The Week

The Week, 3 February 2023

India Woodward
Senior Events and Fundraising Officer

Regular readers of The Week will know one of Reform’s pet peeves is short-termism. This week, for once, we are able to celebrate some wins for long-termism.

Today the Department of Health and Social Care published its “inaugural” Medical Technology Strategy which builds on last year’s Life Sciences Vision. The aim of the strategy? “Delivery of high-quality care, outstanding patient safety and excellent patient outcomes in a way that makes best use of taxpayer money.” Tick. Tick. Tick.

The strategy shows we are learning from the pandemic, as it promotes channelling innovation towards protection against external factors. One suggestion is building supply resilience by moving away from single-use models of supply to reduce dependency on raw materials.

In addition, it calls for innovation in diagnostics to support models of care that reduce the elective backlog. Again, a more than welcome focus on how to harness innovation to relieve pressure on the NHS and build long-term capability and resilience.

But — there’s always a but — as is often the case, the strategy focuses largely on fixing existing problems in the system rather than preventing bad health in the first place. For the MedTech revolution to truly be successful it needs to focus more on how innovation can contribute to health creation.

Also this week, in response to the Care Review, the Government has set out its vision for children’s social care and opened a consultation. It seeks to “overhaul” the children’s social care system. This is long overdue, with care leavers facing significantly worse outcomes. For example, as Josh MacAlister points out in a blog on the strategy, “those who’ve grown up in care are 70% more likely to die early”.

For help in the short-term, the Government will implement measures such as an above-inflation increase in foster care allowances. In the long-term, and getting to the roots of the problem, there will be more local support for families to prevent issues spiralling to the point of crisis.

Alongside these measures will be a strengthening of the children’s social care workforce. There will be local support for authorities to recruit new social worker apprentices, a consultation to reduce over-reliance on agency social workers, and a new ‘Early Career Framework’ to ensure workers have the knowledge and skills they need. Reform looks forward to seeing this strategy in full!

Also this week, the Department for Levelling Up, Housing and Communities published the latest stats on Right to Buy — sales and (replacement) starts. As our handy graph below shows, we are still failing to replace those social houses sold on a one for one basis (this is a requirement). This means a continuing erosion of the social housing stock, which in turn means more low-income families pushed in to the significantly more expensive private rental sector, which means a higher housing benefit bill for us all. Bad policy.

Onto a read and listen...

The Institute for Government published its tenth annual Whitehall Monitor this week. Its central message is that a year of political turmoil — there were more than sixty cabinet appointments in 2022, more than double the number in any other year — has had a significant impact on government's ability to make progress in its priority policy areas. This disruption has also led to a slowdown in efforts to reform the civil service itself, with little progress beyond moving parts of departments out of London and improving digital skills. (Relative) political stability may have now returned, but growing budgetary pressures for departments and falling staff morale will create new obstacles in 2023, as (among other things) Whitehall works to deliver a “major project portfolio” that is now larger than ever before. Less than 10% of these large-scale projects are expected to be finished on time, and £37bn worth of these priority projects are already officially categorised as “unfeasible”.

Up next, a slightly geeky listen on hospital design from the Health Service Journal discusses the relative merits of shared wards and single patient rooms and their impact on how long patients stay in hospital. Evidence emerging out of a completely single room hospital in Liverpool suggests that improved patient sleeping patterns and reduced infections are driving down length of stay. However, this doesn’t seem to square with existing evidence on this subject – see the BMJ’s report – leaving the debate wide open.