Andrew Lansley, the new health secretary, could be about to make his first big mistake.
In opposition, he sided with professional hatred of Labour’s myriad targets in the NHS, and now – although he hasn’t yet quite said it in words of one syllable – he appears set to scrap the lot, including the 18-week wait: the promise that no-one need wait more than 18 weeks from seeing their GP to their hospital treatment starting.
Yesterday he quoted approvingly from one of the many inquiries that have already been held into the scandal at Mid-Staffordshire hospital, which said the fear of front-line staff that they would lose their jobs if the waiting time targets were not met contributed to the hospital’s appalling standards of care.
Waiting time targets were also in part blamed for the huge outbreak of hospital acquired infections at Maidstone and Tunbridge Wells.
But two exceedingly bad cases do not invalidate the waiting time goal. More than 200 other NHS trusts have got waiting times down, managed their finances more or less successfully, and not subjected patients to appalling standards of care. In other words they have managed apparently conflicting objectives successfully, as virtually every business has to do. Read more
One important question for the new coalition – and anyone interested in policy – is just how far is either party now held to what was in their manifesto or their previous political commitments. Or is it now ground zero for everything?
Both parties have already given appreciable ground on previously cherished policies to form the coalition.
But in the run up to the election campaign David Cameron told pensioners “you have my word” that winter fuel payments, free bus passes and TV licences, along with the pension credit, would be protected. Read more
A hung parliament will produce governmental paralysis and economic mayhem. Well maybe. But may be not.
The Institute for Government, which like the Institute for Fiscal Studies tries to offer up a few facts to inform the fevered pre-election debate, has a neat briefing on hung parliaments on its website.
One particular piece of Powerpoint is well worth the look for those who fear that a hung parliament will see the UK knocking on the door of the IMF within days.
It plots governments, whether they be coalitions, majority or minority controlled, against the size of their structural deficit. Read more
The three main parties’ health spokesman – Andy Burnham, Andrew Lansley and Norman Lamb – took part in a not entirely even tempered election hustings today in front of worthies from the British Medical Association, the King’s Fund and the Royal College of Nursing.
But it produced one good laugh. Early on, Mr Burnham declared on one particular issue: “I would agree with Norman ….” – a statement that produced instant giggles from the assembled doctors, nurses and policy wonks. Read more
Tensions continue to rise over the transition between Labour and the Tories that may or may not take place after May 6. And after their furious row over the social care “death tax” there is increasingly little love lost between Andy Burnham, the health secretary and Andrew Lansley, his Conservative opposite number.
Lansley is cross with Burnham, the health secretary, for going ahead and appointing a new chair of Monitor, the independent foundation trust regulator, just ahead of the election. Burnham appears incandescent with rage at Lansley, for questioning his judgement.
Burnham vetoed earlier candidates to take over Monitor in the autumn, leaving it temporarily leaderless. Now, suddenly, he has given Steve Bundred, the outgoing chief executive of the Audit Commission, a four year, £75,000 per annum contract to do the job from May.
Last week he put in a courtesy call to Lansley to run through the short list of candidates. Lansley said he didn’t want to know the names. Read more
Not in the sense that the arrival of the new personal pensions in 2012 will cause riots on the streets. But in the sense that a once simple policy goal becomes so complicated by practical considerations and compromises along the way that it fails. Spectacularly.
Ministers yesterday announced, in outline, how people will be charged for the new pensions - and the way that is to happen may just prove the straw that breaks the back of the scheme.
The goal for the new personal pensions – now known as NEST – was clear when Adair Turner’s Pensions Commission recommended, back in 2005, that they should be introduced from 2010.
A simple, low cost pension, into which millions of lower to middle income earners with no pension provision would be automatically enrolled, through with the right to opt out.
Since then the timetable has slipped, and a series of practical considerations have led to a swift start becoming a decidedly prolonged roll out. Read more
Andy Burnham’s policy that NHS organisations are now the health service’s “preferred provider” is proving something of a running sore.
Given the [still small] amount of care that the NHS already buys from the private and voluntary sector, and the way that has expanded over recent years, at least some competition and procurement lawyers believe that rowing back to a preferred provider approach may well breach EU competition law. Read more
Nicholas Timmins is the FT’s public policy editor
An election may be coming, but nothing quite forgives total abuse of statistics.
Stephen O’Brien, the Conservative health spokesman, is accusing the government of trying to tie the next administration in to some £4bn’s worth of central NHS IT contracts by completing a deal ahead of the election that is aimed at saving £600m from them.
There is one statistic that really hammers home how expensive the 10p U-turn is. About £2bn of the £2.7bn in compensation is going to those who had already won from the 2007 Budget. Officials insist this was the only simple and quick solution. But there was another way that was cheaper and more comprehensive.
Ian Mulheirn, chief economist at the Social Market Foundation and a former Treasury official, thinks he has the answer. He believes the chancellor could have compensated all those who lost out for just £1.5bn. By contrast, the chancellor’s plan was almost twice as expensive but only covered 80 per cent of the 10p rate losers. Read more
Lord Darzi’s pledge yesterday that future health service changes will be evidence based and subject to external review is all aimed at making some entirely necessary changes to the shape of services more understandable and palatable.
As part of the reassurance, service changes will be put through the government’s “gateway review” process, one that subjects major government projects to peer review to identify failures and risks early so they can be put right. Read more