Editor’s blog Monday 22 March 2010: US reforms; Blairites rumbled; NPfIT in bits; and Tories to keep everything open

They’ve done it. It’s watered-down, and not perfect. It does very little to really address the causes of cost-inflation, let alone the crucial issue of tort reform. It is going to cost them something in the November mid-term elections.

But the US has – just - got its health bill past Senate.

Back here, the FT suggests that darling Chancellor Darling will mark the patient up for surgery in his budget. Sounds sensible. Will he leave himself some nice wriggle-room over how to define 'front-line' services?

And it looks like Whoops! Apocalypse for Lorenzo. This would be funny if it weren't so desperately serious in temrs of actually gathering timely data that can be used to know more about the quality and outcomes of care in much closer to real time.

Well, we can dream.

The lobbyist will see you now, minister
If darling Alistair is looking for ways to raise revenue, he should probably chat to some of the ex-Blairites.

Dear old Matron Stangelove made it back from the political grave with her colleague-in-coup Geoff 'Buff' Hoon to parade herself for our delight one more time in a nice lobbying sting by Dispatches on Channel 4.

Also snouts in the trough were Blair's office manager Baroness Sally Morgan and Stephen Bye-Bye good-day-to-bury-bad-news Byers.

Blairite after Blairite (and a token Tory) made their bids of the lobbyist Euro. Dignity is no issue for these folk.

Recon Woman
At last week's Reform report launch, La Strangelove was on top form, as everybody wittered on about how poor the NHS is at distributing best practice.

Intrigued by this rewriting of history, I pointed out in a question that the DH had (for once) developed an effective mechanism for distilling, developing and distributing best practice in the NHS Modernisation Agency ... which Patsy abolished.

She gave me that 'you cheeky fucker' stare, and insisted to the room (in that unmistakable remedial Roedean wannabe accent) that the Mod Agency had been successfully replaced by the Aye-Aye-Aye.

Now you, dear readers, are not stupid people: that is why you are here.

And that means you know that despite the Aye-Aye-Aye doing some good things on Better Care, Better Value and other bits, it has no 'doing to' remit. The furthest it goes to implementing, chivvying and doing is some training and the innovation stuff.

The Aye-Aye-Aye does not get its people out on the road, interfering, politely but firmly kicking recalcitrant arse as the MA did. The MA was a not-insignificant contributor to getting momentum behind the cuts in waiting lists and improvements on national targets.

Matron Stangelove was also preening hefrself as a great champion of reconfiguration, stymied by the political pygmies aroudn her.

Which is news to those of us who remember her conduct over the reconfiguration debate over St Helier versus Sutton. You can see what local NHS managers wanted to do here; what the leaks showed here; and what La Strangelove did here.

History, eh? Has a funny habit of still being there if you know where to look.
Ooop! And here's a good news flash: Strangelove, Buff and Bye-bye Byrers have all been suspended from the Parliamentary Labour Party.

It's not much of a punishment ... but it's a little something.

Conservatives: no acute adaptation
Pulse has this handy story about the Conservatives' plans for reversing the government's proposed changes to move more care out of hospitals.

Apparently, there ain't no capacity in primary care. Which is, buildings-wise, a point: one I have been making for a few years now. Lansley sees outpatients and A&E as  his Rourke's Drift, and will let decisions be made locally.

It always looks so good in opposition, does localism.

And it looks bold ... though a cynic might suggest it is opportunism on the back of the Primary Care Foundation's recent report that assumptions about how much activity in A&E is unmet primary care need are wrong - the PCF suggest that, when measured correctly, it may be as little as 10% and no more than 30%.

Isn't it great not to be a cynic?