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The Maynard Doctrine

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

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


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.

The Maynard Doctrine: A guide to the bollocksfest of NHS management jargon

Health economist Professor Alan Maynard turns his attention to the beautiful world of NHS management jargon

The ways in which NHS staff communicate with each other and the public are a wonder to behold! There is redundant use of adjectives to emphasise perfectly adequate nouns … and then there are phrases which are mis-speaking, misleading or just vacuous.

The latter are charitably collectively known as ‘jargon’. Less charitably, they are known as ‘bollocks’.

The Maynard Doctrine: What to do with “Big Pharma”?

Health economist Professor Alan Maynard examines the ills of Big Pharma, and offers his own prescriptions for improvement.

Big Pharma is struggling, and with a continuing history of naughtiness involving greed and corruption, its critics are out for blood.

The Maynard Doctrine: A leak from Lynton on policy and strategy

Health economist Professor Alan Maynard has received a wholly-authentic leak from a well-known political strategist to a well-known Jeremy. We publish it here in blatant defiance of the Data Protection Act.

NHS Downing Street briefing

Top secret: for your eyes only

Dear Jeremy,

Dave asked me to brief you on what he would like done with the National Health Service. As ever, and certainly until after we are re-elected in 2015 with a majority, the party line is that we are the heroic defenders of the NHS.

The Maynard Doctrine: Are policymakers and politicians stupid, ignorant, or both?

Health economist Professor Alan Maynard looks at NHS reform plans from 1974, and finds that all too little has changed.

An appraisal of the history of NHS reform since 1974 shows a naïve belief that altering organisational structures will improve the processes of healthcare and benefit patients in terms of their outcomes: i.e. improve their length and quality of life.

The links between structure, process and outcome are assumed, with reformers asserting unevaluated and un-evidenced conclusions from their repetitive and learning-light organisational reforms.

The Maynard Doctrine: The harsh reality of NHS reform: time to end the purchaser-provider split

Health economist Professor Alan Maynard suggests we need radical reform: end two decades of policy failure and let purchasers merge with providers

The Health and Social Care Act 2012 has created a plethora of new bureaucracies, whilst undermining collective memory about past decision-making by retiring and making redundant many effective managers.

The Maynard Doctrine: Cautionary policymaking tales

Publish Date/Time: 
03/05/2013 - 14:19

Health economist Professor Alan Maynard skewers the policy commissariat

“We know it’s stupid, but it is policy” said the Department of Health civil servant as the Secretary of State (SoS) left the room.

“But why don’t you tell Jeremy that it’s stupid?”

“Don’t worry we have but he just smiles, congratulates us on our insightful support and ignores us. It was, with varying degrees, ever thus!”

The Maynard Doctrine: Why are managers so dumb?

Health economist Professor Alan Maynard queries why healthcare managers appear unwilling or unable to learn from history and evidence.

Non-clinical managers and their medical colleagues appear to be dumb, as defined by their failure to learn from history and evidence. For this dumbness, they are highly paid and continue to manage the delivery of care characterised by variations in process, cost and outcomes that damages patients and taxpayers.


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