The Futility Monster

He'll pointlessly derive more enjoyment out of your resources than you

NHS Groundhog Day

Posted by The Futility Monster on July 16, 2010 @ 09:31

Francis Maude and Andy Burnham even had a lively exchange of views...

One of the bigger items of news this week has been Andrew Lansley’s statement to the Commons about his White Paper suggesting the poor old NHS should undergo yet another reshuffle.

The issue was covered last night on Question Time, and when I heard the start of the original question my brain already started going to sleep. But I gave it a chance, and it turned out to be the most interesting part of the programme.

The main reason for that was because the somewhat left-wing panel (George Galloway, Sally Bercow, Andy Burnham) found itself an unusual ally in the ample shape of Nick Ferrari, the always excitable, never unopinionated talk-show host. The four of them battered the lone policy defender, Francis Maude, a quiet and unassuming man, and were aided by very generous rounds of applause, and one or two bouts of heckling.

NHS reorganisations are probably the most boring thing to happen in this country. But one thing you can’t say is that they’re not regular. Every Health Secretary under Labour seemed to have their very own pet project to implement. Now, step forward the new Tory Health Secretary, who doesn’t want to feel left out.

The whole exercise is pointless. The main reason is simple: it has been tried before in the late 80s and it didn’t work (see Simon Jenkins in Tuesday’s Evening Standard). The goal of is to “put GPs in charge” of the money. I’m not sure why we’d want to do that, as I don’t believe most GPs entered the profession to be accountants.

I’ve said it before, and I’ll say it again, we need bureaucracy. We don’t need waste, and we don’t need over-regulation. Stop the press. But we do need good, professional administrators to handle the difficult organisational decisions so that the people who want to do the caring and the treating can actually do it.

Like most things in life, structures do matter, but only to a point. Beyond that point, the rest is down to the people involved. Just like poor schools failing because of poor management, hospitals and other health organisations too suffer when there is a failure in leadership. If the coalition wants to do something useful, it should be to start in that area, and let the current system at least have a chance to bed down so we can see what impact it actually has. Especially as changing them now is going to have a £1.7bn price tag.

All sounds too easy, doesn’t it. Well, of course it isn’t. Finding good managers is tough. Might it be that they have to be poached from the private sector with generous wages? Talk about a minefield.

What is it about governments, of all colours, that they feel they must be seen to be doing something? I had high hopes that this coalition might actually resist the New Labour hyper-legislation reflex.

It seems to be a poor showing so far.

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One Response to “NHS Groundhog Day”

  1. Nigel Quinton said

    It is also worth noting surely that Lansley’s white paper is completely counter to what was published in the coalition agreement, which says:

    • We will stop the top-down reorganisations of the NHS that have got in the way of patient care.
    • We will ensure that there is a stronger voice for patients locally through directly elected individuals on the boards of their local primary care trust (PCT). The remainder of the PCT’s board will be appointed by the relevant local authority or authorities, and the Chief Executive and principal officers will be appointed by the Secretary of State on the advice of the new independent NHS board.
    • The local PCT will act as a champion for patients and commission those residual services that are best undertaken at a wider level, rather than directly by GPs. It will also take responsibility for improving public health for people in their area, working closely with the local authority and other local organisations.

    Am I the only Lib Dem activist who is appalled that the party has given no reaction whatever to the white paper?

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