JiscMail Logo
Email discussion lists for the UK Education and Research communities

Help for AAHPN Archives


AAHPN Archives

AAHPN Archives


AAHPN@JISCMAIL.AC.UK


View:

Message:

[

First

|

Previous

|

Next

|

Last

]

By Topic:

[

First

|

Previous

|

Next

|

Last

]

By Author:

[

First

|

Previous

|

Next

|

Last

]

Font:

Proportional Font

LISTSERV Archives

LISTSERV Archives

AAHPN Home

AAHPN Home

AAHPN  May 2012

AAHPN May 2012

Options

Subscribe or Unsubscribe

Subscribe or Unsubscribe

Log In

Log In

Get Password

Get Password

Subject:

'integrated care'

From:

Calum Paton <[log in to unmask]>

Reply-To:

Calum Paton <[log in to unmask]>

Date:

Tue, 22 May 2012 17:37:16 +0100

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (37 lines)

Chris,

No offence - was having fun being Mr. Grumpy.

Re the serious debate: I do feel strongly that the health reform
industry in England has (what's the quote from Harold Wilson) taken
minutes* and wasted years.

(*in this case, produced myriads of policy changes in
cyclical and indeed circular direction of travel)

I know you can have 'integrated care' in a market context, or shall we say
in a 'post-purchaser/provider split' politics. Competing HMOs/Enthoven's
original model of managed competition (for Bismarck rather than Beveridge
contexts): in England, citizens could choose among 'HMOs' ie
commissioner/provider organisations with no geographical catchment basis as
PCTs/CCGs had/have.....OR.....HAs/ PCTs/CCGs could be the
purchaser/commissioner choosing among 'integrated care organizations' ie the
citizen is still with the geographical purchaser, which chooses among
different 'integrated' providers.

But to me these are Heath Robinson-esque, tortuous means of ticking the
'market' box. This is done either on the grounds of ideology or out of
pragmatism (ie Old Tory/ New Labour/Coalition neo-liberalism is the only
show in town) ....OR on the grounds that integrated care without competition
is bound to lead to what Simon Stevens calls doctors colluding behind the
bike-sheds.

But the 'empirical' question then becomes: is 21 years of market economics
moderated by 'garbage-can' (Cohen, March and Olsen) politics more
efficient/effective than a planned, integrated health service with
appropriate targets and outcome criteria?  Put it another way: if all the
investment' in commissioning/the market/whatever had been applied instead to
improving and integrating a non-market NHS, would we have got just as much
benefit or more?

Best, Calum

Top of Message | Previous Page | Permalink

JISCMail Tools


RSS Feeds and Sharing


Advanced Options


Archives

April 2014
March 2014
February 2014
January 2014
December 2013
November 2013
October 2013
September 2013
August 2013
July 2013
June 2013
May 2013
April 2013
March 2013
February 2013
January 2013
December 2012
November 2012
October 2012
September 2012
August 2012
July 2012
June 2012
May 2012
April 2012
March 2012
February 2012
January 2012
December 2011
November 2011
October 2011
September 2011
August 2011
July 2011
June 2011
May 2011
April 2011
March 2011
February 2011
January 2011
December 2010
November 2010
October 2010
September 2010
August 2010
July 2010
June 2010
May 2010
April 2010
March 2010
February 2010
January 2010
December 2009
November 2009
October 2009
September 2009
August 2009
July 2009
June 2009
May 2009
April 2009
March 2009
February 2009
January 2009
December 2008
November 2008
October 2008
September 2008


WWW.JISCMAIL.AC.UK

Secured by F-Secure Anti-Virus CataList Email List Search Powered by the LISTSERV Email List Manager