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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Will entrepreneurs be allowed to play any sort of role in developing the NHS?

Filed Under (Health Policy, Private Sector, Reform of the NHS) by Paul on 27-01-2012

On Tuesday evening I heard an inspiring speaker talk about the role he and his company are playing in the development of efficient hospitals in India. This was the third such talk I have heard over the last 6 months or so – all from Indian entrepreneurs who are driving down the cost of health care and thereby bringing it to many more people than under current provision.

This man, Shivinder Mohan Singh, unlike the others, is not a doctor. But like the others he is developing some very straightforward organisational principles and driving them into creating much more efficient hospitals. In fact he concluded his talk with the phrase “Keep it Simple” – all the time trying to apply very simple improvement techniques to what we all know are complex organisations.

During the Q and A it became clear that both he and the audience recognised that it would not be possible to simply apply what he was achieving in India in this country. In fact I recall that last year when a doctor who had revolutionised access to heart care through his hospital was asked if he would come and replicate what he was doing in this country he said that he would be mad to do so.

So at the end of the evening I was left with some complex thoughts.

First, entrepreneurs have a set of skills and capacities which would be immensely useful for the development of the NHS. What they do is bring very different approaches to the way in which value is achieved and those skills can help the NHS deal with the very hard tasks it is facing.

I don’t think they are the answer, but I do think they can add to our stock of answers. The main place I see that happening within the NHS at the moment is through the experiences of a number of non-executive directors (NEDs) in FTs. Increasingly the boards with which I work are trying to understand how they can develop new business models to provide better services. Frequently NEDs recognise they have a wide range of experiences which have achieved better value in previous worlds in which they have worked. Often the insights, precisely because they are from outside the NHS, point to a clear way forward. Sometimes their experience can’t be translated to the NHS.

Over the last 5 months or so I am hearing these voices make a bigger and bigger contribution to sustaining the NHS.

My second thought was a bit more depressing. There are thousands of people who care deeply about the NHS who see entrepreneurs such as Mr Singh as being not just outside of the NHS – but its enemy. The anger and alarm about the private sector and its involvement in the NHS that has swept through the debate about its reform over the last year has been the clearest example of the Government’s lack of narrative.

The debate has now settled into a common set of assumptions about the bad impact that the private sector would have on the NHS. This means that Mr Singh is experienced by some in the debate as an enemy.

This is very sad. The NHS cannot afford to turn its back on skills and processes which will help it deliver the much better value health care needed in the future.

This Government has completely failed to make that case.

But it still needs to be made.

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