Wednesday, 4 May 2011




Sunday, 23 September 2007

David Cameron on the NHS

This time last year I had a simple message for our Party Conference. I said I could explain my personal priority not in three words, as Tony Blair once did, but in three letters: NHS.

Since then, we have been translating that commitment into action.

Over the Spring and Summer, we campaigned with junior doctors who have been let down disgracefully by the shambles of their new medical training programme.

We have published the report from the Public Services Policy Group, and Andrew Lansley’s NHS White Paper – both of which contained specific proposals to improve the NHS.

And in August we stepped up our campaign over the future of district general hospitals.

No one should be under any illusion on the scale of closures and cut-backs the NHS faces. At least 29 hospitals face the closure or downgrading of either maternity units or A&E units - or, in some cases, both. Gordon Brown’s new health minister, Lord Darzi, has said that “the days of the district general hospital are over.”

Yet where is the evidence to support such an approach?

In the case of A&E, only 2 per cent of attendances need the highest level of specialist care. These cases should either be taken straight to a specialist centre or stabilised at a local A&E and then transferred.

Downgrading the local A&E unit won’t help these people. And it will mean that the other 98 per cent of attendances will have to travel further.

Yet recent research demonstrated that every extra six miles a patient has to travel to an A&E unit adds one per cent to the chance that they will die before reaching hospital.

In the case of maternity units, the Government can point to no clear published evidence to suggest that small consultant-led units have worse outcomes than larger units. Indeed, many parents opt for smaller units, because they appreciate what can often be a calmer atmosphere and more personal service.

This is presumably why some ministers appeared on picket lines claiming they were trying to help “save” their own local services – from themselves.

It is little wonder that even Gordon Brown’s own health adviser, Derek Wanless, recently questioned the Government’s approach on hospital reconfiguration – saying “question marks remain” over the “robustness” of the evidence it is using.

I think two factors are really behind these cutbacks.

The first is the dire financial situation in which many hospitals now find themselves – not through their own mismanagement, but as a result of the poorly negotiated GP and consultant contracts, the botched NHS computer, the Government’s endless costly reorganisations, and the red tape which results from Gordon Brown’s target regime.

Quite simply, local health services are paying the price for central government incompetence.

The second driver of these reconfigurations arises from the way doctors are trained, and the requirements of the EU Working Time Directive. In my view these are not legitimate reasons to cut local services.

We have set out five steps to stop the cuts.

First, there should be an immediate moratorium on closures to allow breathing space for the right changes to be put in place.

Next, we should scrap the top-down targets that have added so much cost to local NHS services.

Third, it is time for the Government to take action and delay implementation of the Working Time Directive, as it is permitted to do, and seek to amend the Directive so that it affects the NHS no more adversely than the majority of other European health care systems - as it has tried, but failed, to do.

We need to put GPs in the driving seat of the NHS, commissioning care on behalf of their patients - and thereby ensuring that services are driven by their needs rather than by the diktats of central government.

Finally, we need to give real freedom to hospitals and their clinicians to determine how to deliver services, including allowing them to work with colleagues in neighbouring hospitals to provide the relevant specialisms.

These steps illustrate the simple divide between the parties.

On the one hand, there is Labour’s top-down central control, seen in the blueprints for hospital reorganisation which they continue to impose from on high.

On the other, there is our tangible commitment to real devolution – seen in our commitment to empower GPs.

The NHS will be a vital issue at the next election. And, as in so many areas, there is a battle between Labour’s belief in state control, and the social responsibility and devolution of power which lies at the heart of the modern Conservative approach.

This is a battle we can and must win

Monday, 3 September 2007

Half of GPs condemn Labour performance

Almost half of UK GPs believe the Labour government's performance has been poor or very poor, according to a GP survey.

GP Magazine says

We all know the NHS has not fully utilised the huge increase in expenditure it has been given. Why is this?

It is easy to be critical but what are health professionals doing about it?

Thursday, 12 July 2007

Public Health Meeting

This week the Conservative Medical Society hosted an excellent meeting on Public Health-Changing Behaviour, the principles, practice and policies.

Prof Martin McKee from the London School of Hygiene and Tropical Medicine spoke on the "principles of public health"

Prof Robert West from Cancer Research UK Health Behaviour Unit spoke on the "practice of public health"

Andrew Lansley MP Shadow secretary of State for health spoke about Conservative Party policies on Public Health.

We were left in no doubt that changing public behaviour in regard to healthly lifestyles is important but represents a significant challenge for clinicians and politicians. Nevertheless it is essential if health care costs are going to be contained in the future.

The Conservative Party have just completed a consultation exercise on Public Health the results of which will be published shortly.

The CMS encourages debate and is independent of the Conservative Party. Yours views are welcome

Sunday, 25 March 2007


Following pressure by a number of different sources including David Cameron and Andrew Lansley MTAS application system for junior doctors system is being changed. Juniors will now be given a fairer chance by being able to submit their CV and having the guarantee of at least one interview. It is a pity that the fiasco was allowed to happen


Building on last week’s announcement, at a minimum, every long list able applicant who applied through MTAS and meets the eligibility criteria for their relevant specialty will be invited for an interview. Under this guaranteed interview scheme, candidates will be able to choose which of their preferences to be interviewed for in light of geographic specialty-specific and ST level-specific competition ratios which will be available on the MTAS website. We are in discussion about the implications
of this for the timetable.

The recruitment system has worked satisfactorily for General Practice and this will continue. In other specialities, there is evidence that the shortlisting process was weakand we will therefore eliminate this part of the process immediately. In contrast, the interview process has been working and therefore the revised approach will ensure that all long listable candidates will be interviewed. The Review Group believes that this new approach is the most equitable and practical solution available. The Group also recognises the enormous effort by the consultants, service and deans that has already taken place to ensure that the interview process has worked. The time and effort required for further interviews is recognised by the service and the time required will be made available. Therefore first choice interviews that have already taken place should not need to be repeated.

In accordance with the advice already issued, we reiterate that all interviews will be informed by the use of CVs and portfolios and probing questions.

In broad terms, this means that all eligible applicants at every stage of their training, whether or not they have already had interviews or interview offers, will be able to review their stated first choice preference and have the opportunity to select the one for which they want to be interviewed.

We will be discussing operational details over the next week and these may differ between specialties and between different parts of the UK dependent on local circumstances. We will also consult widely. Exact details for how applicants will be able to do this will be available week commencing 2 April on the MMC website at In the meantime, interviews will continue and applicants should attend unless they are confident that this will not be their preferred choice.

No job offers will be made until all these interviews have taken place. Discussions are taking place on the implications of this for the filling of General Practice training places. We expect that the majority of training places will be filled through these interviews. Unfilled vacancies will be filled through further interviews.

The Review Group has recommended the development of a programme of career support for applicants at all stages of the process. Further details to support applicants, deans and selectors through this process will be available next week on the MMC website. Future work will explore what the possibilities might be for doctors to change specialties.

Professor Neil Douglas

Sunday, 18 March 2007

Job Selection Shambles


"Yesterday I spoke to 12,000 junior doctors in London. I was joined by Shadow Health Secretary Andrew Lansley and we also heard from some of the junior doctors who are affected by the current online application system - it really is a shambles"

Listen to more on webcameron

Wednesday, 14 March 2007

The first centre-right, independent, stand-alone, web-based Think Tank for health and social care was launched on 1 October 2006. was partly inspired by some CMS members wanting to enable all professionals the opportunity to get involved in thinking on health and social care. It is also unique among think-tanks in wanting to form policy proposals from the grass-roots up, giving professionals the chance to have their voice, experience and ideas heard and valued.

Led by professionals, central to the work is the building of a nationwide network of people working at all levels in the professions who want to be involved in thinking about, developing or commenting on the policy that they may well one day have to deliver.

The website enables everyone to contribute, but when people actually register on the site as Partners, this enables 2020health to contact them on in relation to their specific areas of interest and experience.

"Already we are looking at major issues of Public Health, Dentistry, NICE and the interface of science and health" says Director, Julia Manning. "It is really exciting to be able involve professionals at all levels. We have pledged too that as we develop policy ideas we will get responses from the Policy makers so there is ongoing communication with all those working with us."

Please do visit the site and register your details. If you have any queries you can contact Julia through