU referendum debate, rehearsed many of his arguments for improving safety and quality and highlighted the need to tackle variation across the country.

He told managers he was aware people were worried about the deficits in their own organisations, saying: “The question some people ask is if resources are tight should I focus on quality and safety, should I focus on access targets or should I focus on tackling my deficits?”

But, in an answer which some delegates afterwards told HSJ was perilously close to insulting managers, Mr Hunt said: “That is precisely the wrong question. It is the job of health service managers to deliver high quality, safe care, that people don’t have to wait too long for, that is within the budgets we have.”

He said there was risk when politicians asked managers to focus on one area at the expense of others, citing care scandals such as Mid Staffs – “Patient care and good finances are two sides of the same coin.”

Mr Hunt offered delegates no new measures to help them achieve this, but hinted at plans for “three year budgets for healthcare providers”, which could be brought in later this year.

Linked to finances, the health secretary said the Department of Health estimated there could be £1bn of savings a year if trusts moved to the average cost for healthcare products, telling delegates he wanted “elimination of variation.”

On the EU referendum debate the health secretary, who is campaigning to remain, said: “Any suggestion the NHS would receive a dividend from leaving the EU is utterly bogus.” He warned of a “brexit hangover” for the NHS with damage to the economy meaning potential cuts to NHS spending.

Talk among conference delegates is that the DH is saving its big announcements for tackling the financial challenge in the NHS until after the vote.

For those wondering about Mr Hunt’s future, he made a pitch to keep his job: warning about the alternative if the NHS had a health secretary not prepared to take a stand on important issues.

He told the conference he wanted to do the job “for a very long long time”.

NHS knight shares his knowledge

Sir Leonard Fenwick is the longest serving chief executive in the NHS. He has led Newcastle Upon Tyne Hospitals Foundation Trust and its predecessor organisations for 38 years, and has worked in the health service for over half a century.

In that time he’s seen a lot of structures come and go (he talks with nostalgia about his role keeping hospitals running during the 1979 winter of discontent), so it’s significant that he remains to be convinced about hospital chains.

Sir Leonard thinks they could work, if the “geography, the history, culture” are right.

But as the chief executive of a large tertiary hospital, he said he would think twice about taking on accountability for other hospitals “on a day to day, week by week, bump and grind basis”. He said managing a hospital chain could result in him taking his “eye off the ball” at Newcastle.

Sir Leonard was speaking to HSJ after his trust became the fifth in the country to be rated outstanding by the CQC.

He attributed Newcastle’s success to a “tremendous workforce” and the management’s “good relationship with staff side” (a theme which comes up again and again when talking to the leaders of outstanding trusts).

He said Newcastle had a good relationship with neighbouring organisations, though it seems there is little love lost between the trust and Northumbria Healthcare, which is just down the road and also rated outstanding.

Newcastle lost to Northumbria in its bid to run troubled North Cumbria University Hospitals Trust – a decision which Sir Leonard said had resulted in “many years of lost opportunity”.