Good evening - good, that is, if the thunderstorm has passed you by yet, taking with it the louring humidity. The initial rainfall was dramatic and short - which is as good a segue as I can manage to the thoroughly good news that Film Four are this week running a series of classic Ingmar Bergman films, which share both those qualities. Those of an insomniac disposition can acquaint (or re-acquaint) yourselves with The Seventh Seal, Wild Strawberries, Smiles Of A Summer Night, Persona, Summer With Monika.

This afternoon, while I was tasting some wines in Meursault and Volnay, I was having 'that discussion' with the winemakers about how crap New World wines are. Now I say discussion, but actually it's the receiving end of a lecture (it's almost like they're blogging at me or something ...)

No, the lecture is a joke anyway. These are by no means stupid people: they recognise that there are talented artisan winemakers in every wine-growing part of the world.

Tom Smith contrasts emerging approaches to tackling obesity in Japan and England.

Japan has just set a legal limit to the size of waists – and is enforcing it – while England, according to a speech from Alan Johnson to the Fabian Society tonight, will attempt to build a social ‘movement’ to combat the problem. Interestingly, both approaches seek to make obesity psychologically and socially undesirable.

A fairly cosmopolitan friend (Cambridge graduate, former actress, former restauranteur, farmer’s wife, PhD and theatre director) once revealed a surprisingly vehement prejudice. She told me “I hate drag queens, I find it completely insulting as a woman and I don’t see it as funny, flattering or insightful.”

The update to the earlier blog can now be found at www.healthpolicyinsight.com/?q=node/127. Hope you enjoy it.

It’s been a quiet few days for health policy, with the exception of the news that Imperial College plan to experiment with payment for performance, about which more tomorrow.

The main event of the morning was an online discussion between Alan Johnson, the Secretary of State for Health, and Labour members who logged on for a discussion. The questions set out some of the issues that Labour loyalists worry about in relation to health policy.

Alan Maynard is professor of health economics, University of York

Monday 21 July 2008

The trouble with incentives is that they work, but they may produce changes in behaviour that are at once welcome and perverse.

Take, for instance, the fines announced in December 2007 for NHS trusts that fail to hit their C.Difficile targets. These fines are potentially large, up to £3.5 million for unsuccessful trusts. Faced by such fines, managers are striving very hard to improve the performance of their hospitals - just as Ministers hoped they would.

Policy zombies for (self-)love

The Canadian academic Robert Evans and colleagues (www.chspr.ubc.ca/files/publications/1998/hpru98-05D.pdf) have described the existence of health policy zombies: ideas that, no matter how many times you shoot them down with evidence, get back up and keep coming at you.

‘Can Gerry Robinson Fix The NHS?’ was a 2006 BBC2 / Open University TV series, which explored whether the titular proposition was a feasible action plan (www.open2.net/nhs/oneyearon/).

Tom Smith on the debate of the day

At 9 am this morning, BBC Radio 4 hosted a programme on the cost of the NHS and the involvement of the private sector. This involved Allyson Pollock (AP) and Paul Corrigan (PC) setting out their alternative cases and former Lib Dem health spokesman Evan Harris and businessman Sir Gerry Robinson responding. The idea of the show was for Harris and Robinson to listen to the arguments and then make up their minds (as if they didn’t have a view already). Kings Fund chief executive Niall Dickson was on hand as referee.

Tom Smith on IWantGreatCare.