Difficult times * 9

Just listening to the World at One.Some of the highlights following last night' defeat include Alex Salmond caling Labour stone age politicians in a computer age and saying that they no longer have activists but various hangers on.

Alistair Darling is wheeled out as the senior spokesman continuing the hype bole that the reason is the economy and that the party needs to do everything that it can to help the public face the economic hardships ahead.

Graham Stringer hints that a leadership election should now take place and urges the men in grey suits to talk to the PM and explain that the party needs a change of policies and that may mean a change of leader.

Lord Darzi meanwhile be lives that the parliamentary party has no stomach for a leadership contest but despite that Brown should leave on his own accord

Most worryingly though,Gordon Brown's appearance in front of the BBC cameras simply spent nearly three minutes repeating the phrases that he was guiding us through the tough times,he was here for the duration,that the country was best placed.Remarkably he managed to use the phrase "difficult times" 9 times

Darzai report is out.The question is will it work?

The much previewed Darzai review is out and there are no surprises in its recommendations.
Its biggest being the draft consitution that will give patients choice over the GP that they choose to see and the types of treatment available.Patients views on the quality of treatment that they recieve will effect the funding of the hospitals and GP's that they have seen and there is a right to request treatment in other European countries if faced with an "undue delay".

Responding for the opposition,Andrew Lansley claimed that ths was simply just another attempt at the failed "command and control" approach to the service.

Quality in the NHS depends on responding to patients needs. This will not be helped by, it will be impeded by top down policies and the command and control approach,....

The complete lack of vision in these proposals means that, sadly, the Government has missed its "once-in-a-generation opportunity" to enact the real reform that our NHS needs.

Nigel Hawkes writing on Timesonline says

Lord Darzi’s review sets quality of care first, and everything else a distant second. Almost all the detailed changes he proposes are designed to raise standards.
Doctors and hospitals will be measured by the quality of care they deliver, and rewarded accordingly. Patients will be asked their opinion, and other more specific outcome measures - such as how many patients die - will be used to determine just how good their care has really been.

For him though

At issue is whether the levers are strong enough to bring about change. The document assumes that quality improvement will have no victims. But better quality can only come about by chasing out bad: that means eliminating poor GPs, closing failing hospital services, or even entire hospitals. Otherwise there won’t be the money to reward the good.

The last chance for the public NHS

Lord Darzai's review of the NHS is due out today and will be showcased by the Prime Minister and the Health Secretary.

The latter has just been talking on the Today programme where he described the report as groundbreaking and one of the most important developments in the NHS sine it was founded 60 years ago.

Heralding local healthcare and patient choice as being its buliding blocks,it was good to see that Johnson recognises that there should be no blurring of the lines of demarcation between the private and public sectors.

Whether that happens remains to be seen and writing in this morning's Telegraph on what she calls the

heavily trailed that its publication today will be almost an afterthought,

Janet Daley says that

The days of central government being, for all intents and purposes, a monopoly provider of medical services are coming to an end. Not only because it has become economically unsustainable - the fruits of medical progress are coming too thick and fast to be within the reach of a service that is entirely tax-funded - but because the consequences of ideological purity have become absurd and inhumane

The paper also provides an opinion poll which shows that

Labour is no longer the party trusted to bring in the health reforms that are needed to safeguard the NHS for future generations,

Its leading article meanwhile says that

This morning's poll exposes deep anxieties about an institution that may be treasured by the public but which is also seen as wasteful, grossly inefficient and in desperate need of reform - not of more cash. Not for the first time, the politicians appear to be lagging behind public opinion.