First of all I would like to wish you all a happy and prosperous New Year. I am sure that even now you are pondering how best to not conclude your own resolutions. Good luck with whatever you do.
Do you sometimes have what you think are really, really brilliant ideas. Ideas that seem so simple, can solve major problems, but people don't seem to "get it". Well, I had such an idea for the NHS. The NHS reminds me of my time in Hackney. During my time every three months there seemed to be some initiative to change the structure of the Council. So much so that I called it the permanent revolution.
The NHS is going through exactly the same thing, and for the same reason. There is no philosophical basis for the changes. They are piecemeal, and add new structures onto old one's. Such changes are not always bad - take for example Walk in centres, which have significantly drawn users away from Accident & Emergency for minor injuries.
The reality of the NHS is that as "business units", for that is where they are, they are struggling with massive investment, and historic debt. Therefore, if you really want the new regime to work, why not start from the same page and simply "write off" the debt of the 103 trusts saddled with debt they will never be able to resolve without massive injury to patients.
A think tank called Reform as outlined in the Guardian newspaper http://society.guardian.co.uk/health/news/0,,1981111,00.html have made exactly that point.
The Government have already rejected the idea. Shame politics has really got in the way of making the NHS an even better service. What do you think? What about those trusts who have been able to manage their budgets - do you have a view on them? Let me know.
Have a good year.
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