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Editorial Thursday 18 October 2012: The Bellflinger gets an adviser - Sam Talbot Rice

Health Service Journal breaks the story that Health Secretary Jeremy 'Bellflinger' Hunt has appointed a policy and political special adviser, Sam Talbot Rice.


Click here for details of 'Lansleyshambles - game over, as Jeremy ‘Bellflnger’ Hunt does the reconfiguration hokey-cokey', the new issue of subscription-based Health Policy Intelligence.


Talbot Rice is currently head of communications for has a health presence in Africa.

Talbot Rice was previously head of research at the PR company The Open Road's pre-election document 'Cameron's Conservatives' guide thus:

"The young and very bright Head of Research at the Centre for Policy Studies has interests across public services reform from faith schools to the BBC. Keeps a lively blog on the Telegraph. Likely to advise the Cabinet Office".


The Centre for Policy Studies was "established in 1974 by Sir Keith Joseph and Margaret Thatcher, it aimed to ‘think the unthinkable’ with regard to public policy".


This recent blog by the CPS's current health policy lead cites their work showing that NHS productivity has fallen by 34% since 1995.

Which is balls, as the Audit Commission's latest NHS productivity study shows. Previous years' 'More For Less' Audit Commission documents have suggested some productivity decline, as would be expected in any system which had its budget more than doubled and staffing increased hugely.

The Office for National Statistics suggests that there was a decrease of 3.3 per cent in overall productivity between 1995 and 2008.

And Professor Nick Black's Lancet study from this February suggested that even these modest metrics are wrong.

That recent CPS blog was, of course, not Talbot Rice's work. Perhaps he disagrees with such analysis?

No he doesn't - or at least he didn't. In 2009, Talbot Rice wrote for Public Service about the 'database state', warning "If the past 12 years have taught us anything it is that vast spending increases coupled with centralised command and control-style management do not achieve improvements proportionate to the cost nor do they bring greater satisfaction among taxpayers. After all, we can hardly be satisfied with a system that has given us falling productivity in the health service, despite a doubling in the NHS annual budget".

Interestingly, all the links to his blogs for the CPS and the Telegraph no longer work.

The acknowledgements to Talbot Rice's co-authored 'School Quangos: A Blueprint For Abolition And Reform' publication for CPS state that "Before joining the CPS, he was a Policy Adviser in the Conservative Research Department, and a Researcher to two front-bench MPs".

His role Lord Ashcroft's 'war room' for the 2007 general election that never was campaign can be seen at Section 3 in this Guardian link.

Talbot Rice's above-mentioned 2009 article for Public Service concludes, "If we are going to move into what David Cameron has termed the post-bureaucratic age, we will need to think not just in terms of the percentage of GDP spent by the state, but also about the fundamental balance in the relationships of government, the individual, communities and businesses.

"The idea that Whitehall knows best has been under attack for many years, but it is only now that we have the tools to achieve the much-promised, but rarely delivered, decentralisation of power. Indeed, true localism – with proper local accountability – will only be possible if voters have access to the information, whether it is crime maps or hospital infection rates, they need to make meaningful choices and hold those in power to account".

This is interesting stuff, but the evidence that the current NHS reforms are decentralising powers is not very clear at all.

Indeed, prominent advocate of clinical commissioning Dr James Kingsland yesterday told the Westminster Health Forum (according to Pulse) that "we have lost enough [management], probably too much and we need to make sure that the NHS management we have are such that their role is so vital in the redesign of care. Whilst GPs need to be involved in the analysis and the needs assessment of how to secure the best services, we do not expect them to do procurement and contract management - we need NHS managers to do that. We need the right expertise in the right area".