Turning government on its head – we hope so

To coincide with the publication of Liberating the NHS, the Department of Health has published its departmental priorities in the form of a Structural Reform Plan.  SRPs are required by the Coalition Government from all government departments.

Head stands

SRPs are designed, in the word’s of the DH one,  to turn government on its head, taking power away from Whitehall and putting it into the hands of people and communities. Once these reforms are in place, people themselves will have the power to improve our country and our public services, through the mechanisms of local democratic accountability, competition, choice, and social action.

This will be a neat trick in more than one sense of the word if it can be achieved.  We hope it can, because the first priority in particular strikes a strong chord with us about user participation and control of public services.

New priorities

1. A patient-led NHS –  Strengthen the patient’s ability to exercise extended choice, to manage their care and to have their voice heard within the NHS

2. Shift resources to promote better healthcare outcomes – Shift focus and resources towards better healthcare outcomes, including national healthcare outcome measures, patient-reported outcomes and patient experience measures

3. Revolutionise NHS accountability – Create a long-term sustainable framework of institutions with greater autonomy for doctors and nurses, and greater accountability to patients and the public, focused on outcomes

4. Promote better public health – Promote better public health for the nation by centring the Department’s focus on public health, developing a clear strategy and partnering with the voluntary and private sectors

5. Reform social care – Enable people needing care to be treated with dignity and respect; reform the system of social care to provide much more control to individuals and their carers, easing the cost burden that they and their families face

Two observations

First, why have we had to wait so long for something like this? These are the obvious things for a government department responsible for health, well being (public health) and social care to be doing in the first place! Let us hope there are enough talented and committed people left when the department is slimmed down to achieve them.

And an elephant warning

Second,  priority 5 about reforming (adult) social care will turn out to be the hardest to achieve. It is the elephant in just about every room you care to enter.  There is no consensus on form or funding.  That was amply demonstrated by the pre-election squabbles about funding processes and affordability.

The Coalition Government has promised a commission on social care to look at all the options. We know what these are likely to be of course.

There should be a government “vision for social care” by the end of this year, with a white paper in 2011.  The Social Care Commission, when established, will report within 12 months on social care funding options.  The White Paper states: The Commission will consider a range of ideas, including both a voluntary insurance scheme and a partnership scheme. As a key component of a lasting settlement for the social care system, we will reform and consolidate the law underpinning adult social care, working with the Law Commission.

We wish this well.  But if you thought GP commissioning was going to be a punch-up, just wait until we really get into social care funding and provision for a burgeoning older population and the many more people with disabilities who are living for much l0nger.

That will really be the main event.  Tickets available from the usual outlets very soon.  Book early for a ringside seat.