Because Labour are back in power, the NHS has at least avoided the major disruptions to its structure promised by the other two main parties. The resulting Cabinet reshuffle saw the departure of John Reid as Secretary of State for Health – off to play soldiers – and his replacement by Patricia Hewitt. This involved someone who had got to the state of appearing to be on top of his job being replaced by someone who has to learn the job from scratch. The system of Cabinet reshuffles might be compared to removing the boss of GlaxoSmithKline and replacing him with the chief executive of, say, Tesco, and then waiting until he had learned the ropes, and then bringing in the Post Office Chief Executive. However, that wouldn’t happen because people would think that it was pretty stupid and it would not be effective. Although we may now be in another brave new era, the start has been pretty low-key while Patricia gets up to speed. Not much emerged from Mission Control in May. The exact course of change in the NHS over the next few months and years is not certain, but at least we should be pleased that Modernisation per se appears to have run its course. It has been replaced by Choice and Public Health, and perhaps Improvement, as key drivers; but it is the emergence of another M-word – Marketing – that will result in a more profound cultural change than was caused by Mrs T. splitting purchasers from providers. The financial industry, which once upon a time considered that it offered professional services, has now accepted that it sells products and has to compete in a marketplace. The healthcare professional will have to make the same transformation, and it will not be easy. The forthcoming Primary Care White Paper is sure to introduce competition, and the fallout could be dramatic. The traditional British way of thinking told you that if you had a good product, people would come to buy it. No more! With price now out of the equation, each health service provider will have to think about its own USPs – and start to learn what a USP is, and how to make sure its customers know as well. However, GPs have shown that they know a thing or two about extracting money from the system. In the Quality and Outcomes Framework, they earned a few hundred million pounds more than they were expected to. So if their jobs are on the line, it is not beyond the bounds of possibility that they could get really commercial and pack marketing courses around the country. In the meantime, someone is having to think hard about how to find all that unplanned extra QOF cash.

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GPs have shown that they know a thing or two about extracting money from the system A Report has been published by the Ad Hoc Advisory Group on the Operation of NHS Research Ethics Committees, setting out recommendations for the operation of these committees in order to ensure that they review applications for good quality research consistently, promptly and efficiently. In a move to push forward open access publication of scientific literature, the Wellcome Trust – the UK’s biggest non-Governmental funder of biomedical research – has announced that from 1st October 2005, all papers from its new research projects must be deposited in PubMed Central or in UK PubMed Central (once the latter has been formed) within six months of publication. Wellcome spends £400 million each year on producing almost 3,500 papers. After examining the issues, a report on ‘The Ethics of Research Involving Animals’ from Nuffield Council called for a reduction in the level of animal testing, saying that the industry must challenge the demand for animal testing in medicines development. Funding of £74 million was announced in May to provide a major boost to experimental medicine in the UK. Working together as partners in the UK Clinical Research Collaboration (UKCRC), the Medical Research Council (MRC), the Wellcome Trust, the Wolfson Foundation, the Department of Health and the Scottish Executive Health Department have committed funding to a new co-ordinated initiative designed to help experimental medicine develop new treatments for patients. Having complained about the choice of NILSI as a name for the new National Institute for Learning Skills and Innovation, the DoH took our criticism seriously and, even before it had been set up, changed it to the National Institute of Innovation and Improvement. The end is NIII! A list of deadlines for the submission of research proposals provided by the National Health Intelligence Service is provided at www.nhis.info/display/display.asp?id=319

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