HSJ’s roundup of Tuesday’s must read stories and comment

A tale of two speeches

Jeremy Hunt’s speech at the Conservative Party conference on Tuesday afternoon offered little news for health policy fans, with the health secretary instead presenting a greatest hits medley (“party of the NHS”, “transparency and openness” and “Mid Staffs” were all there).

Some wags noted that – much like Ed Miliband at last year’s Labour conference – Mr Hunt had neglected to mention the deficit. Perhaps he hadn’t seen HSJ’s research, which on Monday showed NHS providers continuing to forecast a deficit in excess of £2bn for 2015-16.

About an hour before Mr Hunt took the stage, Simon Stevens started his own speech in London, in which he challenged the government to reconsider its immigration policy.

His comments were politically fiery, coming just hours after the home secretary Theresa May told the Tory conference that mass immigration made it “impossible to build a cohesive society” – a line backed by the prime minister.

Mr Stevens riffed: “My responsibility is to point out that at a time when the need for nurses is growing, when publicly funded UK nurse training places will take several years to expand, and when agency staff costs are driving hospital overspends right now, we need to better join up the dots on immigration policy and the NHS.

“Most nurses I speak to struggle to understand why our immigration rules define ballet dancers as a shortage occupation, but not nursing.”

As a result, from April 2016 non-EU nurses earning less than £35,000 a year who have been in the UK for six years will have to leave the country.

This, the NHS England chief said, “clearly needs a rethink”.

Trusts at full stretch

Meanwhile, the drum of impending financial doom keeps banging.

When we requested that regulators release the financial “stretch targets” issued to NHS trusts in August, they said they didn’t want to.

Following a couple of ignored Freedom of Information requests, we went directly to trusts instead.

HSJ’s analysis of figures obtained from 44 non-foundation trusts perhaps shows why there was reluctance from the NHS Trust Development Authority to release the data.

It suggests that even if the stretch targets are met, this would reduce the overall provider deficit by just 16 per cent.

This “pragmatic” approach was welcomed by Paul Briddock, director of policy for the Healthcare Financial Management Association, and suggests there is sympathy for providers’ plight.

It remains to be seen how this will go down in Whitehall. Unless something drastic happens, the Department of Health is set to breach its overall revenue budget for the year, which ministers have publicly said cannot happen. Will they force the regulators to go back for more?

The ancien regime

More “success regime” news on Tuesday. Dame Ruth Carnall, the former chief executive of NHS London, was announced as chair of the Devon success regime. Her consultancy, Carnall Farrar, will also be providing support to the health economy.

Dame Ruth is the second former strategic health authority boss to be parachuted into a success regime area, after it was announced last month that Sir Neil McKay would be chairing the programme in north Cumbria.

Many commentators have bemoaned the “system leadership” vacuum created by the abolition of the SHAs in the Lansley act. It looks like the nascent success regime is trying to fill the gap on the sly.