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11th May 2026

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News and comment from

Roy Lilley



Playbook...

_____________

Short on time? Get yer ears-on and listen to Roy Lilley read this morning's eLetter... free!

With a sweep of a big Kabuki brush, the make-up lady made the shine across his brow, disappear.


The sound-man made a final check, moving the clip-on microphone an inch up his silk tie


The floor manager raised his open hand in the air…


... five, four, three… the two and the one came in silence as the last two fingers disappeared…


… the light on the camera turned red…


“Ladies and gentlemen, good evening…  


I wanted to talk to you directly; the local government election results are a disaster for the Labour Party and for me, personally.


I take full responsibility. I’m the Prime Minister… that’s my job; own-up, face the music.


The question is; what now?


Should I go? Step back and write a book?


My answer is no… I intend to press on and you’re entitled to an explanation.


You’ve heard, often enough, coming into government we inherited a bad hand. We did, but we didn’t play it well, and...  


... since being in government, world events have taken twists and turns few would have predicted. 


Balancing international affairs, foreign wars, problems at home. 


We find ourselves in a precarious position.


  • National debt is the highest in peacetime records. 
  • Waiting lists in the NHS, stubbornly remain. 
  • The benefits structure is creaking. 
  • National productivity is nowhere near where it should be.  
  • The cost of living… impacted by forces beyond our reach. 
  • The world is at war and stands on the brink of more confrontation.


There is no easy way out of this. There’re no short-cuts. No political promise I could make that I could keep. 


We’re going to have to take a breath and start living within our means. 


There is no other way; between now and the next election, we will have to tighten our belts.  


Tomorrow, I will reshuffle my Cabinet.


In three days time there will be an emergency budget.


We’ll rebalance taxation, raise some, cut others. The vast majority of UK businesses employ fewer than 10 people. We have to recognise that.  


Make adjustments to VAT, NI, cut departmental budgets across government. 


I will pause the complex NHS reorganisation so they can focus on what you all want, waiting lists to come down.


Young migrants of working age will be offered fast track reviews if they agree to work, learn skills, learn English and make a contribution, pay their way... as they do in Canada, Germany, France and other countries.


We have to live within our means, cut our cloth accordingly, find ways of making the taxpayer’s pound work harder.


Put the money back in your pocket.


I’ll be honest with you. This is what I should have done, on day one. I didn’t. I thought we could grow our way out of our problems but the international winds have blown us off course.  


The next few years up-to the election, are not going to be easy. 


What I am asking you all tonight, in the national interest, is to get behind the government, regardless of your political preferences, do it because you agree… it’s time for tough decisions, and……..

___________


…. well, now you know now why I’m not a political speech writer! 


But, I do know when organisations (and the nation) need leadership. Someone with a purpose, a message, a conviction.


Real leadership... uncomfortable because it asks people to confront truths they would rather avoid…


We can’t promise Scandinavian public services with a low-growth economy and an ageing population. 


We can’t endlessly reorganise the NHS and pretend structure is strategy.


We can’t borrow our way to prosperity, and call it investment.


You, can't not know this.


That’s why politics is in trouble. People smell evasion. Spot leaders who want applause, more than outcomes. Those who have run out of ideas.


The moment popular leaders make the hard decisions the don't stay popular... that's why they don't!


  • Churchill was thrown out after the war. 
  • Thatcher was loathed in many communities. 
  • Attlee imposed rationing and austerity...


... the public fell out of love with Blair.


Each, in their own way, successful, but none governed by asking every morning; ‘How do I stay liked?’


They sacrificed popularity for the national interest.


They asked; ‘What must I do?’


In Germany, Helmut Schmidt, took tough anti-inflation and security decisions during the oil shocks of the 70's, that damaged his popularity but were later seen as stabilising.


Leadership is sometimes the art of choosing between being re-elected and being right.


Populism is a long way from the intellectual roots of a Labour Party … that is now, consumed by social media and performative politics.  


That’s Starmer’s test... and be warned... so too, for any successor, from any party. 


Not whether they can win a news cycle but whether they have the nerve to level with the country.  


I just wonder, how far is all this from the Burnham playbook?

_______


Listen to our In-the-Loop podcast; Andy Burnham in conversation with Niall Dickson and Roy Lilley... here.

New - New - New

Podcast

Prof Jim Blair


Did you know that you are likely to die 20 years younger if you have a learning disability?



Did you know that the great 10 year NHS Plan mentions learning disability ZERO times?


In their latest podcast Niall and Roy seek to understand the dire state of health support for individuals with learning disabilities and their families.


Their guest is Professor Jim Blair, a nurse and academic who has campaigned relentlessly for the 1.5 million or so people with a learning disability in the UK.


In a fascinating discussion, Jim lets us into a world that is not understood by professionals or the wider public.


It's a world where individuals and their families are not seen as having worth and where services are not shaped by those who use them; and where abuse and scandals will persist until this is tackled head on.


Jim also highlights those with profound learning disabilities – who cost millions to look after with 24/7 care and who he describes as the hidden among the hidden.


Learning disability nursing is in sharp decline yet this champion of change says to improve their health, learning disability patients need these advocates as they need services that are developed by them and their families, and staff who are trained by users and their families. 


Listen, free, here.

For all the previous

In the Loop

podcasts with

Andy Burnham

Mayor of Greater Manchester

Nichola Ranger

ChEx Gen Sec RCN

Tom Dolphin

Chair BMA

David Gregson

founder of BeeWell

Dr Charlotte Refsum

Tony Blair Institute

Rob Webster

ICB CHEx

Sarah Woolnough

CEO of the King's Fund

Sir Jim Mackey

Dame Jennifer Dixon

Lord Darzi

Professor Tas Qureshi

Dr Penny Dash,

chair NHSE

Richard Meddings,

former chair NHSE,

Sir Jeremy Hunt,

Sir Andrew Dilnot,

Paul Johnson IFS

CLICK HERE


-oOo-


Probably, the most listened to

Podcast in the NHS!

FREE!

Want to contact Roy Lilley?

Please use this e-address

roy.lilley@nhsmanagers.net 

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Dr Paul Lambden


Hantavirus


'... the mortality rate is estimated to be up to 40%...'


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Improving documentation of safeguarding questionnaire in children - Quality Improvement.











This is what I'm hearing, unless you know different. In which case, tell me, in confidence

__________


>> I'm hearing - NHS is to start testing a prototype of single national formulary in June 2026.

>> I'm hearing - The UK government’s Department for Science, Innovation and Technology has appointed Kenan Poleo as director of the Office for Life Sciences to lead delivery of the Life Sciences Sector Plan and support the innovation commitments in the 10 year health plan.

>> I'm hearing - my request for insights into the new NHS uniforms has unearthed some interesting comments. One of the best, so far; '... on the uniform issue, mine was ordered in November 2024, one top one pair of trousers, still waiting for it despite chasing both our procurement team and the company.' It's a common theme. The supply chain doesn't appear reliable.

GUEST EDITORIAL


Daniel de Rozarieux 


Writes about community diagnostic centres...


'... with +300,000 extra tests completed in Sussex, alone, why was their no real impact on the elective waiting list.'

More News

----

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>> Region declares bid to eliminate - A&E mental health waits.

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>> ‘They’ve invented a spurious pseudo-disease’ - why are so many men being told they have low testosterone?

>> NHS Greater Glasgow and Clyde had 85 patient deaths and 400 medical blunders - in two years.

>> Extension of CQC regulation of health care provision at sporting and cultural events - equality impact assessment Page last updated.

 
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