Daily Insight: The devo is in the detail

The self-declared King of the North, Andy Burnham, used to oppose giving local areas more control over NHS services, once claiming this could be a “further break-up of the idea of a National Health Service”.

Since leaving Westminster, the Greater Manchester mayor has become an enthusiastic advocate for more devolution, including as co-chair of a commission looking at the issue.

The commission, which includes cross-party former health ministers, has called for a cull of targets and for more local flexibility for ICSs – a sentiment in line with Patricia Hewitt’s ongoing review.

Speaking at the launch event, Northamptonshire Integrated Care System chair Naomi Eisenstadt – who had a long career outside the NHS advising governments on inequality – suggested this should go further.

Ms Eisenstadt said: “I think we haven’t paid enough attention to the incentives in career structures of managers within the health service, because the problem is their next promotion is based on what NHS England thinks of them, not what I think of them.”

And one senior councillor, David Fothergill, had a controversial take on how to measure ICSs’ success: “It will be when they fully understand they are accountable to their local population and not to the regional NHS structures.”

Taskforce assembles

Ministers announced with much fanfare that the government has set up a new taskforce to focus on how the NHS can better utilise the private sector.

The Department of Health and Social Care statement said the taskforce’s first meeting would take place at Number 10, and it’s understood it was set up under the orders of prime minister Rishi Sunak.

The Daily Telegraph reported the aim was for it to “emulate the success of the covid vaccine taskforce in deploying the private sector to speed up reform”.

So, who is on this “turbo-charging” taskforce? The release said it would be chaired by junior health minister Will Quince but gave no other names.

HSJ was first to report that the group would include NHSE’s elective national director Sir Jim Mackey, elective clinical national director professor Tim Briggs, and national clinical adviser Roberto Tamsanguan.

It also includes Independent Healthcare Providers Network chief executive David Hare; representation from private firm Circle, and Darshak Shah, managing director at specialist private eye care services provider Newmedica.

These are of course broadly the same people already in charge of trying to drive up private sector activity.

But, hopefully, bringing them together in close proximity to the PM will help concentrate minds and finally shift the dial on the NHS’s underutisation of the private sector, a problem which has been allowed to drift for too long.

The proof of the pudding will as ever be in the eating.