Ministers show bad judgment on growth 21 September 2012 As the economy falters the government is not so much pursuing a comprehensive growth strategy as frantically searching for things to throw out of the basket before the balloon hits the ground. Local government controls are among the first objects to hand. Planning rules are a major target for the deregulators. But in their haste to stimulate economic activity ministers are ignoring the fact that planning is a great deal more than red tape. It is, in part, about conflict resolution – between competing strategic priorities when looking at the big picture, and about personal wellbeing when it comes to your neighbours plans for their house. Read the full article on the Guardian local government network __________________________________________________ Jeremy Hunt needs to shut some services 20 September 2012 As health secretary Jeremy Hunt struggles to get to grips with his new brief, it will become increasingly clear to him that the big issue he faces is shutting services. Lots of them. The evidence supporting the case for widespread reconfiguration of services keeps piling up. Just in the last few days Dr Hilary Cass, president of the Royal College of Paediatrics and Child Health, used a fascinating interview with the Guardian's Denis Campbell to point out that it simply isn't safe, let alone financially viable, to maintain the current 218 children's inpatient units. Poor quality in some of these centres appears to be contributing to the UK's high child mortality rate. Read the full article on the Guardian healthcare network __________________________________________________ Can doctors trust Hunt with the NHS? 7 September 2012 Jeremy Hunt’s first steps as health secretary for England were inelegant. He tripped this week over a parliamentary early day motion that he had signed five years ago supporting homeopathic hospitals and also a letter to a constituent supporting homeopathy. The Department of Health claimed that his views had “moved on,” but it is a stumbling start that will focus attention on whether he bases his decisions on evidence. As one prominent medical figure put it: “This has attracted considerable comment. He needs to remember doctors are scientists. There is now considerable scepticism [about him], and he will have to prove himself.” Read the full article at the British Medical Journal __________________________________________________ Pickles guerrilla warfare continues 7 September 2012 While Eric Pickles retains his grip on the Department for Communities and Local Government, changes in the ministerial foothills could influence the coalition's approach to councils. Greg Clark goes to the Treasury but keeps his cities minister role as well as being involved in economic policy. This presents an opportunity for cities to push themselves towards the centre of government thinking on how to stimulate and restructure the economy. Clark appeared energised by the potential of cities, and his city deals have been one of the most significant developments in local government under the coalition. Read the full article on the Guardian local government network __________________________________________________ Lansley had to go - what’s left for Hunt? 6 September 2012 There should be no sentiment about Andrew Lansley's departure as health secretary, no matter how hard he worked, how gutted he is to lose the Tory health brief after nine years or how much he cared about the health service. By every measure of high political office, he was a disaster and he deserved to be sacked. As a strategist, he failed to look for the most pragmatic way to achieve his desired outcome. He simply would not recognise that taking a wrecking ball to NHS structures – at a time of intense financial stress, rising demand and the necessity for widespread changes to clinical practice – was foolish. He compounded this mistake by imposing a structure that resembles a London tube map. Compare that with Michael Gove's pragmatic approach of bending the existing academy programme to his will. Read the full article on the Guardian healthcare network __________________________________________________ The good, bad and ugly of local politics 24 August 2012 The big three parties are as dominant as ever in local politics. According to the Elections Centre at Plymouth University, independents and small parties such as the Greens and the UK Independence party have been putting up more candidates and therefore securing a bigger proportion of the vote, but the first- past-the-post voting system means they get scant reward in terms of seats. In 2011, for example, the Green party received 3.6% of the vote but only 0.8% of the seats. Councillors matter to the national parties both as a barometer of support and as the foot soldiers for the general election campaign; several years of being drubbed in local elections destroys morale and means many local activists and defeated councillors simply fail to turn up to do the hard work. Read the full article on the Guardian local government network __________________________________________________ NHS overseas could be good for patients 23 August 2012 The government's announcement of a renewed push to market the NHS abroad could help improve patient care in the UK – but there are risks. The Department of Health (DH) and UK Trade and Investment want more leading hospitals to follow the example of world renowned institutions such as Moorfields eye hospital and Great Ormond Street children's hospital by establishing franchises abroad. The move was welcomed with unrestrained enthusiasm by the NHS Confederation, which believes the health service could secure a slice of the estimated £2.5 trillion global healthcare industry and reinvest the money at home. But the Patients Association fears it would be a distraction from implementing the government's health reforms and finding £20bn of productivity gains. Read the full article on the Guardian healthcare network __________________________________________________ The tough lessons from Winterbourne 9 August 2012 The serious case review of the Winterbourne View hospital scandal has powerful messages for commissioners and providers of care in the reformed NHS. The findings of the independent review conducted for South Gloucestershire council's adult safeguarding board are reminiscent of child abuse investigations in the 1980s and 1990s – overlapping authorities failing to spot warning signs or share evidence. Even without witnessing the abuse taking place in the hospital, there were warning signs of poor care in NHS records. For example, patients ended up in A&E on 78 occasions, but there was no alert system in place to tell clinical staff about previous visits, so any evidence of a pattern of poor care was lost. Over three years there were 29 police contacts with the hospital and they successfully prosecuted a member of staff, while the council had received 40 safeguarding alerts. Read the full article on the Guardian healthcare network __________________________________________________ Is a Frome flash mob localism’s future? 3 August 2012 A flash mob? Soaring election turnout? Guerrilla tactics? Welcome to local democracy, Frome style. It has important lessons for other councils. Frome in Somerset is one of those west country market towns whose attractiveness to the passing visitor masks significant disparities in wealth and opportunity. In January 2011 five locals, frustrated with the town council, set up Independents for Frome. They put a letter in a local newspaper announcing a meeting in a pub and were stunned when 86 people turned up. Their leader is Mel Usher, former chief executive of South Somerset district council and the first executive director of the Improvement and Development Agency (which was an autonomous arm of the Local Government Association) from 1998 until 2002. Read the full article on the Guardian local government network __________________________________________________ Are junior doctors a burden or asset? 26 July 2012 Junior doctors are often more associated with increasing death rates than raising standards in the public's mind, and have seemed more tolerated than embraced. But attitudes towards this vital and substantial section of the NHS workforce are changing. As the next intake of junior doctors prepare to take their first steps on the ward in August, the General Medical Council has published its annual survey of UK doctors in postgraduate training. With more than 51,000 of the 54,000 eligible doctors responding, it could hardly be more authoritative. While there was a high degree of satisfaction with much of their training, around one in 20 raised concerns about patient safety. Acute services accounted for many of these problems, which the GMC said may indicate "some significant issues across the UK". Read the full article on the Guardian healthcare network __________________________________________________ True impact of spending cuts revealed 20 July 2012 Government figures published this week reveal the true impact on local government services of two years of cuts. On Wednesday, the Department for Communities and Local Government and public sector accountancy body, the Chartered Institute of Public Finance and Accountancy, which seems to have a remarkably low profile considering the intensity of debate around the management of public money, revealed that local authority spending this year will fall below that for 2007-08. Total service expenditure by local authorities in England is estimated to fall by 4.8% this year to £94.7bn. Last year, spending fell by 5.7% to £99.5bn. Average spending for each person this year will be £1,814, a reduction of £238 a person compared with the spending peak in 2010-11 of £2,052. Planning and development has been clobbered the hardest, down almost a third last year and almost 8% this year. Highways and transport is not far behind, down 20.7% last year and another 5.9% this year – figures which need to be seen in the context of increasing damage from extreme weather and a worrying rise in road deaths after several years of decline. Read the full article on the Guardian local government network __________________________________________________ Mandate balances control and freedom 12 July 2012 The publication of the government's draft mandate for the NHS is big news for managers and clinicians. It sets out the priorities for the NHS Commissioning Board for the next two years and beyond. What is in the final version and how the board delivers it will have a profound impact on the culture and practice of the new NHS. Until now the key NHS document has been the annual operating framework, the embodiment of the command and control culture which spells out the targets, priorities and rules NHS bodies must follow. The mandate is intended to be more long-term than the operating framework has been, promising stability rather than lurching from priority to priority as the political winds change. Read the full article on the Guardian healthcare network __________________________________________________ Councils are doomed, so what do we do? 6 July 2012 We're doomed. It's official. The Local Government Association's dryly titled Funding Outlook for Councils from 2010/11 to 2019/20, launched last week, shows that eight years from now there will be little money to spend on anything apart from social care and waste. So what is to be done? The LGA paper should be read by all local government managers and politicians. It is an impressive analysis of both the prognosis for long-term funding and the implications for public policy. The response to the document by communities secretary Eric Pickles is noteworthy for what he did not say as well as what he did. In his speech to the LGA's annual conference he did not accuse the LGA of shroud-waving – the optimistic assumptions on efficiency savings and income underpinning the projections rendered such an accusation untenable. Read the full article on the Guardian local government network __________________________________________________