Reading through the comments on the Future Forum website about choice and competition and accountability to patients, many of them make me want to weep. The now-closed “listening exercise” about NHS reforms has apparently drowned in a tsunami of misunderstanding, misinformation, half-truths repeated as fact and big dollops of distortion from all quarters. How Steve Field and his band of “Future Forumers” (nice pun in that) are going to make something constructive yet critical out of all this will be a sight to behold.
Our friends at National Voices have made it clear in their “Nine Big Shouts” what the main theme for the Future Forum must be: integration, integration, integration. We certainly concur with that. As they say:
Services must become much more seamless, organised around the service user. They must support us to understand and manage our health and participate in all key decisions. The reforms and the Bill should be reviewed and amended to make sure everything lines up behind that goal.
But what of the architect of all this, Mr Lansley? His Bill shredded. The NHS a bloody battleground. Professional tribes revolting. The public anxious about reform. Avoidable, yes, but 20/20 hindsight won’t extricate us from the mire. Voices are raised for Lansley to go despite Number 10’s “nonsense” denials. Will a likely lambasting from Future Forum’s report tempt Cameron to drop the pilot over the side?
Probably not. Cameron is no Kaiser and Lansley is no Bismarck. Off the front bench nursing a spurned prophet’s wounds, Lansley is much too dangerous. The pilot will remain in his place as the rumour mills grind on
Lansley the policy wonk at heart admitted the obvious at the weekend: ‘I’ve stopped being a politician – I just want to get the NHS to a place where it will deliver results. ‘I don’t want to do any other Cabinet job. I’m someone who cares about the NHS who happens to be a politician, not the other way around.’
OK, so here is our “five point memo to the pilot”:
Number 1. Explain and persuade better. There is a case for reform, so make it clearly and consistently. Take a leaf from Norman Warner’s new book: without reform we face an “overspending tsunami”. That’s gripping. QIPP isn’t to most people.
Number 2: Please take Steve Field’s report seriously. Resist the special interests’ siren songs but celebrate good managers. We will achieve nothing without them.
Number 3: Remit parts of the bill back to Parliament, but nail the myths about privatisation, competition and regulation in public services. We have it already, it must be used in constructive ways and the NHS won’t survive if we pretend otherwise.
Number 4: Remember that Monitor has a big job still to do in controlling Foundation Trusts, those ever more powerful elephants in the room. There are going to be mergers and failures in the acute sector in particular. A strong Monitor must be able to handle that whatever other role it might have in competition and cooperation.
Number 5: Above all, put the user and carer at the centre of things from top to bottom.
That’s what you said this was all about in the first place, Mr Lansley. It still is.
The Moore Adamson Craig Partnership supports user and public participation, trains lay representatives and develops responsive health, care and education organisations. We are ready to work with and support all those who want to make sense and a success of the new structures of patient and public engagement within the new arrangements for health and social care commissioning and providing. Feel free to contact us to discuss the opportunities.