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15th June 2011
 

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Crack Pot

 
News and Comment from Roy Lilley
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David Cameron chose Guy's Hospital to complete his retreat on the Health and Social Care Bill.

 

The hospital was founded in 1721 by Thomas Guy.  In his day, something of a Dell-Boy, who made a fortune in the South Sea Bubble, early lovely-jubbly and went on to become a publisher of unlicensed Bibles.

 

Guy's Tower is a cheerless, concrete monster with thin strips for windows and more aerials on the roof than the Kremlin.  Grey, sinister anonymity designed for rainy days.  Depressing.  It has 34 floors and is the world's tallest hospital building.  Thirty four floors of bustle.  Mirror polished floors, tribes of staff wandering in and out of the lifts with arms full of folders and papers.  Battalions of bewildered patients swirling, some with drips dangling, others with dressing-gowns hanging.  Visitors, puzzling at the signeage, circling with plastic bags, stretched with chocolates, clean knickers and hand wipes.

 

 

 

Depending on how you take your politics: Cameron was in full retreat, desperately trying to rescue the Coalition and juggle his right-wing; or has acted maturely in responding to the genuine concerns of the NHS and the public and given a masterful display of managing coalition politics.

 

Perhaps, he's been a lot smarter than we all think.  LaLa has spent 7 years fine tuning his changes but GPs have not ended up in charge of commissioning and Monitor will not turn the NHS supply side into a regulated market.  In the good old days someone would have resigned.  Not these days!  LaLa will tough it out.

 

Overwhelmingly, in emails, yesterday, you told me you had no confidence in him and he should go.  He will not.  For Cameron to sack him signals 'wrong'.  To keep him signals 'listening'. 

 

LaLa toughed it out yesterday in the Commons.  There will be enough in the Bill for Cameron to claim he's modernised the NHS and his friend of 20 years is still, for now at least, in a job. 

 

What did he say at Guy's Hospital?  It doesn't matter.  You'll have seen it on the news.

 

All the changes suggested by the Listeners have been accepted, plus a few more.   Pretty much as I predicted Monday.  This is the DH response document.  It is just eleven, very clear pages, in big type and you must read it.  It is important that you do. 

 

Where does it leave us?  The Guys Tower was built in the mid-seventies.  Around that time I was on a health authority.  It had GPs, hospital doctors, nurses, lay people and experts seconded as required.  We included social services and saw our job as integrating care and making sure the hospital didn't pinch the entire budget.  We never managed it.  David Cameron has given health authorities a new name, 'Clinical Commissioning Groups' and a second chance to make them work.  The only problem is; there could be 200 of them!

 

Monitor has paid the price for threatening to 'dismember the NHS' and now has a sort of palaver-about role around cooperation.  David Bennett surely does not have the brass-neck to stay and take �300k a year for that?

 

In the mean time?  The new structure takes us back 30 years.  NHS finances are in a dreadful state, waiting times will creep up.  There is no proper strategic management, good people are long-gone and the ones that are left are struggling.  There is no chance the Service will save an honest �4bn this year.  It will take five years for the mess to be cleared up and the new structures embedded and working.

 

This whole misadventure has left the NHS like a porcelain plate, dropped and guiltily glued back together.  The cracks will forever bear witness to the clumsy, ham-fisted, idiocy that thought spinning it was a good idea.  Crack pot.   

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