Cooperation and creativity in the NHS | Letters

Readers discuss accountable care systems, health co-ops, hospital real estate and the benefits of regional planning

The gist of Polly Toynbee’s argument is obviously right (The NHS needs cooperation, not competition, to pull through, 19 February). She may not, however, know that here in Cornwall there is an effort being made to introduce an accountable care “system” (ie not “organisation”), which reassuringly does boil down to the sort of integrated care partnership that she and the King’s Fund promote. But there is still vociferous opposition to the plan from local activists and from some doctors, clearly because of the fear of privatisation. I can see that this unnerves local politicians, who fear that they will be stuck with doing their own NHS rationing if it goes through. You just can’t win.

All of us who have followed NHS policy and practice over recent decades must wake up to the fact that the NHS is now a monster: neither smart chief executives nor driven politicians have found it possible to manage as a single entity. It was actually impossible to do this when Aneurin Bevan said he wanted to hear the sound of a bed pan being dropped; and we are still stuck with that centralising mentality.

Continue reading... February 25, 2018 at 11:18PM