This week has been another big week for NHS reform. Last week we heard David Cameron making five personal guarantees to protect the NHS’s core values followed by an outline of potential proposed changes ahead of the NHS Future Forum’s report.
On Monday the NHS Future forum chaired by Prof. Steve Field published its report after the well publicised ‘listening exercise’ that saw thousands of workshops set up and more than 25,000 emails received.
The report, which has been published just two weeks after all the responses were received (incredibly quickly), made 16 key recommendations.
In the tone of the report, there is clear acknowledgement that the NHS will be heading for significant changes, devolving the control to clinicians, giving patients the real choice and outcome driven healthcare, all these are some strong principles underpinning the reform.
Looking at the recommendations it is also clear that there were some strong and genuine concerns on the original bill arising from various quarters of the NHS staff, public and patients.
The government was very quick to respond to the report, almost too quick. It accepted the key recommendations, including reaffirming that ministers are still accountable overall, that there will be much stronger governance structures and accountability through clinicians, professionals and public involvement and that competition will not just be for the sake of competition but that there will be safeguards against price, privatisation and cherry picking.
In addition the government said it would provide strong support towards integrated care and that the transition to the new world NHS would be phased and controlled.
While all the action appeared to take place on Monday and Tuesday, the media has spent the rest of the week criticising Cameron for taking a U-turn on the reforms.
And as much as I don’t tend to symptathise much with David Cameron, you do have to wonder if he can really win.
The ‘listening exercise’, which was put in place to get feedback from professionals and patients, was originally deemed a PR stunt.
The fact that Cameron has taken onboard almost all of the key recommendations collated from the two-month exercise shows that he recognises that they didn’t get it right the first time and are prepared to accept that. Listening to the voice of a democratised society is surely more about that than it is about pretending that every detail of the bill was right in the first place.
While the pause has meant even further delays and it’s looking very unlikely that the bill will make it through the autumn session, it would be difficult to argue that the exercise and Cameron’s willingness to accept he was wrong, are not key steps in finally moving forward with an approach that far more people are onboard with.
