My mission statement

The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

Read my statement in full »

The limited effectiveness of top down authority in making modern institutions work.

Filed Under (Culture of the NHS, Health Policy, Reform of the NHS) by Paul on 10-01-2011

One of the interesting cultural experiences of the NHS over the last few months has been the way in which the phrase “Stalinist” has come to be used as a description of actions by people about their own use of their authority. What is most interesting is the fact that the word is not being used in the way in which most of us has become used to hearing it being used over the last 50 years. That is as a term of derision and abuse. “You are just being Stalinist” to describe someone who is being authoritarian and just expects their staff to do what they are told – or else. Read the rest of this entry »

If the answer is David Nicholson – what was the question Andrew Lansley was asking?

Filed Under (Culture of the NHS, Reform of the NHS, Secretary of State) by Paul on 07-01-2011

One of the main issues for Andrew Lansley in 2011, during what is meant to be his first year of implementing his “revolutionary” reforms, is why he has appointed as his main ally in this difficult daily struggle for reform someone who so fundamentally disagrees with him. This disagreement is not intellectual (despite all the attempts at bluster David Nicholson has a very fine intellectual capacity even if he would hate that to be recognised), but is, as we will see, a very significant cultural difference. Culture is “the way in which we do things around here”. And David Nicholson is very much not the way that Andrew Lansley “does things around here”.

How did this happen? Read the rest of this entry »

Government policy on the architecture necessary to create greater efficiency in the NHS in the short term…

Filed Under (GP Commissioning, Reform of the NHS, Secretary of State) by Paul on 06-01-2011

…as against Government policy on the architecture necessary to create greater efficiency in the NHS in the long term. Are they in any way related?

Last week the Guardian published a letter – from September 2010 – from a challenge group. The letter was written on 7 September by the former APAX chief investment officer Adrian Beecroft, the Chief Executive of the Legal Services Commission, Carolyn Downs, and the Director of Climate Change Adaptation at the Department of Energy and Climate Change, Robin Mortimer. Read the rest of this entry »

Hello NHS reform in 2011

Filed Under (GP Commissioning, Health Policy, Reform of the NHS) by Paul on 03-01-2011

So what does the crystal ball tell us about the NHS in 2012?

As with most crystal balls it mainly gives us a refraction of what was happening at the very end of the year before. The future really is a continuation of the past. And December 14th and 15th 2010 set the seal on 2012. Read the rest of this entry »