NHS reform – Wot? More listening?

When I’m feeling pretentious, I can call myself an international healthcare entrepreneur, but when I keep it real I’m a consultant and commentator. Whichever hat I’m wearing, and despite it thankfully being the start of the weekend, I must confess today to feeling confused and pretty grumpy.

I have just read an article in the Health Service Journal (www.hsj.co.uk ) that David Cameron was today due to launch the ‘second phase of the NHS Reform listening exercise’. I’m not sure how I missed this initiative, and I certainly remember some talk of ‘ongoing consultation’, but the plans for a second listening exercise had somehow escaped my consciousness. In the same way that a brain blocks out traumatic memories, maybe my psyche just couldn’t cope with more listening.

I thought that I understood the progress of the Health and Social Care Bill and hadn’t appreciated that there was much more listening to be done before the inevitable ‘tweaking’ is completed.

The phrase ‘fiddling while Rome burns’ and ‘shifting deck chairs on the Titanic’ has been applied many times to the coalition’s approach to these reforms. And never have these clichés been more true. The NHS continues to operate with blurred boundaries, unclear ownership, confused responsibilities and unconfirmed budgets. Is that any way to run a multi-billion pound organisation?

The stoics in the NHS accept that the reforms may not be to their liking and may not agree with many of the specific changes that are being suggested. But they are prepared to make the best of it, roll up their sleeves and try to make the reforms work. But they can only do that when the way forward is confirmed. How long can Andrew Lansley, UK Secretary of State for Health, prolong this agony?

There is a great comment on the HSJ website from an anonymous contributor (in other words, someone who actually works in the NHS). He or she says ‘Carry on listening... in the meantime, that gurgling you can hear in the background is the PCT/commissioning brain drain’. Yes, with every day that passes and every unclear statement or wishy washy soundbite, talented individuals will continue to vote with their feet.

Maybe the events of 2011 will provide a new cliché in English folklore…

 ‘If too many cooks listen, the broth will spoil’