My final report from the event held on 18th May.
Please see previous postings for the first 3 instalments of this report.
Liz Kendall MP: The Shadow Health Minister dashed in just before she was due to speak, over-ran, stayed for a few questions and dashed off. In her defence, she was rushing to get to Prime Minister’s question time in the House of Commons and she apologised sweetly for her brief attendance. I have been impressed with Ms Kendall’s performance in parliament, usually clear and concise in making her point. But I was underwhelmed this time. She constantly fidgeted with her hair, tucking and re-tucking it behind her ears and flicking the ends (of her hair not her ears). This was incredibly distracting. That aside, it was a very flat presentation – and reviewing my notes – I have written ‘Is she missing a trick here?’ I think she was.
Each of the other speakers left me with a very clear idea of their views and their personal ‘deal breakers’ associated with the Health and Social Care Bill. Not so Ms Kendall. Personally engaging but bland when it came to content. She demonstrated her knowledge but didn’t really come up with anything new, ‘You need to bring the people with you’ to implement reforms successfully. She referred to the ageing population and long term conditions as key challenges for the future. She said there needs to be a change in emphasis but I wasn’t clear how she would recommend this could happen.
I was delighted that Ms Kendall referred to the success of the NHS London with the implementation of the Stroke Strategy. This initiative, based on targets, performance measures, mandatory staffing levels, expertise and training has had an incredible impact on stroke care in the capital. This NHS improvement strategy was initiated by the Labour government and if was her I would have made more of this and other service improvements over the past decade. Ms Kendall wisely bemoaned the fact that expertise is being lost daily from the Primary Care Trusts. She was generous in her support of independent service treatment centres and the introduction of competition based on outcomes. In fact for a moment I thought she was Tory.
Janet Davies: Executive Director of Nursing and Service Delivery, Royal College of Nursing (RCN) had the toughest slot – speaking just before close of play and after the big guns had been and gone. With a wry smile she mentioned that no doubt the audience was pretty clear where the RCN stood on these reforms (following their recent vote of no confidence in Andrew Lansley,
Secretary of Sate for Health). Ms Davies stated that the RCN are not against reform but they believe that the Bill will fail to deliver the necessary improvements. The RCN represents nurses from ‘Bedside to Board’ – great phrase, as well as ‘clinical is good and management is bad is wrong’. She summarised her wish list for reform, noting that even the best minds were struggling to understand the Bill: UK
1) Modelling. Test the theories before implementation
2) Risk Assessment. Where are the fail-safes in Lansley’s strategy?
3) Evidence. Where is the evidence to justify these reforms, and who is evaluating the pathfinders.
Ms Davies mentioned that the RCN have written to pathfinder GPs about their strategy for ingoing evaluation. No reply. She would like to see her nurse on every commissioning board and feared that Consortia were putting their ‘favourite’ nurses on their board, even though they have no commissioning expertise. I do like to hear a straight talker, and Janet Davies is a fine example.
Baroness Young: Brought the meeting to a close, reminding us that patient choice should not be about ‘shopping’, but ‘informed decision making’. Sounds good to me.
And so my first, and possibly last, NHS Future Forum came to a close. I felt very privileged to be part of the select audience. The questions and observations from the floor were all pretty much in line with my feelings about the proposed reforms, and we can only hope that our voices have been heard and our comments noted. As I reflect on the event, there were no real surprises, although I was a little shocked at the apparent desire for world domination by the GP lead of the NHS Alliance.
I fear that despite the extreme good sense spoken by many of the speakers, this Bill will continue on its potentially destructive path, cutting a swathe through much that is good about the NHS and driving a divisive wedge between primary and secondary care.