HSJ’s daily roundup of the must read health stories and debate

Chipping away Lansley’s legacy

“Another Lansley reform tossed into the dustbin of history” – that was HSJ editor Alastair McLellan’s reaction to Lord Prior stating that the creation of NHS Improvement represents a “fundamental change” from Monitor’s role as a financial regulator.

The health minister made the claim in an exclusive article for hsj.co.uk, in which he also appears to suggest there is no market in the NHS (another pillar of the Health Act 2012).

In the piece, published on Wednesday, his lordship says welding Monitor and the TDA “is not just about bringing together the two organisations, it’s creating a new organisation with a new purpose: to support providers to improve”.

“This represents a fundamental change from a financial regulator, and I hope providers will see a real difference, and feel that NHS Improvement is here to help.”

A quick history lesson: Monitor was created in 2004 as a regulator of foundation trusts’ governance and finance. Under the Lansley act, it was made the economic regulator for the NHS, with a specific duty to ensure the system was “economic, efficient and effective”, and has continued to closely oversee FTs’ finances.

As things stand there is expected to be no major change to NHS legislation for the creation of NHS Improvement, despite Lord Prior’s suggestion the NHS will no longer have a financial regulator.

While some readers may welcome problems being addressed through improvement rather than regulation, the prospect of losing provider financial oversight in the NHS will surely raise eyebrows at a time of huge deficit and difficulty. How it can be squared with the plan on the table for NHS Improvement to set and monitor individual organisations’ savings targets is also an interesting question.

Some boards are more equal than others

The chair of NHS Improvement has promised to help the HSJ Women Leaders network promote gender equality in the health service, and thinks there should be “really strong targets” to achieve parity at board level.

Ed Smith, who is also equality champion for the NHS, made the pledge at the most recent HSJ Women Leaders event. He said he would like to see 50 per cent of all senior leadership posts in the NHS held by women.

While the NHS was performing better than some corporate industries in terms of gender equality, Mr Smith said it was still “not good enough”. He said a realistic date to achieve a 50/50 gender ratio would need to be set – and the network agreed to set a target for gender representation on boards at its meeting in March. Find out how you can get involved on the HSJ Women Leaders page.

On targets, Mr Smith said NHS Improvement “could set that target as a requirement on the provider side and talk to Simon Stevens about how we might do that across the whole system”.

Counting and publishing the number of women on boards was one of several measures in an action plan to reduce gender inequality launched at the same event.

The 50/50 proposal has proved divisive among HSJ readers commenting on the story. Watch the video of the discussion and have your say at hsj.co.uk.

Tim’s tech funding teaser

NHS England’s outgoing director of patients and information, Tim Kelsey has cited his role in setting up the National Information Board, the leadership committee for IT policy across the Department of Health and its arm’s length bodies, as his proudest achievement of his three year NHS tenure.

So it was interesting to note what he chose to focus on at the NIB’s annual summit on Tuesday, his last official NHS appearance before he departs for Australia.

His “prediction” that NHS organisations should have to commit to making their estate free wi-fi zones if they want a share of £1bn pledged towards tech projects could have been more a case of what he wants to see happen, rather than a genuine stab at fortune telling.

But the motivation behind his insistence that the government had committed “a minimum” of £1bn in NHS technology funding over the rest of the parliament could yet prove the more interesting of Mr Kelsey’s parting comments to the committee he helped create.

As HSJ correspondent James Illman observed on Twitter: “@tkelsey1 tells NIB meeting gov will ‘bravely’ invest ‘at a minimum’ £1bn of capital in NHS technology. Does he know something we don’t?”

Last month’s spending review document said: “New investment of £1bn in technology will support this transformation and integrate patient records across health and social care by 2020.”

It was not prefixed by the words “a minimum”. So, was Mr Kelsey’s comment made in hope rather than expectation, or could the settlement yet deliver a further boost for NHS technology projects?