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‘Something doesn't add up. How could it happen…’
As one reader put it; ‘How is it possible to wake up one morning and decide that NHSE must be demolished’.
A better question is, 'why'?
On the basis of no published evidence, our great leader says there is… ‘significant duplication’ between NHSE and the DHSC’, and this is his primary reason for the reorganisation…
How 'significant'? Dunno.
… ‘overlapping responsibilities and inefficiencies’… policy and strategy functions traditionally associated with the DHSC had become ‘embedded within NHSE’.
How overlapping?
What responsibilities?
How deeply embedded?
Dunno.
As far as I know, there was no overwhelming argument to bring in the demolition squad. It says to me, perhaps a careful review? A strategic realignment? Maybe.
NHSE is, broadly responsible for ten headlines;
- Commissioning Healthcare Services
- Strategic Leadership and Policy Implementation
- Performance Management
- Quality and Safety Oversight
- Financial Oversight and Resource Allocation
- Service Transformation and Modernisation
- Public Health and Prevention
- Workforce Planning and Development
- Digital Transformation and Data Management
- Emergency Preparedness and Response
… if there is an overlap in any of this, it is because various ministers at the DH+ have tried to muscle-in on the NHSE (an arms length body), and take control.
The DH+ has no skills or capacity to do any of these ten vital responsibilities.
There is no justification, whatever, for closing NHSE.
A reset? Yes, why not? Ploughing-on with closure, no plan, no impact analysis.
Bonkers.
There must be more to this than meets the eye.
NHSE now in limbo, left firefighting.
Fighting fires in ICBs, dousing fires in NHSE, stamping out fires in the DH+ and somehow trying to kindle a fire to cut NHS waiting lists, that are, again, on the up.
Distracted and confused. Making chaotic decisions. For instance...
Last week there were two announcements.
Experienced managers offered £40,000 to relocate away from where they are working, to someplace else that is struggling. Help them to get onto the front foot.
And…
Experienced managers were being offered up to £80,000 to clear their desks and retire early, with the rebirth of the Mutually Agreed Retirement Scheme.
Experienced managers relocating? They are bound to have families, partners, mortgages, roots, friends, kids in school. Up-end all that for forty grand… I don’t think so.
Experienced managers offered a MARS settlement, get them off the payroll? It’s only going to appeal to time served, skilled managers that are close to retirement. Eighty grand to tide them over until they can call down their pension… very nice, thank you.
So, do we need experienced talent or not?
A chaotic system, resulting in conflicting decisions.
Are we recruiting or reducing? Fixing the problem or creating a new one? With no idea what the impact of all this really is.
Streeting has one job… reduce waiting lists… they are going up and most likely to continue to do so, all the time management is distracted…
... he is desperate to take over the NHS and run it...
... no thought about what happens when you pull the plug on a huge organisation and expect it to keep ticking over.
Meanwhile, his ten-year plan bounces around the system. There's been two attempts to finalise the draft by two different authors and still the final text isn't agreed.
There is no justification for causing this chaos but I think, there is a reason.
The Cabinet Office Minister Pat McFadden is struggling with his target to reduce the civil service headcount.
He aims for a 12,000 reduction by 2030… that’s about 2,400 a year. Just under 50 a week.
Looks easy until you look at the complexity of civil service redundancy protocols. Insiders tell me it ain’t gonna happen.
Streeting has confessed his difficulty in cutting what he calls, the NHS’s ‘bloated bureaucracy’.
His big problem, no money for redundancy payments from the Treasury.
However, work with McFadden who has plenty of redundancy money, close NHSE and by the time of the next election… McFadden's target accomplished and Streeting gets his way.
There you have it… over a weekend policy is formed and chaos ensues.
Somebody told the new chief executive, who was recruited to get the NHS back on its feet but suddenly had the feet pulled from under him.
Somebody told the incoming chair, an ex-McKinsey consultant who will well recognise the folly of this, that her job was to shut up shop, on the basis of no evidence whatever… she will now be remembered for the chaos.
If there is another explanation to all this... let them tell us.
It’s not called government, it’s not called management, it's not called reform, it's not called reorganisation, it’s not called anything other than what it is…
... politics.
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