Wednesday 20 April 2011

83 and onwards

It's my Father's birthday today. 83 is not a bad age and , as I'm now an expert on health matters I was able to tell him he has significantly less long term conditions than many his age. He was off to the village pub for a pint ( I recommended 2 ), ploughmans and afternoon snooze ( in that order).I can report for all those dog loving blogg readers out there that the Hound successfully swallowed worm tablet. And loo is safely installed. I'm sure you are relieved!

So it was off to a meeting with GPs at the Department. I suggested that there are 3 main drivers of change behind the health reforms:

# an ageing population ( a quarter of today's children will reach 100 )

# burgeoning long term conditions

# patient and citizen power

That means that whoever was I power , reform of the NHS was going to happen.

It's interesting that many of my baby boomer generation are now coming face to face with the issues around care for the elderly in our current system. We like and appreciate the fact that our NHS is free a to use and that even hugely expensive treatments are available to all, regardless of income. Let's keep it that way!

But let's also be honest that care for the frail elderly ( not you dad !) can often be shockingly inadequate. And the current medical model for long term conditions is unsustainable. Given  growing patient power this makes for a heady mix for health spending!

I had a superb meeting with 2 outstanding examples of forward looking and brave thinking GPs from the NHS Alliance, Dr Dixon ( who Chairs the Alliance) and Dr Hynes.

 We have made a good connection between ACEVO and the Alliance and intend to do some joint work, together with Ippr,on how to promote the third sector to GPs. We were planning all this long before the "pause" but it proved doubly useful to get their views on the reforms.

I have to admit that when I hear from GPs like the two I met yesterday , I see the huge potential of GP commissioning for more effective public health.

Dr Dixon made the interesting point that the Lansley model returns GPs to their historic role in the country,  where the GP was a pillar of the local community and saw the connections between public and individual health, jobs and a good environment.

Dr Hynes put it rather brilliantly in describing how we treat depression: no good just dispensing tablets when the fact is that the people he sees have mega reasons to be depressed; no job, benefits cut, housing problems etc. So acting on those problems is as crucial to better health as a pill. They both gave me interesting examples of how they make use of the local third sector to support the people they see.

But is this the general picture for all GPs?  A thought occurs to me. Should we be insisting that the new GP commissioning consortia are set up a CICs ( community interest companies ) ? Should we encourage GP practices to set themselves up as CICs? There is , after all, concern that the new arrangements do not give rise to excessive private, as opposed to public profit.

I leave the good doctors for various meetings at No 10. The first , an interesting collection of key media and comms leaders from the third sector meeting with Steve Hilton and the feisty Caroline Deihl ( ACEVO member, CEO of the Media Trust ) to talk about whether the sector could play a bigger role in encouraging social action through public awareness campaigns . Can Government help promote or support this , especially with encouraging media support ?

We met in the Cabinet Room; if only I had a camera to record the historic sight of third sector leaders sitting around the Cabinet Table. I was sat next to that force of nature, Emma- Jane Cross of Beat Bullying. Fizzing with ideas ( was there something in the coffee? )she played a great role in pushing the debate forward. We are to meet again. 

She also has a famous Blog. I tell her I shall mention her. There you go.

Then its off upstairs for another in the listening roundtables that the PM and Andrew Lansley  are  holding. A meeting with the Foundation Trust Network. A good meeting that took place under the glaring presence of Margaret Thatcher ; portrait on wall, it was previously her office I'm told  .  Reassuring to discover that it is not just meetings of third sector folk that spend time whinging about not having enough money.not that I'm complaining about that; I whinge for the nation about cuts to our sector. And , after all , we now have news of increasing waiting lists in hospitals so the fact that cut backs are happening does flow through to the front line of patient care.

The evening was rounded off over a glass of Chablis! I was meeting with Chris Sterling and Mary Reilly from Deloitte. Deloitte have been a long standing corporate partner of acevo and Chris and Mary had agreed to meet up to brainstorm some of their experience and knowledge  of the health sector and its challenges. We begin at the beginning. How do you define choice! What does it mean in practise.

He shows me some interesting research that demonstrates that the exercise of choice works better in city centres, but not in rural ones. So inequality can build up; a point I need to reflect on.

I get home late realising I have had neither lunch nor dinner. Is this healthy? I must ask my Doctor!


Anonymous said...

Are you serious in your suggestion that the current reforms of the NHS are simply a smart strategic response to these three emerging demographics?

Not a hint of ideology or dogma in sight?

This is not what I am picking up from many in the VCFS, including CEOs that I talk to.

Joel Leeds said...

And it isn't driven by the desire for profit of companies like Deloitte as well?