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nhsManagers.net

11th November 2025

 


News and comment from

Roy Lilley



Room...

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

The 1914 ‘Great War’ became a stalemate… trench warfare. 


Both sides constructed extensive, fortified lines that stretched from the Swiss frontier to the North Sea.  


In the winter the trenches filled with water and were shared with rats and sometimes mustard gas. About as ugly as warfare can get.


My grandfather served with distinction but was scarred for life by the gas. Later eventually, like so many, it claimed him. 


New military technologies of their day like machine guns and rapid-fire artillery favoured the defender. Large-scale attacks across the No Man's Land, between the lines, left hundreds slain.  


British poet and distinguished soldier, Siegfried Sassoon wrote about the horrors of war.


Despite massive, prolonged battles… the Somme and Verdun… strategic objectives were rarely achieved. Territorial gains were minimal. Measured in yards or inches.


A war of attrition… which resulted in unprecedented casualties, on both sides.


The German army’s failed spring offensive of 1918, in advance of the Americans joining the war with fresh troops and supplies, led to what historians call the August ‘Black Day’ of the German Army.


Allied forces launched a series of successful counter-offensives, with superior combined-arms tactics with infantry, artillery and tanks. 


They broke through and forced the German army into a continuous retreat… convincing German commanders, the war was lost.  


A ceasefire came into effect at 11am on the eleventh day of the eleventh month. The guns on the Western Front fell silent at that exact moment. Ending the fighting...


... among other things, what we will be remembering today.  


To mark the end of the war Sassoon’s mother, a sculptor, planted an oak tree, in the village of Matfield, Tunbridge Wells.


Whilst there is nothing by way of parallel...


... all this flooded into my mind, along with memories of my school days learning about it, whilst I was looking through the cuttings thinking...


... what light is there left, to shine on the ugly relationship between the resident doctors, heading for another strike and Wes Streeting, when I discovered, back in July said;


… striking doctors ‘will lose a war with this government’ .


'A war'? How foolish. How gauche is that metaphor. How ridiculous. Provocative. How inept, stranded, sorrowful and forlorn does he look.  


Somehow Streeting has turned himself into his Tory predecessor, Steve Barclay. Cuttings show Streeting accused Barclay of mudslinging and provocation during a former round of doctor strikes.


Streeting never supported those strikes but maintained doctors were making a ‘fair argument’ and urged the government to compromise to ‘avoid industrial action’.


Once in power he simply caved-in, bought them off with no thought to the consequences.


Perhaps this shows a wider problem? Something to with politics? Why public trust has been eroded. Why populism is replacing pragmatism. 


In his mind I do not doubt Streeting sees himself 'at war’ and has dug himself in. 


He’s offered to pay doctor's exam fees and improve working conditions but refuses to move on pay. 


His tough stance may find him allies in the Treasury and approval from the Times... in the their £walled leader yesterday they called doctors’ demands ‘extravagant’ and accused them of ‘striking recklessness’.


But…


… the junior doctors aren’t listening to newspaper editorials or public opinion polls; they want recognition and respect after years of real-terms pay decline.


They’ve been…


… let down by the BMA, whose senior members had it tough whilst training and saw no reason why today’s cadre should have it any easier.


… let down by politicians who exploited the conviction doctors would never dismiss Hypocrites.


… let down by a system where employment contracts are with the DH+ but their working relationships are mainly in hospitals who have had neither the money nor the impetus to change anything for the better. 


The public are let down. They don't seem to matter to either side.


Streeting now risks hardening mistrust. 


Each new round of strikes damages morale, patients’ prospects and the very workforce the NHS needs to retain. 


The longer this goes on, the harder it becomes to rebuild relationships back at the front line. 


It's time for Streeting to step back.  


When in opposition he called repeatedly, for the conciliation service Acas to be brought in to mediate the dispute.


He should take his own advice.


Hand the process over. Let impartial mediators create the space for compromise… a neutral forum to repair the conversation. 


Streeting must learn…


... leadership means knowing when not to be the loudest voice in the room.

PODCAST

NEW

Release


In their latest podcast Niall Dickson and Roy Lilley engage with


Sarah Woolnough the Chief Executive of The King’s Fund...


... one of the country’s leading health think tanks.


In a frank discussion, Sarah defends the role of think tanks and laments the government’s failure to embrace public health and prevention in its first year in office. 


She is highly critical of the decision to kick the social care can down the road and says the Fund is now exploring radically different ways it could be funded, including social insurance.  


She is no fan either of the current reorganisation, arguing that she would have done it differently and quoting NHS leaders warning that it is already a major distraction.


She calls on the government to be honest about what can and cannot be achieve within current funding constraints. 


Join Niall and Roy with Sarah,


In the Loop!


For all the previous

In the Loop

podcasts with

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


Basal Cell Carcinomas


'... the cause is not known but they are associated with the same factors that cause melanoma, namely over-exposure to ultraviolet light, sun-beds, pale skin which burns easily, and red hair.' 


News and Other Stuff

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>> CQC turnaround ‘on track’, despite ‘disruptive’ CEO departure - that's not what insiders tell me...

>> NHS likely to balance finances “by hook or by crook” - but this comes with trade-off that trusts will likely fall just short of elective goals. This means for fear of overspending Trusts will delay care.

>> Mental health Bill - Commons' amendments.

Reducing do not attends in health visiting...

This was published a couple of years ago... worth a look to see how far we have come, or not...







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

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>> I'm hearing - Nearly one in three GPs are unlikely to be working in general practice five years from now, according to RCGP polling that claims the profession is facing an imminent 'mass exodus'.

>> I'm hearing - 60 Jhoots locations have been taken over by Allied Pharmacies.

>> I'm hearing - In some places block contracts for diagnostics haven’t been uprated for years. It's claimed, inpart it is driving the deterioration of these services... they are woefully underfunded, particularly some of the more ‘niche’ or lower volume tests. 

>> I'm hearing - Chemotherapy for 13,000 patients at risk owing to ‘significant’ aseptic capacity issue.

More News

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>> NHS dentist crisis sees thousands sign Mirror petition - demanding cut reversal.

>> Former NHS nurse, 83, desperately searching for food and shelter - after Hurricane Melissa.

>> Fungus is sweeping UK hospitals, leaked memo shows - highly infectious and can lie dormant for years

This is seriously good journalism and today's cuppa-builder's read. It exposes misleading numbers, political strategy and calls-out name calling, really good.

 
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