Health services: too important to fail?Follow @pwc_ukgov
By Janet Dawson, Healthcare Lead Partner, PwC
How can we ensure that essential health services continue in the event of a provider failing? This was on the (certainly topical) agenda of a roundtable meeting we convened on Monday with think tank Reform.
It’s the third in a series of Under Pressure roundtables examining the multiple pressures public service providers are facing – from shrinking budgets to growing demand for services and an ambitious reform agenda.
We were joined by the health commissioners, providers and regulators whose job it is to answer this key question. The debate also covered; is there the political and public will to accept the failure of insolvent or poorly performing providers? What health services should be considered essential? And how might risk be balanced between providers and commissioners?
It may surprise some - given the topic - that the discussion opened on a positive note – the relationship between success and failure. The point here was that failure has a key role to play in improving our health services by, firstly, drawing attention to wider failings in the system, secondly, focusing leadership on generating solutions and thirdly, allowing new providers into the market, thereby fostering innovation. Of course, the flipside is that failure has its own price tag – with a human, financial and service cost attached. The challenge is to reduce these costs – by preventing failure in the first place.
Participants discussed the definition of essential services, a question at the heart of the debate on the health reforms. But there were differences of opinion on who is best placed to decide this. Flexibility was also thought to be a crucial component in managing an organisation in distress. It was acknowledged that in an age of diminishing resource, providers require more flex to reconfigure their services than in the years of plenty. But at the same time concerns were raised about unleashing local innovation. This raised the question of whether an intermediate tier is needed between the national Commissioning Board and local Clinical Commissioning Groups with some oversight of the wider healthcare economy.
The jury is still out on whether there is the political or public will to accept and deal with failure – but deal with it politicians must – the success of the Open Public Services vision depends upon it.
Email: Janet Dawson
Tel: +44 (0) 20 721 35244