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- bring commissioners and providers together
- end contracting and the internal market
- focus on community and service integration
- improve efficiency with better data and innovation
- Is the NHS run by the Department of Health? You'd have thought so, but they are not so sure.
- Is it run by the Board of NHS England? Do you know who is on the Board of NHS England and who appointed them?
- Is it run by your local Clinical Commissioning Group (CCG)? Do you even know what one of those is?
- Is it run by your local GP or your local hospital? Do you know how much freedom and flexibility they do and don't have in practice?
- Cuts that reduce the independence of disabled people are introduced by the Personal Independence Payment
- Lower incapacity benefits for people who can't work is renamed the Employment & Support Allowance
- Blaming families for poverty is handled by the Troubled Families Programme
"The US health care system has been subject to heated debate over the past decade, but one thing that has remained consistent is the level of performance, which has been ranked as the worst among industrialised nations for the fifth time, according to the 2014 Commonwealth Fund survey 2014. The UK ranked best with Switzerland following a close second."Promoting ACOs, by reference to organisations like Kaiser Permanente is a terrible example of cherry-picking. You take the best example of something and then pretend that you can easily replicate its benefits, despite the fact that it only provides cover to 3% of US citizens and has taken over 70 years to evolve. Innovation and efficiency in health care is not that easy. I do not mean to suggest that the NHS could not be improved. There are lots of practical ways it could be improved and there is a real need to empower patients, work better with local communities and end internal markets. But this won't happen because of another grand structural reform. What the NHS needs is constitutional protection to ensure that its basic structure is much harder to change. It is political interference and ongoing structural reform that has undermined meaningful innovation in the NHS. Changing structures at the whim of each incoming minister undermines leadership and the relationships of trust and security that enable more meaningful change and innovation. I would commend the position of the Socialist Health Association, the organisation who originally proposed the creation of the NHS in 1930. We need to get back to a strong national structure - and then bind Odysseus to the mast - make it really difficult for ministers to fiddle with that structure. Perhaps we could create a law that meant we need 75% of MPs to back any structural change to the NHS. Do you remember the story of the boy who 'cried wolf'? We have heard the claim that the NHS is threatened with privatisation many times; but the threat is real. The level of privatisation has increased and this next non-reform puts the NHS at even greater risk. The Government will continue to claim that the NHS is 'safe in their hands'. But if you did intend to privatise the NHS, then creating Accountable Care Organisations, bundling together all health services in large geographical areas, is exactly how you would begin.