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The 2020 Public Services Trust Blog

Friday, May 29, 2009

Health-Check for a Responsible Britain

By Henry Kippin

The RSA hosted a packed lecture yesterday from Andrew Lansley, Shadow Secretary of State for Health.  He talked on the subject of ‘Improving Health Outcomes for All’, sketching out a blueprint for a future Conservative Party policy agenda. 


Overarching themes were ‘responsiblity’, ‘reform not reorganisation’, ‘choice and empowerment’ and ‘efficiency’.  Some were better explained than others.  Anyway, here are my quick reflections on the main points:   


Empowering Frontline Professionals

The Shadow Secretary placed considerable emphasis on the need to empower frontline professionals – the most obvious example being GPs who, under Conservative plans, would be far stronger guardians of quality control, holding hospitals (for example) to account.  Questions here concern potential variation in service levels, and the potential capacity of GPs.      


From Targets to Outcomes

This shift of responsibility downwards would be representative of a broader move towards an outcomes-driven approach to public services.  Mr Lansley was unequivocal about the need to do away with top-down ‘tick box’ targets, and towards broad public health outcomes.  But as Matthew Taylor notes, one danger is that broad outcomes can simply become umbrellas for ‘proxy targets’.  And some targets may be necessary - does the Shadow Secretary’s position risk throwing the baby out with the bathwater?


Choice & Competition

The Shadow Secretary talked about the need for more and better in this area, as a means to make essential efficiency savings, and to drive up quality. There is broadly consensus across parties on this.  But this will be contingent upon…


Access to Information

The lecture set out access to good quality, comprehensive information as key to making a choice agenda work.  But as my colleague Matt Grist pointed out, Robert Shiller and even George Osborne have recently spoken on the need to get past the assumption of rational, economic decision-makers.  I can’t help feeling that more thought needs to be given to appropriate choice architecture in this area. 


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Posted by Henry Kippin at 2:41 pm
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