The Week

The Week, 6 January 2017

As 2017 begins, health and social care remain in the headlines. This week, amidst reports of high demandbed-blocking and office cake culture, three Select Committee Chairs called on the Government to establish a cross-party review and to urgently integrate health and social care to remove “avoidable barriers and inefficiencies.” The Prime Minister is set to give her first major speech of the year on Monday, focusing on mental health. To deliver an affordable, high quality healthcare system the focus must be on service reform and innovation.

Charlotte Pickles, Deputy Director and Head of Research

Reformer of the week

NHS England, who are trialling the use of artificial intelligence to deliver medical advice via an app. Only open to North Londoners for now.

Good week for…

Health reform baby steps

On TuesdayThe Times reported that 61 per cent of GPs and secondary care doctors think GPs should be located in accident and emergency (A&E) departments. An encouraging recognition that GP provision is more appropriate for many patients than A&E, it nonetheless misses the central need to stop them walking through a hospital door.

Excessive pay

On Wednesday, the Chief Executive of NHS Improvement, Jim Mackey, criticised the excessive hourly rates paid to some locum doctors. Despite a pay cap, two thirds are above the £76.10 an hour upper rate.

Competent public procurement

On Tuesday, the Financial Times reported that Whitehall procurement officials will attend an assessment day to test their commercial skills. Those topping the class with a grade A will be deployed to the central Government Commercial Organisation, mid-level (grade B) performers will be given extra training, whilst officials scoring a C will be removed from commercial functions.

Bad week for…


On Tuesday, workers were advised to hide cakes and biscuits in the office to “combat cake culture”, which is driving obesity and tooth decay. Former Great British Bake Off contestants argued that cake brings “joy” to the office.

Efficient use of hospital care

On Friday, the BBC reported that the number of bed days lost due to delayed discharge has increased by 56 per cent in psychiatric trusts and 30 per cent in acute trusts in October 2016 compared to November 2015.


On Friday, it was reported that Bank of England Chief Economist Andy Haldane admitted that economists had had a “Michael Fish moment” in failing to foresee the 2008 financial crash. He said the profession was “to some degree in crisis” after the crash and Brexit forecasting.

Quotes of the week

“The fact is that private developers, left to their own devices, will not build enough to meet demand, especially when the greatest need is for affordable rented housing in urban areas. It is not in their interest to do so, since the result would be lower house prices and land values, eroding their profitability. Any solution to Britain’s housing crisis must include a bigger contribution from the public sector. Rather than coercive measures, the focus should be on enabling local authorities and housing associations that wish to build social housing. They should be allowed to set planning fees, to levy taxes on idle land when developers fail to use planning permissions and, crucially, to borrow in order to fund their own social housing developments.”

FT View on Thursday

“We should do what we can to make the tax system fairer and more effective. But the real challenge must be to make inheritance matter less. That means action in the housing market — building more houses, cutting stamp duty, increasing council tax on more expensive properties. It means doing still more to promote social mobility through education and skills policy. And it means tilting policy away from supporting the relatively wealthy old towards the less wealthy young.”

Paul Johnson, Director, Institute for Fiscal Studies, writing in The Times on Friday

Reform’s week

The Reformer Blog

On Thursday, Alexander Hitchcock, Senior Researcher at Reform, argued for more competition for GP contracts to boost competition and incentivise innovation in primary care.