The September Newsletter: Births, Babies, Bathwater

A frenzy of procreation and parturition has characterised the MAC Partners’ and the nation’s life over the summer. I am exercising a grandfatherly role to Samuel who is 3 months old now, Mrs Cameron has someone extra to lug back from her hols, the new Government is experiencing a wave of multiple births with a host of new ideas and initiatives – Gove first off the blocks (lucky not to have been brought back by the starter after early errors) but close behind has been Lansley with his new visions and plans for the NHS. The MAC response – 17 blogs – 9 in July and 8 in August.

The blog pieces are a mix of the political and the personal. The pole political position was Andrew’s long analytical piece on the relationship between Healthwatch and LINks – if you need to catch up on this, look here. Good blogs prompt responses and the follow-up piece byAndrew took up a comment made by Jeremy Taylor about accountability and the proposed relationship with the local Healthwatch bodies and local authorities with the latter as the funder and also the body being held to account. Biting hands that feed etc Accountability came up again in our latest blog on Ownership and Foundation Trusts. The concern is that FTs will no longer be publicly accountable if they are wholly owned by employees. Community and patient members would be frozen out.

Innovation was praised with the Secretary of State for Health holding up the National Commissioning Support service supported by major neurological charities as an example of innovative best practice – Andrew’s piece quotes him as saying that the vision of liberating the NHS foresees innovation coming up from users. There is more to come here in the way of innovation as NCS prepares to launch its new commissioner support software in the autumn while the neurological grass roots local associations prepare themselves for productive relationships with commissioners with a new guide on Shaping Services published this summer by the Regional Neurological Alliances. We like it – we co-wrote it.

A  lot of the debate about commissioning of course is focused on whether the new lords of commissioning – the GPs – will be able to hack it. MAC advises you to read the BMA’s General Practitioners’ Committee’s view on how patient and public involvement is central to the new commissioning arrangements and how GP should address these issues. GPs are having some fun with the chance to work with acute trusts and as an article in Pulse points out. they can address the tricks trusts play to generate more income for themselves.

Policy has to be balanced against the personal and in all this heady talk about Liberation and Power to the People, we still need to honour the individual patient experience at the heart of it all. How is that going? Do more written complaints with the numbers breaking through the 100,000 a year barrier mean that things are going to the dogs? A MAC blog says it is a classic mistake to publish numbers without putting them in a satisfaction context.  Will a single number – 111 – make it easier to make that call for advice to the service that we are told will replace NHS Direct? But not everything can get done on the phone. Things get even more up close and very personal when Partner Adamson gets taught a lesson about leaving his body out in the sun too often as bits get sliced off his nose while the medics chat. The post-operative experience includes not only the satisfaction questionnaire but the charitable donation mailing. The humanising touch is not forgotten in the new NHS as the receptionist’s daughter plays the cello for us all.

So as the new(ish) Government proceeds with its programme of change and reform throwing out the bathwater of the regime formerly known as New Labour, we will always insist that the babies that remain will flourish best if nourished at the breast of public participation and engagement.


  1. Colin Adamson says

    A comment on the newsletter:
    Colin and Andrew,
    Thank you for this newsletter.

    There is little chance that delegation to GPs will succeed locally, as Andrew’s 2009 frank survey/report of Wandsworth GPs makes clear, or nationally.
    There are too many of them that lack the management skills and motivation to make it work. Nationally it failed in the 90s last time, and we have failed to pick up the lessons learnt.

    In Wandsworth, just one out of four of the newish GP clusters is working. This is not enough.

    So we really need to speak out clearly and say so – all of us.
    Nigel Crawford
    Wandsworth LINk Member

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