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.

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The Election and the NHS

Filed Under (Conservative party, Election campaign, Health Policy, Labour Party, Liberal Democrat Party) by Paul on 27-04-2010

Whilst the opinion polls  show that the electorate still see the NHS as the second or third issue of importance to them (Behind the economy and in some polls behind immigration), there is really no trace of the politics of the NHS in this election. Given my comments on the Conservative manifesto this is exactly what the Conservative Party would hope from the campaign. At the start of the campaign the Labour Party was trusted with the NHS more that the Conservatives and it would therefore be to the Conservatives advantage if there was not much discussion of the NHS.

But in reality in this general election all of those past rules of thumb don’t really work anymore. For the last two weeks the election has really been about the leader’s debates. And the most interesting political issue to come out of that has not been the personality of Nick Clegg, but has been the rage in the newspapers at there being a series of events that allow the public to look at politics unmediated by the newspapers.

At the moment this looks to be the biggest process issue for the politics of the country to come from the election.  After the first debate, it was clear to most people that saw it that Nick Clegg did better than the other two leaders. For 72 hours the newspapers reported this as ‘news’ and then the editorial line recognised that the ‘news’ presented a problem for the political parties that the newspapers supported. You then get 72 hours of vituperation being poured all over Nick Clegg by the papers. But it didn’t seem to work very well.

So the next tactic is to trash the debates as X factor politics. The TV debates are then painted as in some way as being less serious (although how on earth the tabloids can say that – as if their own approach to informing the public was in the tradition of Demosthenes and Cicero!). But that is a bit late now.

In the distant past politics was unmediated in its relationship to the public because it took place at traditional hustings in front of very public meetings. As they declined, the whole of politics went through the mediation of the media and in particular the newspapers. The 1992 election had the Sun proclaiming the day afterwards its famous headline that it was “The Sun that Won it”.      

In this election it is a bit too early to say but it may be the case that no newspaper will have ‘won it’.

What does all this mean for health? If, as seems likely, there is not a majority government, then it is almost certain that the biggest issue about the result of the election will be what proportion of the vote did each party get and what number of seats do they get with that share.

For those obsessives like me there is a handy gizmo on the BBC web site in their election Coverage 2010. You can play with an election seat calculator which translates share of the vote to number of seats won in Parliament. If the three main parties each get 30% of the vote then the Conservatives will have 206 seats, Labour 315, and the Liberal Democrats 100. The electorate will not give us such a neat outcome but it shows the sort of issue that any the outcome of the election is likely to throw up.

Whichever political party forms that minority government. It will have been elected in a system that for the first time will become the political issue. It will become the political issue for the next Parliament because if the Liberal democrats have the nerve they will make it the price to be paid for any support they give a minority government.

Usually changing the voting system is only really of interest to a small group of constitutional experts. But the whole country will get a very clear view of the outcomes of our current system at this election – which will be underlined by the politics of Parliament every day – that the votes that were piled up for two parties were unfairly translated into seats for them when compared to the other.

In this political battle, the politics of the NHS will not be seen to matter very much.

In itself, this will prove interesting. Since whilst the politics of the NHS may not matter very much, at the same time the economics of the NHS will become really central, Whilst there may not be less money the money will not keep with the growth in demand.

So our attention, usually riveted to what the Secretary of State is doing or thinking will change to how we provide significantly better outcomes for the same resource.

If the NHS can develop a clever approach to economics then it will thrive. Politics in the NHS for a little while will be of much less significance.

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