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The Maynard Doctrine

The Maynard Doctrine: BMA bunkum

Professor Alan Maynard casts a sceptical eye over the BMA’s unfavourable response to the ‘Equity And Excellence – Liberating The NHS’ White Paper

You have to love the British Medical Association. They are just so predictable.

The Maynard Doctrine: Regulating GP commissioning consortia - who? And how?

Professor Alan Maynard considers the chaos, confusion and celerity surrounding the development and assurance of GP commissioning consortia.

As yet there is little enlightenment about how entry into GP consortia status will be achieved and what the powers will be given to the gatekeeper. This after one bland White Paper; a fistful of consultation documents; and much punditry from academe and think-tanks

The Maynard Doctrine:: The irrelevance of NHS structural reform

In all healthcare systems, politicians continually strive for the Holy Grail of system improvement. This goal breaks down into three elusive targets: macro-economic expenditure control, equity and efficiency.

The upheaval inherent in the current NHS reforms may undermine expenditure control. This is well evidenced by NHS chief executive Sir David Nicholson continually telling managers that financial balance is an imperative and failure in this domain will lead to their dismissal.

The Maynard Doctrine: A more brutal view of NHS reform

Professor Alan Maynard scours the horizon for plausible post-2015 scenarios for the NHS

The Con-Dem coalition government is made of competing factions, driven by different ideologies. As in other governments, political and economic events lead to particular factions getting their hands on policy reform.

The current dominant political faction appears to have adopted some poorly-designed reforms that beg more questions than they answer. They may regret their choices.

The Maynard Doctrine: An autumn agenda item

Publish Date/Time: 
09/02/2010 - 05:03

Professor Alan Maynard looks at clinical excellence awards, clinical audit and individual clinicans’ performance – a significant item on the NHS’s autumn agenda.

You will recall GPs benefitted from the quality outcomes framework some years ago.

The taxpayer coughed up nearly a billion pounds and the GPs rushed to meet an array of process targets, many of which did little to improve patient health - but increased the comrades’ expenditure on cars and holidays for practitioners and their families.

The Maynard Doctrine: Udder problems for the NHS

Professor Alan Maynard ventures into the anthropomorphic, assessing the porcine nutrition issues arising from the latest NHS redisorganisation

The American economist Uwe Reinhardt has likened a healthcare system to a sow, with beneficiaries of her milk competing for suckling rights. In the NHS, the ‘milk’ level exceeds £100 billion. Accordingly, the ‘piglets’ are bodies such as the pharmaceutical industry, hospitals and general practitioners.

The Maynard Doctrine: What does the White Paper mean? Incoherence and confusion – both opportunity and threat.

Publish Date/Time: 
08/01/2010 - 19:15

Professor Alan Maynard decodes the White Paper’s literary and political influences

The primary characteristics of the recent White Paper on the NHS, Equity and Excellence: Liberating the NHS are incoherence and ambiguity. The consultation papers that have emerged subsequently do all too little to reduce the conclusion that Chairman Lansley is not sure where he is going.

’Incoherence and confusion are both an opportunity and a threat.’

The Maynard Doctrine: The risks of another bout of NHS musical chairs

Professor Alan Maynard assesses the impact of the "blank" White Paper and associated restructrings and power shifts

The White Paper published earlier this month was in effect a “blank paper”, lacking detail of both the Government’s objectives and how reform was to be achieved.

Since then, Sir Humphrey and his fellow civil servants have striven mightily not just to put flesh on the bones, but also to reveal vital parts of the skeleton which were omitted from the “blank paper”.

The Maynard Doctrine: It’s the incentives, stupid!

Professor Alan Maynard looks at what a future based around outcome measurement and new incentives will mean.

The Coalition’s reforms depend for their success on the creation of an efficient set of incentives which “bring the horses to water and makes them drink” in a co-ordinated and efficient way.

The Maynard Doctrine: As the dust settles on the boomerang of reform …

As the dust settles from the White Paper where are we? Apart from the mere issues of detail to be provided in the ten (yes, ten!) consultations in the next few weeks - essential beach reading, with comments requested by October 5th - what is changing?

Goodbye old bureaucracy, hello new bureaucracy
There is a major assault on bureaucracy, with PCTs and SHAs to go. But hold on a minute: aren’t the proposed GP commissioners just PCTs run by GPs?

Moving from 152 PCTs to 500 GP commissioning consortia (GPCCs) is like going back in time to when we had 300 or so too many PCTs.

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