Our thumbnail of a fictional flooded Central London (Flood 2007) must reflect the mood amongst those in Government who are now awash with views – MAC’s amongst them – from all us who responded to the invitation to fill the NHS Pause for Reflection with a great tsunami of opinion and argument. The film may have been forgotten but those who are charged with fielding the responses may well feel that they drowning and going down for the last time. The “Listening Exercise” closed today. Now the hard work starts to make sense of it all as we wait for the Future Forum report from Prof Field and his merry band in early June.
The NHS pumps out a lot of information at the best of times but just at the moment, the information flow meter has gone off the clock. NHS Networks newsletter clocked 6 news flashes on NHS related stories between 12.16 and 12.32pm on 26th May – Care co-ordination; mental health NICE guidelines, something on dentists, flu planning and a revamp of the Blue Badge scheme. The next day saw another 4 in a similar space of time including the Reform think tanks response to the Listening invitation. The Times has just finished running a series of three articles on the NHS by Camilla Cavendish (no link – behind the paywall); other media are doing the same. We hope that someone has a very big bucket to capture this flood.
No Newsletter just Blogs
We plead guilty to adding to the flow – the flavour of the times are best shown in the blogs ‘Pause, Reflect and Improve – MAC grabs the Lansley moment‘ and more urgently, ‘HMS Health and Social Care Bill – dead in the water?’. At least we had the good grace to add a question mark. Have a look at what we wrote by all means – it would be good to know if it gets read and there is plenty more where that came from – and in fact a lot of what has been generated is worth a look and not just by health policy wonks. While even Partner Craig would not claim to have read it all, our take on this is that organisations and individuals have not just been dusting off and lightly editing what they put in the last time this horse ran the consultation course but are coming up with new stuff that develops and deepens what they said before.
For example, it is now much clearer where GPs and their representative organs stand – foursquare behind their membership who would be really put off and upset by someone caring for patients better down the road (how could that be?) and patients signing up with the competition (can this be allowed?) We have seen some interesting work and debate locally with a recent meeting convened by the ghostly form of Wandsworth PCT. We have been in touch with some of the lucky people on the NHS Future Forum who are working hard in a very short time frame to say useful and helpful things. In our material, we have as usual focused on patient and lay involvement and what is happening both nationally and locally in ‘Patients as Customers Prof Field?‘, ‘RCGP gags patients and public‘ and on the process of transition for LINks . Most recently we have sent in our views to the Future Forum on how the public interest must be represented in the authorisation of commissioning boards.
Behind the Smokescreen – an end to the action drought?
Researchers recently came up with the thought that to control even the most complex of systems, you do not need to try and manage everything – just the key control points. Of course to know what the key points are, it is essential to understand the system and what it is designed to do. Has this ever been true of the NHS? What is going on now? As we said in the title, we have seen the flood of words but have a drought of action. It seems to be more and more likely that just as the smokescreen pumped out to hide preparations to cross the Rhine in 1944 hid the dispositions for the great assault, so the present frenzy of solicitation is a screen to hide changes in the dispositions of the legislative array. What will the field of battle look like when the smoke clears? Will we have the same General? The C-in-C is not going anywhere but could the same be said of all his colleagues? It is interesting that we are only now beginning to hear the voices of those that thought that the proposed reforms had a lot of good sense in them. It is not an option for the NHS to stand still and remain unchanged. Our fear is for a service that is paralysed with no mandate and no money for progress, standing in the rubble of its own institutions and intentions with hospitals half-shut, PCTs mostly abolished and GPs almost having decision making powers. The Nearly NHS.
We won’t ask you what you think – you have probably told someone else already. Enjoy the early strawberries.