The Week

The Week, 17 February 2017

Health policy filled the vacuum left by Parliamentary recess this week. In a report published on Thursday, Reform set out how NHS England could make a success out of its Sustainability and Transformation Plans (STPs). Meanwhile Keith Willett, Director of Acute Care at NHS England, highlighted the dangers of a partisan debate about health reform.

William Mosseri-Marlio, Research Manager

Reformer of the week

Keith Willett, who made the unusually frank admission that the current way of delivering healthcare is “broken”, adding that inertia puts at risk the future health of the NHS.

Good week for…

Alternatives to custody

On Monday, the Secretary of State for Justice Liz Truss MP reaffirmed the Government’s commitment to family, drugs and alcohol courts.

Cross-subsidised social care

On Wednesday, consultancy LaingBuisson reported that care home residents who pay their own fees are subsidising local-authority funded residents by more than £100 a week.

Naming and shaming

On Wednesday, the Department for Business, Energy and Industrial Strategy published a list of 350 employers that have not been paying their staff the minimum wage.

Bad week for…

Treasury influence

On Monday, in a review commissioned by the Labour Party, Lord Kerslake urged Number 10 to give control over the domestic policymaking agenda back to Whitehall departments, citing concerns about Treasury “mission creep”.

Evidence-based policymaking

On Monday, the Education Select Committee challenged the Government’s assertion that grammar schools will help pupils from lower socio-economic backgrounds.

Spending targets

On Monday, following revisions to economic growth, the Ministry of Defence was forced to deny claims the UK had failed to deliver on its ambition to spend at least 2 per cent of GDP on defence.

Quotes of the week

“We cannot just ignore what we now know, or how needs are changing. When it comes to healthcare, inertia can be truly harmful. It is no longer realistic to say ‘if it’s not broke don’t fix it’—believe me, it is breaking.

What I most fear is an overly-politicised conversation that seeks to damn every proposal as a “cut” and paralyses progress. None of that is going to help the staff who are committed to caring within the NHS, nor their patients—that’s you and your family.”

Keith Willett, NHS England’s Director of Acute Medicine, writing for the i on Monday

“Being in vogue is not the same as being sensible. A guaranteed income does not answer the question of how people who find fulfilment in work would find it in a world with not enough work to go around. In most scenarios it would be unaffordable; to pay even a fifth of average earnings to every American would require a 10 per cent increase in net taxation. A universal basic income would involve handing billions to people who do not need it, and if the past is any guide, it is unlikely to be needed anyway. Capitalism has proved effective at offering new ways to earn a living as old ones die out.”

The Times leader column on Wednesday

“Payment by results is perhaps the most important of all the lessons in Cove’s book. You get what you pay for. If you pay providers according to the size of the problems they have, you get more problems. If you pay them according to the number of problems they solve, you get more solutions.

We began adopting some of this in the UK with the Work Programme, allowing contractors to find answers to joblessness and paying them if they succeeded. At first, the results were disappointing. But just as you would expect, things quickly improved as companies absorbed early lessons. Before long we were getting better results than the traditional state programmes — and for less money.”

Lord Finkelstein, writing forThe Times on Wednesday

Reform’s week


On Saturday, Louis Coiffait, Head of Education at Reform, wrote an article for Schools Week following the publication of Work in progress: Towards a leaner, smarter workforce. He argued that the education workforce is the most important factor in improving outcomes for students, and discussed the potential of technology to help.

On Monday, Alexander Hitchcock, Senior Researcher at Reform, wrote an article for Public Finance following the announcement of the Government’s Transformation Strategy. He argued that government should use data and online communication to become more efficient and responsive to the public.

On Thursday, Reform’s publication Saving STPs: achieving meaningful health and social care reform was covered by several external media outlets, including:

  • The Times, where Andrew Haldenby, Director at Reform, argued that STPs should be strengthened to increase local and democratic legitimacy.
  • Conservative Home, where Kate Laycock, Researcher at Reform, argued STPs would not deliver on the Government’s ambition to integrate health and social care.
  • Prospect, where Elaine Fischer, Research Assistant at Reform, argued that STPs need more financial muscle to succeed.

The Reformer Blog

This week the Reformer featured a series of articles first published in the Reform Annual Conference Brochure.

  • Jonathan Slater, Permanent Secretary at the Department for Education, Daniel Searle, Chief Digital & Information Officer, Public Sector for Hewlett Packard Enterprise, and Alexander Hitchcock wrote on the theme of ‘Government at Your Service’.
  • Jane Cunliffe, Director of Public Spending at HM Treasury, Bernard Jenkin MP, Chair of the Public Administration and Constitutional Affairs Select Committee, and William Mosseri-Marlio, Research Manager at Reform, wrote on Whitehall’s stories of success.
  • Rt Hon Steve Webb, Former Minister of State for Pensions, Sumita Shah, Public Policy Manager at the Institute for Chartered Accountants of England and Wales, and Charlotte Pickles, Deputy Director at Reform, wrote on how to pay for the welfare state.
  • Louisa Rolfe, Deputy Chief Constable of the West Midlands Police, George Freeman MP, Chair of the Prime Minister’s Policy Board, and Matt Warman MP, Member of the Science and Technology Committee, wrote on reinventing public services for citizens’ use.

The Reformer also featured two blogs to follow the publication of Saving STPs:

  • On Thursday, Elaine Fischer laid out Reform’s key steps to make STPs fit for purpose.
  •  On Friday, Kate Laycock argued that STPs lack the legal independence and operational autonomy to achieve their aim of integrating health and social care.