Published: 24/02/2005, Volume II5, No. 5944 Page 9
The Conservatives' trademark managerbashing and 'clean hospitals' rhetoric has ruffled a few feathers. HSJ asked leading figures in health policy and management for their views.
Professor Chris Ham, professor of health policy at Birmingham University and former Department of Health director of strategy
'There is a real contradiction running through the document. The Conservatives say they want to scrap central targets, but there is a lot on national standards. They say they will instruct the National Institute for Clinical Excellence to come up with standards of healthcare for chronic diseases. If That is not centralisation and micro-management then what is?'
Professor John Appleby, King's Fund chief economist
'The problem for the Conservatives is that before they can draw breath with a new policy, Labour have not only thought up their own version but are already starting to implement it. The Tories say: 'Under a Conservative government, funding will follow the patient.' It is already happening; do try and keep up. Labour has won the political battle over the NHS.'
Un-named strategic health authority chief executive
'The abolition of SHAs is the usual cheap shot and the idea of no intermediate tier to keep some barrier between politicians and the NHS will not work.
'The use of the private sector in a spot market with NHS subsidy will simply take NHS staff into it with no contribution to training or other costs. Without a rule limiting NHS staff work in the private sector, this will increase costs back to the old rip-off levels and re-incentivise NHS consultants to have long waiting lists.
'More worryingly, reduction of inspection and the introduction of the private sector makes for a very dangerous combination of small units, short-term management and lack of quality checks.
No other country I can think of would advocate that. These proposals just take old dogma-based solutions and rerun them. They didn't work pre-97 and they wont work just because of a little extra money this time.'
Barbara Kennedy, chief executive, Milton Keynes primary care trust
'The NHS spend on management is still reasonably good compared to other international benchmarks. If costs are reduced I would be concerned about whether we have enough people to manage the service effectively.'
Dr Tom Coffey, chair, New Health Network
'The large contribution to patients who choose to use a private provider not only seems an unnecessary subsidy to people who would go private anyway, but might encourage independent providers to increase their charges.'
Stephen Thornton, chief executive, Health Foundation
'The Conservative Party is right to prioritise safe and clean hospitals.
However, the manifesto's focus on hospital-acquired infection is a narrow one, and it neglects other causes of patient safety problems. Patients may want cleaner hospital wards, but they also more effective care overall.
'The Tories should generate more debate about other aspects of healthcare quality and clarify how they will assure the public that national standards are being met.'
Dr Gill Morgan, chief executive, NHS Confederation
'NHS trusts can be trusted to act responsibly by shutting wards that are affected by hospital-acquired infections.
It is grossly unfair to accuse NHS managers of chasing government targets at the expense of safe patient care.
'However, we strongly support any initiatives to streamline decision-making and increase local accountability.
Foundation trust status is already enabling the pioneers of this new model of management to make a real difference.'