Healthcare according to Boris
After a week of local elections and Boris’ victory in London, it seems that a blue wave is sweeping the country. Credo is generally apolitical, but we thought it may be fun to think about what healthcare would look like in a Boris-run future. In his manifesto, we saw a couple of ideas we actually liked – a stress on public health spending, and a rebuke for PCT cross-subsidisation.
An emphasis on public health
As we are based in London’s West End, we had more than a passing interest in the Ken and Boris show. Boris based his health manifesto on promoting a healthier London, and to try and cut the inequalities between the rich and poor. However, Boris has very little direct control over the healthcare budget, so how exactly is he hoping to achieve it?
Well, he can’t do much to be honest. But one core message stands out. His health campaign has concentrated on public health – especially in the promotion of preventative actions – and we think he has a good point.
Boris quotes the Wanless Report of 2004, which states that the NHS could save c.£30bn through more effective spending on public health. He also points to a huge inequality amongst London Boroughs on their level of spending on public health [see chart below] – Boris states that this is due to poorly performing PCTs that use public health money to help plug deficits elsewhere.
Source: www.backboris.com
Boris’ idea is a good one – he wants to ringfence public health spending to protect it from being used elsewhere.
We think the move towards more proactive preventative steps is right on the money. We have seen private providers like Nuffield Hospitals moving into the “well-being” arena – note their purchase of the Cannon’s gym chain as a start.
As the lines between primary and secondary continue to blur, a more joined-up approach to healthcare, linking prevention with cure, becomes more relevant.
Preventing cross-subsidisation will promote better practice
And we like the fact that Boris wants to stop PCTs moving funds around to shore up finances elsewhere. Although this may hurt PCTs in the short-term and could expose weakness, it will lead to a more effective commissioning arm. And that can only be a good thing for the sector in general.
What about polyclinics?
Interestingly, Boris’ health manifesto questioned whether the money required for Darzi’s polyclinics may be taken from public health spending. Although he doesn’t go so far as to condemn polyclinics outright, his statement provides further insight into continuing Conservative concerns about the move towards polyclinics. Opinion is quite evidently split on the Darzi reforms (see this CHN’s news for very different takes on Darzi’s plans). Mr. Cameron himself is a very vocal critic of polyclinics.
So it will be interesting to see how far down the polyclinics route we have travelled by the time of the next election. A policy U-turn would create uproar on the waste of resources to date – but could Cameron continue with a policy he has so far opposed?
We’ll put the crystal ball away. For now.
