12. Alan Johnson's announcement of a "once in a generation review" of the NHS in England, on 4 July, is a very considerable barrier to reform.10 The Review represents a damaging delay when practical solutions are needed now to urgent issues.
13. The Review is directed much more at the NHS producer interest than at patients. Gordon Brown said:
"I believe we need to listen to patients' experience and expectations to forge a new partnership with doctors, nurses and other practitioners and together produce a way forward that will lead to an NHS that is changing to be truly patient-led and ever more responsive to their needs. Lasting change can only come from clinicians and staff. We need to do much more to empower staff, to give them the time with patients that they need to improve care, to put them in the lead in developing ideas on improving patient-care, and to respect their professionalism. The review will undertake an unprecedented process of engagement and consultation with NHS staff up and down the country in order to establish how best to involve them in the change we want to deliver in the NHS." 11
14. This is in direct contrast to the advice offered by Tony Blair as he left office:
"The old monolithic provision has to be broken down. The user has to be given real power and preference. The system needs proper incentives and rewards. The purpose should be so that public services can adapt and adjust naturally - self-generating reform - rather than being continually prodded and pushed from the centre. Public-sector unions can't be allowed to determine the shape of public services." 12
15. The publication of Sir Ara Dazri's Review of the London NHS also raises concerns about the direction of the new Government's thinking. It is based on central planning of health provision. It hinges on the wholesale adoption of a completely untried model (the "polyclinic") and ignores the record of London primary care in developing new services.13
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10 Department of Health (2007), Shaping health care for the next decade, news release, 4 July 2007.
11 Ibid.
12 Blair, T. (2007), interview with The Economist, 31 May.
13 Healthcare for London (2007), A Framework for Action.