I can’t remember how many times the NHS has been ‘reformed’.
Each new Secretary of State for Health feels obliged to ‘reform’ the NHS. They come and go. Not much changes.
The biggest ‘reform’ was probably when Ken Clarke introduced the ‘Thatcher Reforms’.
Labour’s, Alan Milburn, tried to turn the NHS into a market and only proved the NHS defies the laws of business logic; contracting and markets neither get a handle on costs, nor a lever on quality.
The rest have been fiddling about. Apart from Lansley, who, I'm convinced, was a lunatic and mercifully Parliament is unpicking his bonkersness.
Sensible people know the task is not ‘reform’, it is preventing the NHS turning into a black-hole. Disappearing under the weight of demand and not enough people to deal with it.
I wonder what it is, in No19’s mind, that tells him he his equipped to do anything other than, be the custodian of the NHS, during recovering from a tricky-time, catching its breath after a pretty horrible-time and exhausted by a disastrous-time…
… ten years of flat-line-funding, two years of Corona-Virus and probably five years of catching up with waiting lists.
He is a jobbing politician, six jobs, who walked out on BoJo and was fortunate to wriggle back into front-line politics after his predecessor was discovered to be ‘too-handy’ for the job.
Nothing in his life’s experiences, previous work or education has prepared him to be the secretary of state for health, never mind knowing enough about how it works, to have the temerity to think he can ‘reform it’.
But… reform it, he will. In a speech, delivered yesterday, that was mainly waffle, a sprinkling of tropes and tripe, some well trodden pathways and name checks for places he's popped into, he tells us he has had a ‘vision’.
We shouldn’t under-rate the vision-thing. Moses and the burning bush, Saul on the road to Damascus, visions of the Virgin Mary and Mohammed's vision of the Angel Gabriel.
Let’s not forget Lourdes. For a proper definition;
A vision is something seen in a dream, trance, or religious ecstasy, especially a supernatural appearance that usually conveys a revelation. Visions generally have more clarity than dreams, but traditionally fewer psychological connotations.
I’m starting to think No19 is getting a bit above himself.
Companies have ‘vision-statements’: Disney, to make people happy; Oxfam, a just world without poverty; Ikea; to create a better every-day-life for the many people…
. .. even in this company he’s out of his league.
No19’s reforming vision? Dig into the waffle and there are seven identifiable 'things';
Enhancing patients’ right to choose
They can do that now, guess what, most don’t do it?
It’s about ‘place’, another NHS policy.
Getting sorted at the right time, by the right people, in the right place. It doesn’t usually involve hobbling back from Sheffield, if you live in Southampton, with a two-day-old, new hip.
Expanding the number of people benefitting from personalised care
All care is personalised, we just don’t have the people to make it personal enough.
Expanding personal health budgets
We’ve got them now. They are not popular. People who have them find them difficult to manage, it’s a palaver and they're last thing you want to worry about when you are worn down by a long-term condition.
Increasing use of the NHS App to help people manage their health.
The App-store has thousands of Apps going that. If it’s about getting test results, fine… and what happens when you’ve got them?
Rolling out electronic records to 90% of trusts by December 2023 and 80% of social care providers by March 2024
Show us the money.
Raising awareness of the ‘Shared Lives’ scheme
What is it? The schemes match someone who needs care with an approved carer.
The carer shares their family and community life, and gives care and support to the person with care needs.
We don’t have enough carers to make it work.
I needn't have worried; this isn’t reform and isn’t visionary.
It’s a rehash of stuff that is already out-there and stalled, mainly because we don’t have enough people to make any of it work properly.
This is Sunday’s roast, stretched to cold-cuts and pickle on Monday and served up as Tuesday’s mince and potatoes.
>> I'm hearing - about an Afghan Anaesthetist who was messed around by the authorities here and the Dozy Home Office, for over 6 months, eventually came to the attention of the Norwegian government, who gave him and his family a visa, in two weeks, re-housed them and gave them language lessons.
>> I'm hearing - a matron has been appointed by the Queen’s Nursing Institute as its new national expert on children’s community nursing; Rebecca Daniels.
>> I'm hearing - No19 wants the NHS to write a workforce plan. It can't; it has no authority over HEE, who are responsible for the number of people being trained; neither the Treasury who don't want to pay for it, which is why we don't have a workforce plan, now.
