Policy and Politics
Clift, Stephen, Perspectives in Public Health
'In sickness and in health': What can we expect from Dave and Nick's marriage of mutual convenience?
As a lifelong Labour supporter, living in a constituency with a strong conservative majority, I decided before the election to vote tactically. While I agreed with the Liberal Democratic position that electoral reform is now essential and perhaps unavoidable, my main motivation, like many tactical voters this time around, was to try and prevent a Tory victory in my area. I must confess that I didn't take much account of the main parties' policies on the NHS and public health. In the event, the media-invented Clegg factor failed to materialise, and now we have, for 'better or for worse', a coalition government.
So what have we in store in terms of health policy from this new government? Prior to the election the Conservative Party published A Healthier Britain. The joint programme for Government has been published, including the agreed agenda for changes to the NHS and the business of public health, and the Queen's speech announced a new Health Bill. This will set up an independent health board which will allocate resources and provide guidance on commissioning. It will also give a strong role to GPs and users of health services in local decision-making about the use of funding. These changes will prevent future governments imposing top-down reorganisations of the health service (through imposing one of course). Already Andrew Lansley's decision to stop locally planned changes in the NHS in London has provoked resignations from board directors. This may set the tone for further protest and controversy as the bill progresses through parliament and is eventually introduced. Nevertheless, given the difficulties and impacts of successive reorganisations across the public sector this further step towards localism is to be welcomed. The devil will be in the detail.
The introduction of GP commissioning, may well be good thing given the general dissatisfaction with the current framework for commissioning. As a Trustee of a third sector organisation I have recently engaged with this process within my local PCT. I became very aware of the problems of communication, complexity, timing and general lack of transparency involved for anyone outside the NHS and even for those with senior positions within it! …