PROFESSOR NIGEL EDWARDS Chief Executive, Nuffield Trust, UK
Why good health policy goes bad Excerpts from the inaugural John Deeble Lecture 2019—part 1
The John Deeble Lecture was established by the
role—he had a plan based on his experience as a
Australian Healthcare and Hospitals Association
civil servant involved in the privatisation of energy
(AHHA) as an annual event to commemorate the
and telecoms utilities, but it was not really clear
life and achievements of the late Professor John
who he listened to in developing his ideas.
Deeble AO as a distinguished scholar, health economist and health policy leader. Excerpts from the lecture are published
His plan was to boost the National Health Service (NHS) quasi-market, giving GPs purchasing power and organising them into groups to do
below. The focus in these Part 1 excerpts is on
commissioning. There would be much more
policy failings. In the February 2020 edition
emphasis on patient choice and competition,
of The Health Advocate we will publish Part
including price competition. The idea was also
2—Professor Edwards’ suggestions about what
to simplify the system and, a favourite of all
needs to be done to improve the health policy-
politicians, to ‘reduce bureaucracy’. As part
making process, including his arguments that
of this, and as an attempt to remove ministers
traditional calls to get more evidence into
from the day-to-day running of the NHS, it was
policy miss important aspects of the world we
proposed to establish an NHS Board to oversee this
now inhabit. He suggests some helpful strategies
system and an economic regulator to deal with
to overcome these problems.
competition and pricing issues. Both of these were
1. So big it can be seen from space
to be independent of direct ministerial oversight
Andrew Lansley became Secretary of State for Health (UK) in 2010, having spent an unprecedented six and a half years in the shadow
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The Health Advocate • DECEMBER 2019
and would be at arm’s length from government. The half-finished project of making hospitals autonomous would be completed and there would be greater private sector involvement.
