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| Television personality and former nurse Jo Brand |
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| CQC Chief Executive Cynthia Bower |
Is it just me, or is CQC Chief Executive a spitting image of Jo Brand?
You decide. Please look at the two, and you figure out who the comedienne is.
Friday, 12 August 2011
NHS Spitting Images
Is it just me, or is CQC Chief Executive a spitting image of Jo Brand?
You decide. Please look at the two, and you figure out who the comedienne is.
Is it just me, or is CQC Chief Executive a spitting image of Jo Brand?
You decide. Please look at the two, and you figure out who the comedienne is.
Monday, 8 August 2011
Does competition improve quality in the NHS?
A debate has recently been re-ignited by Zack Cooper and colleagues' article in The Economic Journal on whether hospital competition improves clinical quality. Cooper et al find that "hospital competition can lead to improvements in hospital quality."
Such a finding immediately attracts attention. If true it would vindicate the policy of choice and competition, and as such receives warm welcome in some areas. In others, it is lambasted. For example, Allyson Pollock, professor of public health research and policy at Queen Mary, University of London, claims many faults in the research.
As an aside, Militant Manager cannot understand how Ms Pollock is a professor of anything. There is no disinterested detachment that you would expect from an academic: her website, her writings and her approach are all about confirming her beliefs, rather than challenging them in the face of evidence. The references she gives for her claims (on the lack of link between competition and quality, and on the limitations of data and methodology) are so generic, it begs whether she has really gripped the detail.
Back on topic, MM also has some qualifications on Cooper et al's findings. MM did not have access to their latest peer-reviewed publication; and so had to do with reading their working paper. They essentially find that hospitals who in more competitive markets have better mortality figures for heart-attack emergencies. MM's issue is whether this may be because more local hospitals allows the ambulance to route heart attacks to the better heart-attack centre (as happens in London?). So this finding would not be because there is competition, but because there are a number of local hospitals, and ambulances are routed. Perhaps Cooper et al may have addressed this in the EJ article; but MM would appreciate a better understanding of this.
Nevertheless, what MM found convincing was Cooper et al's review of the literature on the impact of competition on quality in the US (section 3.1). What they document is a number of consistent studies that show that in a regime of fixed prices, increased competition results in increased quality. This is exactly the situation in the NHS.
That is the most powerful finding for MM; and one that many should pay attention to in designing or criticising reforms.
Such a finding immediately attracts attention. If true it would vindicate the policy of choice and competition, and as such receives warm welcome in some areas. In others, it is lambasted. For example, Allyson Pollock, professor of public health research and policy at Queen Mary, University of London, claims many faults in the research.
As an aside, Militant Manager cannot understand how Ms Pollock is a professor of anything. There is no disinterested detachment that you would expect from an academic: her website, her writings and her approach are all about confirming her beliefs, rather than challenging them in the face of evidence. The references she gives for her claims (on the lack of link between competition and quality, and on the limitations of data and methodology) are so generic, it begs whether she has really gripped the detail.
Back on topic, MM also has some qualifications on Cooper et al's findings. MM did not have access to their latest peer-reviewed publication; and so had to do with reading their working paper. They essentially find that hospitals who in more competitive markets have better mortality figures for heart-attack emergencies. MM's issue is whether this may be because more local hospitals allows the ambulance to route heart attacks to the better heart-attack centre (as happens in London?). So this finding would not be because there is competition, but because there are a number of local hospitals, and ambulances are routed. Perhaps Cooper et al may have addressed this in the EJ article; but MM would appreciate a better understanding of this.
Nevertheless, what MM found convincing was Cooper et al's review of the literature on the impact of competition on quality in the US (section 3.1). What they document is a number of consistent studies that show that in a regime of fixed prices, increased competition results in increased quality. This is exactly the situation in the NHS.
That is the most powerful finding for MM; and one that many should pay attention to in designing or criticising reforms.
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