HSJ’s roundup of Tuesday essential stories and talking points

Where the axe should fall

With the Department of Health facing a 20 per cent budget cut following last week’s spending review, it is clear that bold action is going to be required.

In a leader column on Tuesday, HSJ editor Alastair McLellan argues it therefore “makes perfect sense for one minister to join the hundreds of DH staff who will soon be made redundant”.

The DH currently has five and a half ministers (George Freeman is shared with the Department for Business, Innovation and Skills), with five making it into this year’s HSJ100. But, as the editor says, they all “generate both effort and cost as they go about their work”.

It’s a good opportunity, then, for the government to lead by example on efficiency, recognising that moving to a smaller department, shifting responsibility to NHS England, and local devolution will require fewer national level political leaders.

“Reorganising the department with one less minister would be a proportionate and appropriate reaction to both its financial challenge and a desire to give the service greater local autonomy,” is Mr McLellan’s suggestion.

Our call is not about naming individuals or a comment on the ministerial team’s abilities. Of course, it’s not hard to guess who junior doctors would like to get the chop, even if Tuesday ended up without a strike.

Get the de-icer out

The urgent and emergency care system could “fly blind” this winter because NHS England will not publish weekly data on important performance areas such as cancelled operations, delayed transfers of care and patients waiting over four hours to be seen in an A&E department. That’s the warning from the president of the College of Emergency Medicine, Clifford Mann.

The number of ambulances queuing outside an A&E will not be published at all, whereas delayed transfers, cancelled operations and four hour waits will only be published monthly and with a six week lag.

Dr Mann said the delay in publishing data would mean trusts could not compare how they were performing against others and said it was akin to a doctor taking a patient’s temperature but only revealing the result six weeks later. 

In a turn of phrase suitable for chilly winter mornings, Dr Mann added: “It seems as though somebody has decided to glaze over the windscreen.”

A spokesman for NHS England said the published data had been scaled back because it was “seeking to minimise the bureaucratic burden on frontline hospitals and GPs”.