An opportunity for localism in the NHS

Yesterday, in response to an earlier posting of mine, someone suggested that Cameron, and I "by inference", want to accept the NHS "more or less as is". Whilst I won't be so presumptuous as to speak for Cameron, nothing could be farther from the truth for me.

My starting point philosophically is not against change in the NHS, however what we must not do is follow the Blairite or Thatcherite route of applying policy based on high theoretical ends. The NHS is an operational unit, as such change must be controlled and measurable. As David Cameron said in his speech, we cannot take the approach of re-org after re-org with no time for bedding in of change. The NHS is not a project waiting to go live.

The funding decisions that have been made for the NHS in conjunction with rapid structural change have clearly not worked. Hospitals closing wards, redundancies and deficits, are not signs of a healthy organisation. Taking a short term approach to the problem whilst failing to address the cause for deficit in the long term is not a sensible approach to take. It's a hack, not a solution.

The first step to getting the NHS back on track is a removal of the political drivers that are found in targets. The operational effective of NHS services should be a matter for the people on the ground doing the work. It should not be driven by top-down targets which assume a one-size fits all requirement for health needs across the country. Locally set priorities for by local health professionals (not politicians) would be a step in the right direction.