Informed analysis on public policy: the NHS reforms and other changes

With so much change swirling around public services it’s useful to have a place to go for informed analysis. Today I stumbled on the LSE's British Politics and Policy blog which features a wide range of academics. Some of the bloggers, such as Tony Travers, are found in publications like CIPFA's Public Finance; others are more elusive (I cannot remember reading anything by Nicholas Barr since studying public sector economics at university sometime ago.)

This morning I read with interest Julian Le Grand’s thoughts on the Coalition’s plans to overhaul the NHS. Le Grand is a former advisor to Tony Blair on public service reform. He describes Andrew Lansley’s proposals as “impressive” with “their origin in policy reforms initiated by John Major’s Conservative government in the 1990s and subsequently developed by Tony Blair’s Labour government”. Similar sentiments were expressed last month by another advisor to Tony Blair – Simon Stevens wrote in the Financial Times that the Coalition’s plans take forward earlier reforms blocked by “internal opposition”.

The NHS, EU competition rules and social enterprises

I had mixed feelings reading in the Financial Times that NHS services procured by PCTs etc are likely to become subject to EU single market and competition rules.

This should ensure that competition and contestability inject more innovation and value-for-money into our NHS. On the other hand, I would be disappointed if these rules prevented the Department of Health providing support to not-for-profit social enterprises run by professionals (and ideally with accountability to patients and communities).

Social enterprises are developing new and novel models of managing provision - they need support when up against BUPA, Nuffield etc.

Democracy in the NHS - participation in Foundation Trusts

The Daily Telegraph isn’t the most objective and non-partisan observer of the recent Foundation Trust (FT) elections – does anyone seriously calculate turnout in terms of total population (including under 18s)? does anyone really believe that everyone will join and participate in FTs, particularly the specialist hospitals?

Nevertheless, there are grounds for concern. FT elections choose the governing bodies that ensure that the FT boards are held accountable so they are important.

Membership figures are low. Public awareness is even lower. The FTs were created as mutual institutions using models found in the co-operative movement – yet, many in the co-operative movements don’t appreciate or understand this.

OK. I confess. I am only now joining my local FT.

The regulator of FTs, Monitor, keeps a register so you can find the contact details of your local FT. I would urge everyone to join and get involved – especially if you care about the NHS and believe that public services should be accountable to their users and communities.

Are the FTs nurturing their memberships and developing their accountability frameworks? There is guidance out there. Are the FTs applying it?

While giving users a choice is vital to ensuring that public services are responsive and effective, it is important that users have a voice and use it so they can be heard alongside professionals, managers and other interests. Voice is especially important in rural areas where the extent of choice is inevitably less wide.