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The Maynard Doctrine: Professions, guilds and silos

Professor Alan Maynard OBE torches a Spaghetti Junction of bridges with the professions. The RCN in particular will be very fond of him for this …

There is a proliferation of professions in healthcare and as George Bernard Shaw emphasised, these institutions are “a conspiracy against the laity”.

The Maynard Doctrine: Boomerang health policy: what goes around, comes around

Professor Alan Maynard OBE admires the Buddhist nature of NHS reform. The wheel turns and civilisations rise; the wheel turns, and civilisations fall …

Health policymakers continue to rediscover ancient and well-researched problems, and to repeat the redisorganisational mistakes of yesteryear.

In part, this is due to a failure to distinguish between organisational structures; processes of care (or outputs); and patient outcomes - i.e. the rather important question, ‘did we make the patient better’?

The Maynard Doctrine: pre-electoral questions about NHS spending

Professor Alan Maynard OBE casts a critical eye over the information divulged by the Health Select Committee. Medical unemployment; nurse substitution for GPs; and the delivery of real efficiency increases; and management consultancy spend all come under acerbic review.

Recently, the Select Committee on Health of the House of Commons published its annual report on Public Expenditure. This sets out DH responses to Select Committee written questions, and is a goldmine of extraordinary information.

The Maynard Doctrine: Saving money to save the NHS

Professor Alan Maynard OBE looks at the upward drivers on healthcare demand, and predicts some patterns of probable NHS behaviour in response

The fate of healthcare funding and the NHS is unclear. Despite the rhetoric of decades, there is little evidence that community care is cheaper or more efficient. With patient demand for care continuing to increase, community care may be no solution.

The usual explanations of increased patient demand are technology, an ageing society and patient expectations. Let’s review each of these.

Worthy innovation?

The Maynard Doctrine : Time to reform Clinical Excellence Awards!

Professor Alan Maynard OBE proposes changes to the vexed and vexing system of Clinical Excellence Awards.

The NHS is facing severe financial problems and the Department of Health requires the service to save and re-cycle £15-20 billion over the next three years.

At the same time as this edict from the Department of Stealth is being implemented, hospitals and PCTs across the country have been given their annual earmarked funding to finance clinical excellence awards (CEA).

The Maynard Doctrine: The party’s over …

The party’s over: it is time to call it a day. After 60 years, there is a rising tide of attention being paid to changing clinical behaviour and measuring whether healthcare actually benefits the patient.

After a decade of generous indulgence with the Blair bonanza of increased NHS funding, the government has returned to that Thatcherite theme of demonstrable “value for money”. This change is occasioned not only by the recession (which shows little sign of reversing), but also by concerns about public sector productivity.

The Maynard Doctrine - Conservative health policies: signs of confusion?

Professor Alan Maynard OBE reviews the consistency and coherence of recent pronouncements on Conservative health policy.

In a recent speech, leader of the Conservative Party David Cameron spelt out his views on NHS policy. He said:

The Maynard Doctrine: The faithful following the foolish - blundering on into parsimony

Professor Alan Maynard OBE dissects the NHS and politicians’ approach to financially straitened times ahead.

The NHS is about to have a severe financial crisis due to bankers undermining the economy. The costs of our banking bail-out continue to escalate. The UK economy remains reluctant to return to 2007-08 levels of national income and growth.

But has the NHS really got this message yet?

Flat cash

The Maynard Doctrine: QIPP - the sound of panic, or a belated vital sign of intelligent life?

Professor Alan Maynard OBE looks through the prism of QIPP at the NHS's task to avoid becoming heir to Royal Mail's strikes preceding privatisation. His solutions include a primary care-led A&E; turning the noun 'collaborator' into a positive; and the Kwik-Fit hospital.

QIPP: the policy announced in David Nicholson's August 2009 “need to know“ letter to Chief Executives as a follow-up to Ara Darzi's “Next Stage Review”: Quality Innovation Productivity and Prevention (or backing all horses in the hope that one will cross the finishing line!)

The Maynard Doctrine: How do you encourage a crab?

Professor Alan Maynard OBE reflects on the true crisis in NHS dentistry - PCTs' lack of teeth

Policymaking in Whitehall Village is like watching a crab traverse the beach: it is slow, and you despair of it ever getting there. As you think it is getting there, it is engulfed by a wave of nonsense which sets it back to from where it started.

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