Health Policy Debate
1-15 June 2005
Politics
On June 14th the Financial Times published an interview with new health secretary, Patricia Hewitt – her first since taking office. While her hints that the impact on the NHS of private involvement may have to be limited were welcome, she continues to articulate her predecessor’s belief that creative discomfort will benefit the NHS.
“It is not only inevitable but essential, that payment by results and these other elements create instability and change for the NHS. That is precisely what they are designed to do”.
The aim is to improve the performance of NHS trusts if they fail to, “yes, there is a real risk of a unit closing because it simply can’t deliver the quality of care and the value for money that all of is as patients and taxpayers want”.
She acknowledges the temptation for a Labour health secretary to win “enormous plaudits from some parliamentary colleagues and a lot of NHS staff” by slowing the changes down, but “I won’t succumb to that because it would be absolutely the wrong thing to do for patients, the public and for NHS staff themselves – because it is getting these reforms right and embedding them that will create the world class and patient-led NHS that staff themselves want. So we are not letting up on the pace and direction of reform”.
Hewitt says it is important that any changes in services take place “pretty quickly in next two or three years”. It seems the aim is to create havoc quickly (and then get re-elected after the fuss dies down). “It is better to take the pain and change now, and confront the need to reconfigure our services now in the first year or two than do it in the year or two running up to the next general election”. [Go to note 1]
Her view that services can be quickly reconfigured followed by a settling down period is naïve. She hasn’t considered the need for a consultation process, about which, more in a later section. Perhaps she doesn’t fully appreciate the ecology of health services and the interdependence between key departments.