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 »

PFI, failing hospitals and the question of who else was going to pay for the new hospitals that we need.

Filed Under (Hospitals, PFI) by Paul on 28-06-2012

Yesterday was the fifth anniversary of Tony Blair’s departure from Number 10 and  last night I had a small party at my place for some of us who worked for him, so it’s perhaps fitting that today’s post defends one of his health policies.

On Tuesday as South London Hospitals NHS trust was moving towards administration a number of radio journalists asked me to go on the media and talk about it. Unfortunately I didn’t have time on Tuesday but in conversations with the BBC it was clear that the Government was blaming the PFI at the hospital for the financial problems. Read the rest of this entry »

Some more thoughts on the Secretary of State’s attack upon New Labour and PFI

Filed Under (PFI, Private Sector, Reform of the NHS, Secretary of State) by Paul on 01-11-2011

(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 »

How Andrew Lansley made PFI popular with the NHS

Filed Under (Hospitals, PFI, Secretary of State) by Paul on 27-09-2011

Yesterday I explored some possible explanations of what might lie behind last Thursday’s announcement by the Secretary of State that 22 trusts have problems of financial and clinical stability because of PFIs. Today I want to explore the NHS reaction to this to show how that demonstrates the current Secretary of State’s lack of political touch necessary to do the job.

Last week the Secretary of State achieved something that was really quite remarkable. His attack upon the potential clinical and financial stability of 22 trusts meant that he forced their CEOs and representatives to come into the public domain to say that, for their hospitals, the cost of PFI wasn’t that bad. Read the rest of this entry »

It just may be that 22 hospitals really ARE on the brink of losing financial and clinical stability. But it probably isn’t just ‘caused’ by PFI.

Filed Under (Hospitals, PFI, Secretary of State) by Paul on 26-09-2011

Last Thursday Andrew Lansley tried to highlight the cost of PFI to the NHS and did so by listing 22 trusts which he said were claiming that their clinical and financial stability was undermined by their PFI deal. Read the rest of this entry »