It doesn’t take a management consultant, healthcare expert or even brain of Britain to work out that the radical restructure of an organisation at the same time as introducing stringent cuts is a tricky assignment. Add into the mix that the organisation has an annual spend in excess of £100 billion, over 1 million staff from a multitude of disciplines, and 60 million potential customers and the project gets a whole heap tougher. Then throw in unrealistic timescales and take away the support of the majority of that 1 million staff and you are on the road to hell.
You don’t need to be Sherlock Holmes to see the link between this scenario and the current state of the NHS as the Health and Social Care Bill continues to de-stable an already unsteady ship.
No surprises either to hear that the report of a cross party commons select committee chaired by former health secretary Stephen Dorrell voices serious concerns about the effect of ongoing debate about reform, saying they were ‘complicating the savings process’ because they were acting as a ‘disruption and distraction’.
Stephen Dorrell and his committee are the voice of reason, stating that the ‘need to achieve efficiency savings in the NHS was paramount, and that the bill must come second’. Dorrell continued ‘The priority is to deliver more efficient care, in order to meet demands placed upon the system - and the implementation of the bill has to fit in around that’.
This point is key. We should be creating savings by developing cost effective, high quality integrated care pathways. Just the goal of 4% savings, year on year, should be sufficient to generate some of the behavioural changes required and alongside this goal, some long term strategies for sustainability of state funded care could be explored.
But back to Andrew Lansley, current UK secretary of state for health. I say ‘current’ because I cannot see how much longer he can dig in, hanging on to his precious Bill, despite all those around him, wiser, more experienced and the majority not politically motivated who believe he is over-complicating an already complex issue.
I listened to a radio interview with Lansley earlier today as he was asked to respond to the growing cacophony of opposition to his reforms. As usual, he continued to tow his own special party line, ignoring his detractors and sticking to his polemic – his ritualistic support of his own brand of reality. He still chooses not to hear the combined chorus of the majority of medical and therapy organisations, charities and independent think tanks. He rejects the findings of the committee in the same way that he ignores any other report failing to support his one man mission.
This Bill has now become a bigger problem than the issues it seeks to repair. It is, as Dorrell quite rightly says, a distraction. Lansley’s commitment to this flawed reform is admirable but misguided.
Lansley is alone in his wilderness – I would rather he came back into the fold and started to respond to the wise people around him. Failing that – Cameron should release him into the wild to roam free – as far away from the NHS as possible.