(In yesterday’s post I made the point that I felt that the Secretary of State had shifted his position and now wanted to act to stop the bad results of the variation of practice with the NHS. This met with a number of responses from readers. Some of the early Twitter comments felt I was being incurably optimistic that the Secretary of State would really begin to tackle variation of practice by radically changing hospital organisation. It’s strange to be in the position of defending a very damaged Secretary of State, but I feel he has come to this position not through choice, but because he has had to.
18 months into the job he becomes responsible for the NHS and everything that happens to it. That means that the results of the CQC inspection that was published the week before stops being ‘the fault of the Labour Government’ and becomes the fault of this Government. Given that he has now agreed a set of changes to his Bill which demonstrate that he is firmly responsible for the NHS, it’s about now in the Parliament when, so far as the public are concerned, he becomes clearly responsible.
Therefore when any credible body now criticises the NHS he will need to say what he is going to do and given that he will have to say what he is going to do, someone will start to hold him to account for it.
This will also happen to the Government in other areas of policy and economics. For as long as possible they will say that it’s the previous lot’s fault, but sooner or later the public will think that too much time has passed since the election and that argument will no longer work. This responsibility has come earlier in health than in other policy areas because the last 15 months have been such a noisy political mess over NHS reform. The public clearly know that so far as the NHS is concerned there is a new Government – because there has been so much noise and such a mess.
So my belief that the Secretary of State has changed his position on tackling variation in the NHS does not come from a naive position that he has suddenly changed his mind about his responsibility for improving bad practice. No, I believe he has started to take this seriously because the public and the voters have recognised that after 18 months in the job he is in charge. From here on in. It is his responsibility).
Today I want to comment on another part of his speech that will obviously become a theme. On 27 September I mentioned the fact that when the Secretary of State named 20 trusts that were potentially clinically and financially unstable because of PFI deals he managed – in one speech – to make the leadership of trusts come out in support of their PFI deals. Read the rest of this entry »
