New government proposals for ‘harm free’ healthcare are modelled on a marketised view that prioritises blame over learning and support

In the wake of multiple healthcare scandals involving the ill-treatment of patients, the Coalition government is determined to promote ‘harm free’ care within the NHS. Bob Hudson explores the implications and omissions of new proposals aimed at improving patient safety

The unsuccessful privatisation of social care: why it matters and how to curb it

Adult social care is rarely out of the headlines. It is underfunded; it is damaging the NHS through delayed hospital discharges or failing to reduce emergency admissions; it is financially crippling for users; care workers are being sold short; there are serious concerns about the quality of care; and providers say they are about to go bust. But oddly, writes Bob Hudson, these debates rage without any mention of one key feature of the care sector in England: provision is almost entirely privatised

Adult social care: is privatisation irreversible?

The privatisation of adult social care is a 30-year process that has grown unchecked, made worse by austerity politics. Should the private sector lose interest and leave the market, the consequences will be grave. Bob Hudson writes that, whilst it is not feasible to eliminate a model that has become so deeply embedded, improvement is possible. He explains how this would include a combination of better funding and smarter commissioning

Can technology save the NHS?

The NHS has been facing considerable funding and service challenges. In response, a potentially damaging plan aiming to ‘reset’ the £2.45bn record deficit has been launched, while the impact of Brexit will only make things worse. Bob Hudson explains how bottom-up technology initiatives, backed by a robust strategy, can help tackle many of the challenges facing our health service and can offer huge rewards

Instead of more inspections and regulation, the NHS needs to adopt a ‘bottom-up’ improvement model

Bob HudsonThe evidence base for improving public health services by top-down regulation is thin. An alternative approach is the ‘bottom-up’ rather than the ‘top-down’ perspective. But what are the ingredients of a bottom-up service improvement model? In this article, Bob Hudson suggests three essential components: people, context and complexity

The four deficits of the English devolution process

The issue of devolution is squarely on the agenda. Yet despite appearing to have obtained the coveted policy position of a principle without political enemies, the devolution mission itself is not guided by any clear principles, writes Bob Hudson. Instead, actions have been tactical rather than strategic, while current proposals are characterised by democratic, constitutional, financial and strategic ‘deficits’

Inside the ‘new NHS’: where are the citizens?

Where does accountability lie within the NHS? Bob Hudson writes that the current ways of the healthcare system make public scrutiny and citizen accountability opaque and increasingly incomprehensible to outsiders. He argues that engaging with citizens is key to giving the healthcare debate legitimacy

What do we do when the public services market fails?

Bob HudsonWhat happens when outsourced contractors are no longer able or willing to continue with the provision of public services? Bob Hudson explores the downsides of outsourcing public services and finds the proposals currently in train to address ‘market failure’ in both health and social care to be lacking. He goes on to explore alternative approaches and writes that public services should be seen as something more than a contract put out to the market to secure ‘value for money’

DevoManc and the NHS: Mind the gaps

Following an agreement last year to devolve powers to the Greater Manchester region and for the creation of a directly elected mayor, George Osborne has announced a new agreement to devolve the NHS to Manchester. In this article, Bob Hudson examines the agreement in depth, explaining that there are four main policy-implementation gaps regarding national governance, regional/local governance, financial governance and democratic governance

Short on detail but not on ambition: four problems with the new NHS white paper

Bob Hudson writes that, on the face of it, the new NHS white paper’s recoiling from the primacy of competition and markets warrants a warm welcome. Yet reactions have been underwhelming because there is remarkably little detail on how this ambitious mission is going to work