Health Policy Insight
Healthcare management online analysis and intelligence
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The Maynard Doctrine

The Maynard Doctrine: Memo for Simon ‘Sir Galahad’ Stevens: a message from Merlin

Dear Sir Galahad,

Your noble intentions in pursuing the Holy Grail of increased productivity in the NHS have been noted. As you know, I am a ‘shape shifter’ (i.e. I can appear in a variety of forms). This has enabled me to attend covertly various meetings in Whitehall village and Quarry House, Leeds and listen to the often chaotic burblings and confused intentions of those in charge of NHS policymaking.

The cacophony (as you can imagine) has been considerable because the imminence of the election and the Stalinist efforts of the Coalition to curtail expressions of panic.

The Maynard Doctrine: NHS England And The Holy Grail (of NHS productivity gains)

Publish Date/Time: 
12/01/2014 - 15:53

Health economist Professor Alan Maynard gives a masterclass in the taxonomy of knights and productivity ruses

Sir Galahad (also known as Simon Stevens) is continuing his search for a means to bridge the £30 billion funding gap in NHS finances in period 2015-20.

The Maynard Doctrine: Sir Galahad Stevens' quest for the Holy Grail of increased NHS productivity

The NHS “is a triumphant example of the superiority of collective action and public initiative applied to a segment of society, where commercial principles are seen at their worst”
Aneurin Bevan, In Place of Fear, 1952, page 85

The Maynard Doctrine: Religion and the privates

Health economist Professor Alan Maynard explores the connections between religion and the privates

Competing religions
The Conservative-Liberal Democrat Coalition believes in small government, and has hacked public sector budgets in order to make the poor poorer and to undermine the social infrastructure.

The Maynard Doctrine: Simple Simon says

The new chief executive of the NHS in England is rightly challenging his one million plus employees. They consume £110 billion of scarce public resources providing care for a population exhibiting complex co-morbidities.

Patients are often poorly managed in a fragmented system of provision where unwarranted variation in practice and quality is the norm.

Doctors and evidence

The Maynard Doctrine: Defining low-value care - free lunches and the absence thereof

Health economist Professor Alan Maynard reports not on Lib Dem education policy, but on the latest outburst of magical policy thinking

“There’s no such thing as a free lunch”
Clinical commissioning groups are under continuous pressure from patient groups, clinicians and others to expand services. As a patient, I have great sympathy with such advocacy, provide it is evidence based of course.

The Maynard Doctrine: “In God we trust. All others bring data”

Health economist Professor Alan Maynard reviews mainstream healthcare reform strategies’ cyclical and unfocused nature, and suggests some potentially effective approaches instead.

The reluctance of managers and policymakers in public and private healthcare systems to use data and evidence is remarkable. In a world nominally governed by achievement of objectives such as efficiency, equity and expenditure control, decision-makers blunder around repeating the errors of yesteryear and usually being paid large salaries for their failures.

Policymaking by myopic politicians

The Maynard Doctrine: Table manners at the healthcare feast - advice for Simon Stevens

TOP SECRET
Briefing from Professor Nala Dranyam, Kroy University, People’s Republic of Yorkshire to the incoming Chief Executive of the NHS, Simon Stevens

TABLE MANNERS AT THE HEALTHCARE FEAST

Dear Comrade Simon

Welcome to the increasingly parsimonious healthcare feast. Following four years of austerity during which the NHS “ring fenced” budget has been raided twice to fund social care (£1bn in 2011-12 and planned £3bn in 2015-16), NHS activity and adherence to performance targets has survived quite well.

The Maynard Doctrine: Health policy delusions, supply-induced demand and sanity deficits

Health economist Professor Alan Maynard outlines the sanity deficits and supply-induced demand risks in current policy trends

Current NHS policy is founded on delusions about how the NHS is organised and how it can be improved. Have decision-makers gone mad or are they suffering ‘innovation’ diarrhoea induced by panic over austerity and continuous faith-based policymaking?

The Maynard Doctrine: It's the clinicians, stupid!

Health economist Professor Alan Maynard reflects on political learning and real reform

Fashions come and fashions go, but clinicians - primarily doctors - still largely determine what healthcare patients receive. They lead the teams that consume £107 billion of taxpayers’ hard-earned money a year. Their vagaries, waste and unwarranted clinical practice variations can determine your survival as much as their energy, humanity and efficiency.

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