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Who said it was feasible? (Remember that word)
Setting aside modesty… I certainly didn’t… and I doubt you did, either.
NHSE is being abolished, functions being folded into DH++. Two headquarters will become one.
Duplication will disappear. Accountability will be clearer. Thousands of jobs will go and £1bn a year will be saved and reinvested in care.
Oh really!
That was the announcement. Then, reality turned up.
HSJ reports that some NHSE staff may have to be parked, outside DHSC.
Because…
... NHSE employees are not civil servants. Pay scales are different. Pensions are different. Contracts, redundancy arrangements and continuity-of-service provisions are different, and…
… some overseas nationals employed by NHS England may not satisfy Civil Service nationality rules.
We have an organisational merger that may not be able to merge the organisation’s people.
The finagle under consideration, is another arm’s-length organisation to employ the staff that DH++ cannot.
NHSE 2.0... really!
An new organisation created to accommodate the consequences of abolishing an organisation before anyone had worked out how to abolish the organisation.
It would be funny if thousands of livelihoods and the management of a £200bn health service, were not attached to it.
There’s a bigger question. How did silly-boy, Streeting get this far without a plan?
Streeting had political experience and had led a small charity, but…
…had never managed anything remotely comparable in size, complexity or legal intricacy to NHSE.
Nevertheless, he embarked on one of the largest public-sector reorganisations in decades without; a published integration plan, a settled workforce model or...
... apparently, a clear understanding of how much it would cost.
The unfunded redundancy bill alone, was subsequently estimated at between £1bn and £1.3bn.
This was never a job for the operational HR departments and departmental lawyers.
Combining these workforces required …
- specialist employment lawyers,
- pension experts,
- organisational designers,
- financial modellers and …
… people who had previously managed mergers of this scale who understood organisational architecture and digital rewiring.
They all should have been in the room before the announcement. In any serious commercial merger, due diligence comes first.
- The lawyers examine the contracts.
- The accountants identify the liabilities.
- HR maps the workforces.
- Pension obligations are calculated.
- Systems are tested.
- Risks are priced…
…only then does the board decide whether the deal is deliverable.
Here, the political announcement came first… due diligence an afterthought and followed what can only be described as utter recklessness.
Why wasn’t Streeting reined-in?
The supine NHSE board are useless... we had a dud of a PM.
The only people who could have done it was the succession of Permanent Secretaries at the DH++.
It was a stinking policy yet the civil servants held their noses.
It’s true, the Permanent Secretary cannot prevent a minister pursuing a policy coz they believe it’s mistaken. However...
... as the department’s principal accounting officer, they are responsible for testing public expenditure against four standards:
- Regularity.
- Propriety.
- Value for money.
- Feasibility.... (there's the key word, again)
Feasibility… if the accounting officer believes one of those tests cannot be met and the minister insists on proceeding, they can seek a formal ministerial direction…
… that records the objection and makes it clear that the minister has chosen to override it.
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Was there an accounting-officer assessment of the abolition of NHSE?
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Who confirmed that the workforce could be transferred?
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Who calculated the cost?
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Who established that the necessary legal, HR and organisational capability existed?
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Who assessed the effect on NHS operations while thousands of experienced people waited to learn whether their jobs, and even their employment status would survive?
If officials warned about the risks of the proposal, and they couldn’t have done otherwise, why was no ministerial direction sought?
If they didn’t warn against it, what’s the point of an expert, permanent Civil Service?
And, bear in mind it's this group of numpties that want to run the NHS.
The NHSE demands business cases, workforce plans, impact assessments, risk registers and financial approvals from every Trust and ICB.
Yet, DH++ appears to have acquiesced in the abolition of the body responsible for running the NHS and started working out how to do it afterwards.
This goes to the heart of government.
- The minister announces.
- The rest of us are obliged to say ‘how clever’.
- The experts say nothing when they’re told to make it possible.
- The money frittered, spaffed and wasted.
- The careers of thousands, trashed.
Now, reality refuses to cooperate, so another organisation is invented.
Reform may have been necessary…
… none of that excuses abolition without demonstrable merger capability, workforce due diligence, settled finance or a clear feasibility and benefits assessment…
… raising profound questions about both ministerial recklessness and the various Permanent Secretary’s accounting-officer responsibilities.
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