Tuesday 19 April 2011

Listening and worm tablets

A mundane start to Monday. I had to get a worm tablet for She who Must Be Obeyed ( my Hound ), a new toilet and a haircut. Somewhat of a come down from yesterday's spiritual events.

And I even make an appointment with my GP ( NOT part of the listening exercise). Can someone tell me why I have to take time off work to see my doctor? Most parts of the public sector can manage to open evenings or Saturdays. Why can't Doctors? Must ask Steve Field tomorrow!

These tasks accomplished it was into the DH for more meetings with officials as I attempt to get my head round this challenge I have on choice and competition! I'm reminded about how political this is by a rather pointed email from an ACEVO member which says, " the White Paper is fundamentally about privatisation. "

Actually I think as a matter of fact it is not , though there are certainly arguments put that says the direction of travel points there? Choices do have consequences. Yet how do you achieve choice without more diversity in providers. And as I have argued with relentless monotony for the last decade we have to expand the role of our third sector if we are to meet the challenges of NHS provision for the future.

What does the third sector bring to health?

# advocacy and the championing of citizens and patients rights,

# research ( some charities do more research in some health areas than the NHS )

# service delivery that is often more patient centred and cost effective. We need more of this, not less

# More opportunities for staff to set up social enterprises. Use the right to request

# More opportunities to deliver services for long term conditions and end of life care

Of course there is then the issue of the role of the independent sector and that's the point of contention.

I'm getting a lot of emails suggesting meetings, ideas , as well as hints on what I shouldn't do ! As I see the process, its about meetings and discussion, as well as talking to experts. I'm trying to do a lot of this.

But lets be clear. This is not a new consultation; that has happened . There is a Bill in Parliament. And this is a time limited exercise; indeed we have only about 6 weeks in reality.

And I don't have a magic wand that produces an answer to a hotly debated and contentious political issue.

The process is fascinating and I am meeting new people, trying to think out of the box whilst knowing I'm surrounded by professionals who have been in the health service for years. I'm just the naïve new boy..well not so naïve!

But what is also true is that you need to avoid closed group thinking. Professional groups across the sectors can sometimes think in ways that exclude ; the experience of people , carers and families involved in mental health and learning disabilities can bear witness to that.

An interesting editorial in Third Sector by the Editor, stephen Cook, points to my dilemma.

" Last week, seven voluntary sector leaders announced they were to join the exercise, which has been christened the NHS Future Forum. Sir Stephen Bubb has even agreed to take two months away from his job running the chief executives body Acevo to "take the lead" in the strand of the forum's work that relates to choice and competition.

It will be argued that it is better for the sector to be inside rather than outside the tent when such a vital policy area is under review, and that there is a rare opportunity here for health charities to exert significant influence on ministers and policymakers. It is indeed their chance to press for their specialist, patient-centred services to gain better access to the NHS on a more level playing field.

But there are reputational risks here as well. The government's overriding imperative is to get its flagship reforms back on track, and there is a danger that it will try to use the sector as window-dressing in this essentially political enterprise. The sector leaders involved would do well to guard their independence and sup with a long spoon at this particular gathering.

In this connection, Bubb confides on his blog that he was persuaded by the Department of Health press office not to take up a BBC interview slot about his appointment. This is hardly a good omen, and he would do well to fulfil quickly his accompanying pledge that this unusual silence on his part won't last. In an arrangement like this, it needs to be absolutely clear who's calling the shots."

Well, that's marking my cards then!

But I ended the evening with a gorgeous tea and scone with an old friend as we chewed the cud and ruminate on what I'm trying to do. In tasks like this you need friends to keep you on the right track!

1 comment:

nickpahl said...

Hi Stephen
I hope you can make the case for small local players to enter the NHS "market". One of the political fears is that big players with profit motives will suck up NHS funding - but a benefit fo the reforms could be that by placing the commissioning arrangements closer to patient needs, small providers will now have a much greater opportunity to become an ‘any willing provider’. I am e mailing on behalf of the British Acupuncture Council - who hope the new arrangements will permit individual acupuncturists and consortia of acupuncture to compete effectively without undue bureacratic burden.