Private slow down expected as NHS prepares for Stalin Brown

Less emphasis on the use of the private sector and a slow down in market based reforms could be the hallmark of Gordon "Stalin" Brown's premiership for the NHS, according to a review of health experts by Health Direct.

Leading health service academics and commentators have told HSJ that Mr Brown is expected to soft-pedal on use of the independent sector in the health service when he becomes prime minister next month.

Former health adviser to Tony Bliar and London School of Economics professor of social policy Julian Le Grand said he thought it was doubtful that another wave of independent sector treatment centres would be commissioned when Mr Brown takes office.

'I think Mr Brown will still be committed to some degree of contestability, but he is not absolutely sure about market-driven reforms,' he said.

'He has sympathy with the US way of doing things, but is aware of the problems involved in introducing markets and quasi-markets into healthcare.'

'More pragmatic'

And former Department of Health strategy director Professor Chris Ham said: 'Mr Brown will be a lot more pragmatic about a bigger role for the independent sector.

'Tony Bliar did it because he thought it was the right thing to do, I think Gordon Brown will see it not so much as an end itself but will be persuaded by a greater role for the independent sector if it can show innovation or deliver shorter waiting times.'

The Institute for Public Policy Research head of health and social care Jessica Allen said: 'I wouldn't expect a great expansion in the use of the independent sector. I don't think there is any sense he will abandon the use of the private sector completely, but we will see it used where there are gaps in services.

'I think he might have less confidence that the health sector operates in the same way as other sectors, where efficiencies will arise from having a greater market.'

And King's Fund chief economist Professor John Appleby said the treasury, with Mr Brown at the helm, had expressed 'scepticism in an oblique way', about how far the use of the independent sector to increase choice could improve quality of services within the NHS.

Independent NHS board

Before Mr Blair announced details of his resignation, Mr Brown was widely believed to be preparing the ground for an announcement to match his decision to free the Bank of England from government control.

He was expected to introduce an independent NHS board in his first few days at Number 10, but Professor Ham said he now seems more cautious about such a move.

'I would say there is a strong argument for distancing politicians from the NHS and it would perhaps be sensible to start with something modest, like further separating NHS chief executive David Nicholson's team from the DoH and use that as a staging post for something more radical,' he said.

Professor Appleby said he was unsure that Mr Brown would announce a fully blown NHS board.

'Rhetorically it looks appealing for the government to show that they are not interfering, but they have gone a long way down that route already with payment by results and foundation trusts,' he said.

Launching his campaign to become leader of the Labour Party, Mr Brown stressed how important greater access to health services would be under his leadership.

Professor Ham said he expected the man who commissioned the Wanless report to make public health a major priority.

From:
http://www.hsj.co.uk/healthservicejournal/pages/N1/p5/070524

The eventual arrival of a new prime minister will be eagerly watched by Health Direct. We have become used to news of a pre launching policy as to what might happen for the NHS.

However we also have ten years of experience in what has happened to the purse strings. And so has the Great British public.

On April 03, 2006 Health Direct posted that: Gordon Brown to blame for the crisis in the NHS a new poll finds

Gordon Brown is being blamed for the financial crisis in the National Health Service, which has resulted in hospitals laying off staff and closing wards, according to a YouGov poll for The Daily Telegraph.

His credentials as prime minister-in-waiting are being undermined by a growing impression that he is not spending enough on the health service, and his own personal popularity ratings are falling.

According to the YouGov poll, 64 per cent of those questioned believe that there is a financial crisis throughout the NHS, with hospitals having to cut back on patient care. The NHS in England is expected to be in the red by £1 billion this year.

Voters also think Mr Brown has got his priorities wrong. Asked which should receive any extra money, education or the NHS, a large majority favoured the health service over schools.