Why Miss Piggy is bigger news than Andrew Lansley

As the Health and Social Care Bill struggles its way to the statute book (or maybe not), it has to be noted that this has not been one of the Coalition’s finest hours. The Bill has become a political embarrassment and therefore a PR disaster.

When the fabulous David Beckham fell out with the equally fabulous (but in a very different way) Alex Ferguson, manager of Manchester United football club, Beckham had to go. Why? Because in Ferguson’s words ‘no-one is bigger than the club’. This puts me in mind of some of the issues facing the Health Bill. Andrew Lansley, UK Secretary of State for Health, is making more headlines than the reform itself. In the past week alone we have read:

‘Lansley will have to go, says top Lib Dem as party faces revolt’

‘Tories turn ‘toxic’ as health bill falters and reshuffle approaches’

‘Andrew Lansley right man for NHS Reform – Nick Clegg’

Lansley and the coalition PR machine have got it all so wrong. A good definition of public relations is ‘The art or science of establishing and promoting a favourable relationships with the public’.  Lansley’s ‘public’ includes over 1 million healthcare workers, a multitude of charities, care organisations and clinical practitioners. Not forgetting the powerful clinical bodies, colleges and unions. The lack of convincing and coherent narrative and Lansley’s inability to sway from his fixed, flawed vision are the two greatest contributing factors to this debacle. Another golden rule of PR – adapt to circumstances and sadly, flexibility is definitely not one of Lansley’s fortes.

It is widely accepted that reform is needed and some of the content of the Bill makes sense. But the message has been consistently off the mark.

My first job in healthcare marketing and PR was to promote a new private hospital in North London. State of the art medical facilities, cooperative working with the NHS and a high standard of care was of absolutely no interest to the local press, who we were very keen to get on side. We knew that a bad news private healthcare story would hit the headlines but any positive press releases were ignored. And then I got a front news story. A lifesaving heart transplant? Ground breaking technology? No. A baby. We sent pictures to the press of the first baby born in the hospital and the adorable little tot and her proud Mum graced the front page of every local rag.

There just haven’t been any good news stories about how this Bill will actually work. Poor Lansley, who according to his colleagues is ‘a decent man’, will ultimately have to take the rap for not only his, but his party’s failings. They really have made a pig’s ear of this.

Which brings me nicely to the title of this blog. Earlier this week I was flicking through the Metro newspaper (a free circulation newspaper with over 3.5 million readers) as always looking for health news stories. A large headline on one of the early pages caught my eye ‘Miss Piggy wants to start a family with Kermit’. About 10 pages later was a much smaller article entitled ‘Andrew Lansley rules out resigning over NHS reforms’

No contest.

Andrew Lansley fails to ignite the Tory Party Conference

Lansley fails to ignite the conference.

Sad as I am, I sat in front of the TV in rapt anticipation for Andrew Lansley’s Tory party conference speech. I wrongly assumed that the contentious Health and Social Care Bill would be high on everyone’s agenda but the conference hall was only half full as the audience awaited the Health Secretary’s appearance.

The choice of music just before the start of the session was bizarre – Shawn Mullins’ song ‘All in my head’ with the lyrics:

‘Is it all in my head?

Is it all in my head?

Could everything be so right without me knowin’?’

The song goes on:

‘Everyone needs a little love – to make it all work out..’

Was this a subliminal plea to the Tory faithful to be kind to their beleaguered reformer?

Lansley gave, as usual, a polished performance. Quoting many of the good work going on in the NHS and it was notable how often the N word was mentioned. Nurse. Lansley has realised that bigging up GPs as the only clinicians who count with the initial draft of the bill was a fundamental error.

The audience was as lukewarm as a cup of tea left by an old lady’s hospital bed. Ripples of polite applause interspersed the usual sound bites but to be fair, I found the Health Secretary more convincing that normal, especially when discussing outcomes and integrated care.

He received the mandatory standing ovation, albeit very muted – and I couldn’t help wondering if the delegates were stretching their legs after a long day sitting in conference rather than getting excited about a Bill that could cost them a second term.

The panel who joined Lansley were actually more convincing. An amazing nurse called Vicky Bailey spoke with great authority about practice based commissioning and the excellent work that her organisation, Partners in Health, had achieved with integrated care.

The next speaker, Neil Bacon, was billed as ‘a doctor and entrepreneur’. Yes. I’m judgmental and yes I mentally switch off when anyone refers to themselves as an entrepreneur.

Another nurse, Sylvie Hampton spoke with true passion about her wound healing social enterprise, while turning a few gills green by showing an explicit slide of a nasty wound. This speech described a great example of the value of private providers as she demonstrated the high quality cost saving treatments her organisation offer. Sylvie is a powerful advocate for ‘any qualified provider’ and went on to say that her team were ‘a new breed of private provider to the NHS – anyone who thinks this is privatisation is nuts’

And then it was business as usual as Simon Burns, huffed and puffed his way through his presentation. There is always something of the pantomime about this health minister and he didn’t disappoint as he raged about how the reform plans have been ‘discounted by those with an axe to grind’’

It was interesting to note that the most positive and memorable messages came from the two nurses who described the success of their services so effectively. More interesting was the fact that both these initiatives were in place long before the Health and Social Care Bill was a twinkle in Andrew Lansley’s eye.

Vicky Bailey’s initiative was in her words ‘nothing new – we’ve been doing this since 2006’. And Sylvie Hampton’s company first did business with the NHS in 1999.

The words of Shawn Mullins song, played just a hour earlier sprang back into mind..

 ‘Could everything be so right without me knowin’?

My day of discontent

Oh dear. It’s never good when a plan doesn’t come together. My day was well mapped out. I took the afternoon off to watch the England vs India one day international cricket match on the TV and was looking forward to a relaxing time. Alas it was rain stop play and my conscience wouldn’t allow me to ignore the fact that the recommitted Health and Social Care Bill was due to be discussed in the House of Commons.

Reluctantly – I switched over to BBC Parliament and my heart sank as I started to watch parliamentary proceedings. Like a re-run of a very bad movie with a predictable plot, weak storyline and unsatisfactory ending, I watched Andrew Lansley, UK Secretary of State for Health defend both the original bill and the 1000 plus amendments. As always he seemed confident and comfortable with his complex legislation, and still apparently blissfully unaware of the unwavering opposition to his plans.

He accused that ‘the unions, of course, are being misleading’ in their opposition to the Bill. In response to the Labour MP, Toby Perkins who reminded the House of the many and diverse organisations who opposed the NHS shake up, asking ‘Does the Secretary of State think everyone is wrong?’, Lansley smirked and said ‘you obviously haven’t spoken to all the people that I have spoken to in the NHS’

So there we have it. Same old same old. Deja vue. Groundhog Day.

Like the wonderful line from ‘Carry on Cleo’ – when Kenneth Williams, playing a wonderfully camp Julius Caesar shrieks ‘Infamy! Infamy! They’ve all got it in for me!’ Lansley simply thinks everyone else is wrong.

Alas – as the NHS continues to plough it’s directionless course we now face another round of fruitless discussion and lack of clarity.

As Nick Trigg, BBC Health Correspondent asks ‘Are we facing an Autumn of discontent?’

In short and with much regret, the answer is ‘Yes’

NHS - The engine's idling but the meter is still running

There’s a great scene in ‘Bridget Jones – The edge of reason’ where Bridget is en route to declare her undying love for the gorgeous Mr D’Arcy. A taxi is stationery outside her apartment, engine ticking over, meter running as our heroine tries out various outfits for her big moment.

It’s a dilemma many of my female readers can identify with – the ‘wardrobe on the bed’ syndrome where everything you plan on wearing just doesn’t seem right and the panic rises as the clock ticks.

It’s a pretty far stretch to liken Andrew Lansley, UK Secretary of State for Health, to Renee Zelwegger, but where the NHS is concerned, the dilemma bears some similarities.

The Health Service Journal (www.hsj.co.uk) this week divulged that the cost of Lansley’s reforms to the NHS are already ‘near a quarter of a billion’. The bill includes redundancies, payments to GPs for commissioning work and attendance fees for transition meetings. That’s £250 million to keep the engine running while we go nowhere.

Murdoch-watching as ‘Hackgate’ continues to unfold, the tragedy in Norway, and other headline-grabbing events do not detract from the fact that there is a major news story that will have a huge impact on the UK still unresolved.

Two of my contacts in the NHS independently used the word ‘stagnation’ to describe where they are in their particular roles. Others - clinicians and administrators alike, have mentioned frantic activity with no discernable goal or defined outcome. The meter continues to run, the bills mount up and we still have no clear vision of how the NHS is actually going to work. Or how the planned restructure will deliver higher quality care at lower cost. The only theme that appears to be constant is ‘cuts’.

A friend of mine attended a skin clinic to have a cancerous growth removed the other day to be told the minor op couldn’t take place because, according to the consultant ‘we are pretty thin on the ground’.

If only it were as simple as choosing an outfit for a big date. At least Bridget got her happy ending.

NHS Reforms – who do you believe?

I took an active decision to limit the number of postings on NHS reforms recently as I was worried I would start to bore my readers (and myself) as I tried to unravel the fact from the fiction and unbiased judgement from personal opinion. I thought I would enjoy my own version of ‘listen, pause, reflect and improve’.

I had no idea that the News International hacking scandal would provide me with a welcome diversion and potentially rich seam of material. Who could have thought that the dishonest and illegal activities of a bunch of (in my opinion) seedy and amoral perpetrators could be seen as light relief compared to the current state of the Health and Social Care Bill?

But where are the rights and wrongs on NHS Reform? There remains an uncomfortable lack of clarity. Still under discussion, each day a new list of submissions and comments regarding the amendments to the Bill is published. These include contributions from bodies such as the Royal College of Surgeons, Chartered Society of Physiotherapists and National Voices (a patient advocacy organisation). Many of these submissions feature statements of support for the revisions to the Bill, mostly tempered with additional recommendations or reservations.

Today, the Royal College of General Practitioners (RCGP) submitted their comments which make very interesting reading. Included is a survey of their members where 85% of respondents stated that they were not reassured by the planned amendments to the Bill. Over 50% disagreed that the revised model of clinical commissioning groups would lead to a patient led NHS, improve patient outcomes or reduce health inequalities. Conversely, the body of the RCGP response includes the phrase:  ‘We welcome placing General Practitioners (GPs) at the heart of planning services for their patients, and increasing professional and patient involvement in health service design and funding decisions…’

Likewise with statistics on the current state of the NHS. The Guardian website (http://www.guardian.co.uk/) datablog has outlined some fascinating discrepancies on statistics – all true, but presenting a very different message. The Guardian quotes Lansley, UK Health Secretary - ‘Waiting times have been kept low, with the average time patients wait for their operations lower’. Closer inspection of statistics shows that the number of patients waiting in excess of 4 hours in Accident and Emergency has increased by 76% and that an extra 2,400 patients every month are waiting for more than 18 weeks for treatment compared to last year.

What does all this conflicting evidence and opinion mean? Time, and hopefully statistics,  will tell. The listening exercise and Future Forum consultation process has had a positive effect in forcing the government to amend some of the reform plans. But what happens as the Bill proceeds through parliament and on to the House of Lords continues to challenge commentators and those tasked with implementing the changes.

Give me a good old fashioned scandal any day…..