Richard Vize
Public Policy Media Ltd
LATEST ARTICLES
What if the media come for you?
27 June 2013
So what will you do if you are the next NHS organisation to be
engulfed in a crisis? The current febrile run of accusation and
rebuttal around the failure of Morecambe Bay's maternity
service and its oversight is by no means a unique example of
how the public, politicians and the media react when the
health service gets it wrong.
There is a strong punitive element in the reaction to a crisis –
a requirement to identify and punish individuals deemed to
be at fault – and it is extraordinarily difficult for managers to
explain the context in which they are working or the pressures
they are under. Neither is a mistake or poor judgment
mitigated by evidence of prior success or good service. It is
what you got wrong that will count.
Read the full article on the Guardian healthcare network
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The unsparing truth about death
21 June 2013
Local government has endured many league tables over the
years, revealing performance on everything from litter to
benefit payments. Now it has a league table of death.
Public Health England's new Longer Lives website paints in
vivid red the toll of premature mortality – before 75 years –
council by council. It is, of course, dominated by northern
authorities, carving a C-shaped mark of death from Redcar
and Cleveland, westwards through councils such as Stockton-
on-Tees, Darlington and County Durham, across to Cumbria,
then south through Lancashire and eastwards back across the
country through councils such as Barnsley, Wakefield and
Calderdale, with North East Lincolnshire the final stop on the
Grim Reaper's tour.
Read the full article on the Guardian local government
network
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Community budgets grind slowly
on
14 June 2013
Even by the lamentable standards of Whitehall pilots and
initiatives on local government, the community budget
programme is frustrating in its sloth and lack of ambition. But
there is hope.
The four pilots are not actually intended to make it work - they
are supposed to be proving the concept. It is now proved, so
let's get moving.
As Local Government Association leader Sir Merrick Cockell
told a communities and local government select committee
hearing on the budgets: "Now is the time to move from an
acceptance that it is validated to delivery; there is no reason to
hold back."
The LGA evidence to the committee, unintentionally mimicking
the programme itself, at times got bogged down in Whitehall
jargon such as "meshing" (which I think means getting things
to work together) and "rigidities" (which probably means
"some civil servants are being wilfully unhelpful but I'm too
polite to say so").
Read the full article on the Guardian local government
network
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Picking up the pieces of surgery
review
13 June 2013
The Independent Reconfiguration Panel's demolition of
proposals for reconfiguring children's heart services has set
the benchmark for all future service reviews.
The panel told the health secretary, Jeremy Hunt, that the
review of children's heart services had failed in its objective of
recommending a safe, sustainable and accessible way
forward.
While it had no criticism of the underlying aim to concentrate
services in fewer centres, it accused the review team of a
flawed analysis of incomplete proposals that left many
questions unanswered.
These included issues at the centre of the debate, such as the
minimum number of operations that should be carried out by
surgeons and teams, and even what services would be where.
It damned the review for "a paucity of basic information"
about the clinical needs of patients. The panel didn't even
have confidence in the financial viability of what had been
proposed.
Read the full article on the Guardian healthcare network
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Nicholson: passion and
centralism
10 June 2013
Sir David Nicholson’s last speech to the annual NHS
Confederation conference as the leader of the service
reflected all the traits of his seven years in control.
His passion, commitment, and drive were undeniable, but he
failed to acknowledge mistakes which had undermined patient
care, gave little time to the role of local clinical
commissioners, and saw centralised direction as the
overriding driver of change.
Early in his hour long address to the Liverpool audience, he
admitted that a key reason behind his decision to quit after
seven years as chief executive was that he had become the
story over the Mid Staffordshire scandal. He also pointed out
that within the last decade mortality rates across the NHS
have halved; it must seem cruel to him to be taking the blame
for one, but attracting little credit for the other.
His frustration with politicians spilled out. His angry defence
of GPs against widespread criticism seemed in part aimed at
health secretary Jeremy Hunt, and he accused Coalition
ministers of wasting the first two years in power on structural
upheaval when they could have put their weight behind
service changes such as fewer sites for children’s heart
surgery. The “tyranny of the electoral cycle” cannot be allowed
to paralyse vital reforms, he argued.
Read the full article at the British Medical Journal
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A look into local government's
abyss
7 June 2013
The public accounts committee's dissection of the funding
cuts to local government exposes flaws and ignorance in
ministerial thinking which have been apparent to councils for
many months.
Take, for example, the failure of government to analyse how
cuts in one service may affect demand on another. Cuts to
social care are undoubtedly contributing to the current crisis
in some A&E departments because social workers are unable
to provide the support to allow many older people to be
discharged from hospital promptly. But the government is
responding by treating the symptom – the crush in A&E –
rather than helping councils address one of the root causes of
the problem.
As a recent discussion at a Guardian local government
Leaders’ Quarterly exposed, the Department for Work and
Pensions took many weeks to realise that councils were going
to have to deal with the consequences of welfare cuts. Modest
amounts of money are being channeled into supporting some
vulnerable people through the troubled families programme,
but that work is likely to be more than cancelled out through
the harm inflicted by debt, inadequate housing and mental
illness resulting from welfare savings.
Read the full article on the Guardian local government
network
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Will there be NHS cultural
revolution?
5 June 2013
The NHS in England is awash with promises of change. In the
wake of health reforms and the Francis inquiry into the Mid-
Staffordshire scandal – which examined the failure of the
system to identify and act upon poor standards of care that
may have led to hundreds of deaths between 2005 and 2009 –
staff have been bombarded with vows of clinical leadership,
an end to bullying and a renewed focus on patients. But will
NHS managers really take this on board? As one NHS figure
puts it: "Do you seriously believe they won't still scream down
the phone at you?"
The revolution is supposed to begin with clinical
commissioning groups (CCGs) having autonomy to make their
own decisions. Blackpool GP and co-chair of NHS Clinical
Commissioners, Amanda Doyle, believes NHS England, which
has a brief to improve health outcomes for people in England,
"is very much committed to working with clinical
commissioning groups. We have to give it a chance".
Read the full article at the Guardian