Sunday, 23 August 2009

In the NHS QIPP is no joke

A busy weekend but not with the usual campaigning. Instead it was off to Bury in Lancashire to visit my in laws. My wife's grandma has been treated by the NHS and has received excellent care. It made me reflect. 10 years ago the NHS was on the ropes, a chronic lack of underinvestment made many to question the value of the service.

But now we have had many years of record spending in the NHS. Although not everything has been done right, most people would admit that the level of care has increased. It's done this on the back of massive increases in NHS spending over and above inflation. Post 2011, the NHS faces a return to the days of real terms stagnation, with settlements unlikely to go above inflation. That is the case under any potential government.

The NHS has been instructed by the government to look for efficiency savings and push money into prevention. It's little known QIPP programme (Quality, innovation, productivity and prevention) has instructed NHS Primary Care Organisations to look for savings in other areas to move money into Prevention. Essentially this means that some departments will have to make cuts. I hope for all our sakes that the NHS manages the leaner times better than the boom times.

As a non exec director of a Primary Care Organisation, I would say that it's important that politicians of all sides stop accusing the other of cutting the NHS and look carefully at how we can continue to increase patient care without it costing a lot more. A lot more difficult than throwing money at the problem. My preference and that of the Liberal Democrats is to decentralise the NHS and make it accountable to local people through local authority scrutiny. It is very top heavy at the moment, with the Strategic Health Authorities having a lot of power. That is a good idea in an NHS region with underperforming trusts but this is not the case in the NHS, where most of the hospitals and primary care organisations get good reports.

The policy I advocate opens up the potential for the NHS to be more responsive to local needs and to develop innovative solutions. But it does require local politicians to raise their game and for local people to hold them to account. It is infinitely superior in my view to the pseudo democracy of foundation trust boards. However, we must acknowledge that local choice means different service levels across areas and that fans of top down, lowest common denominator politics will start to scream "postcode lottery"!

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