Public Policy Media
Richard Vize
LATEST
ARTICLES
Labour must put patients above
dogma
30 September 2019
As the Conservatives finalised their plans to bury the most
egregious parts of the NHS reforms they forced through in
2012, Labour set out its healthcare policies.
The Tories look set to play it safe on the NHS in the general
election, adopting proposals from NHS England to drastically
reduce the role of competition, sort out the legal mess around
its structures and make it easier for hospitals, GPs and
community services to work together.
Labour, meanwhile, is gunning for drug companies and service
contractors. Speaking in the wake of drug company Vertex
putting a list price of £104,000 per patient per year on the
cystic fibrosis treatment Orkambi, Jeremy Corbyn promised
compulsory licensing would secure generic versions of
expensive patented medicines while a state-owned drug
company would manufacture generics.
A pharmaceutical company charging extortionate prices is a
familiar story, but usually a pincer movement by regulator Nice
and NHS England secures access to innovative treatments at
manageable prices. The fact that Donald Trump has railed
against national healthcare systems “freeloading” on American
drug companies is a measure of the NHS’s success.
Read the full article at Guardian Society
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Cheap fags are last gasp of
health policy
13 September 2019
In a government gearing up for an election, where every
statement is supposed to be choreographed as part of a finely
tuned grid of speeches and events, it takes a particular
stupidity for the chancellor, Sajid Javid, to extol the virtues of
cheap cigarettes and booze just as the health and social care
secretary, Matt Hancock, was heading for Public Health
England’s annual conference.
Having alighted upon what he regards as unequivocally good
news about leaving the EU without a deal, Javid announced on
Tuesday that people travelling to Europe will be able to buy
alcohol and cigarettes without paying UK excise duty.
Javid added chirpily that this decision “will help holidaymakers’
cash go that little bit further”, apparently oblivious to the way
the pound has tanked against the euro since the referendum.
It left Hancock struggling to defend the government’s
commitment to end smoking by 2030 in his speech to the
public health conference on Wednesday.
Stocking up on whisky on your way out of the country may be
an understandable reaction to the government’s inability to get
your usual medication into it.
Read the full article at Guardian Society
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Brexit frenzy wrecks financial
stability
30 August 2019
As the constitutional battle intensifies, public services are
becoming collateral damage. The Brexit frenzy, combined with
preparations for a general election, has torpedoed the chances
of any semblance of financial stability returning to government
spending.
The chancellor, Sajid Javid, will present a one-year public
spending round on 4 September instead of planning for the
usual three-year review. This will give departments short-term
funding once the current spending plans come to an end in
March 2020.
In political terms, it will position the Conservatives for a general
election and allow officials to concentrate on leaving the EU.
There will be some pre-election largesse – some real, some
sleight of hand – delivering the cash to honour pledges already
made by the prime minister on policing, schools and the NHS.
But austerity will be far from over, in terms of both the funding
provided and the enduring damage caused by previous cuts.
Housing, prisons, culture, and legal aid can expect little respite.
The atrophying of the justice system, from funding the courts to
the treatment of prisoners, is a scandal pushed to the margins
of public policy.
Read the full article at Guardian Society
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Diva doctor culture put patients
at risk
16 August 2019
Toxic subcultures are thriving in the medical profession, often
putting patients at risk. Everyone who works in the NHS has
met these people, but dealing with the problem is a huge
management challenge.
A senior manager recently described to me the struggle in his
trust to stop surgeons bullying anaesthetists and admin staff.
He got to the point of having to spell out that he would
personally walk someone off the site, no matter how senior, if it
happened again.
This experience is borne out by General Medical Council
research which laid bare five distinct problematic groups of
healthcare professionals. Ironically, the study aimed to
understand how doctors approach the task of building good
workplace cultures that deliver high-quality care.
It reveals the signs of poor culture, such as cynical staff,
blaming and shaming, a defensive attitude to performance data
and a lack of mutual support. Other flags include a focus on the
technical side of medicine while ignoring patients’ experiences,
professional battles taking precedence over patient needs and
lax implementation of protocols such as surgical checklists.
Stress and burnout are also often endemic in teams with a poor
working culture.
Read the full article at Guardian Society
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Priti Patel will not defeat knife
crime
2 August 2019
Priti Patel is being hailed as the “hardest line home secretary
for years”. Her fan club expects a tough, criminal justice-led
approach that will reclaim the Conservatives’ reputation as the
party of law and order. If so, she will be the wrong home
secretary to tackle the surge in youth violence.
The hard right are looking forward to a return to the tried-and-
failed approach of searching, arresting and imprisoning our
way out of trouble, but the evidence points to the need for
prevention and early intervention by a range of state agencies.
In the year to March 2019, police forces in England and Wales
recorded more than 47,000 offences involving knives, up 8%
on the previous year and the highest total since records began.
In the year to March 2018, 285 people in England and Wales
were stabbed to death. The number of juvenile offenders
convicted or cautioned for knife offences has increased by 48%
in four years.Figures from eight of the largest police forces
reveal that stop and search has more than doubled in two
years. In the first nine weeks of 2019, 10 teenagers were
stabbed to death.
Against this blood-soaked backdrop, the cross-party home
affairs select committee has published its report on serious
youth violence.
Read the full article at Guardian Society
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Threat of Johnson’s fantasy
economics
19 July 2019
In his campaign for the Conservative leadership, Boris Johnson
has pledged more bobbies on the beat, a budget boost for
schools and his team hinted at public sector pay rises. But his
warm words about public services are underpinned by fantasy
economics.
His most eye-catching public service commitment has been to
reverse his party’s cuts to policing by finding £1.1bn to hire
20,000 more police officers. Johnson sees his record on cutting
crime as London mayor as one of his most impressive
achievements, although it is less persuasive when compared
with long-term national trends.
But this pitch to restore the Tories’ battered reputation as the
party of law and order misses the point that cutting crime
requires substantial and sustained investment in technology, as
well as addressing weaknesses in the regional structure of
police forces. Some of those promised officers should be
traded for better kit and stronger organisation.
The cost of his promise on policing is dwarfed by his
commitment to boost the budget for English schools by £4.6bn,
with the aim of returning school spending per pupil to its 2015
peak.
Read the full article at Guardian Society
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Self-reliance on the road to
Wigan cheer
5 July 2019
Wigan council has achieved a remarkable feat. Despite cuts of
£140m, it has maintained, even improved, its services, and
transformed its relationship with residents. But there has been
a cost: more than 1,000 of its staff have lost their jobs – roughly
a fifth of the workforce.
Under relentless pressure to do more with less, all councils
have had to make cuts. Many also bandy the word
transformation around, but few achieve it. A study of Wigan by
the King’s Fund makes clear this council is an exception.
The bedrock of Wigan’s approach is a new relationship with
both its staff and local people. It has rejected the paternalism
that bedevils many public services in favour of working with
individuals, families and communities to nurture their strengths
and build independence and self-reliance. This is known locally
as the Wigan Deal.
Key to its success has been farsighted financial planning.
While many councils in the early years of austerity became
fixated on what they had to cut, Wigan looked at evidence from
across the country to decide what it could do differently.
Read the full article at Guardian Society
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