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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Save the NHS! But what if different people want to save different things?

Filed Under (Reform of the NHS) by Paul on 16-04-2012

Change the NHS! …and if people want to change different things?

One of the near universals in British society is the strength behind both the campaign and the slogan to “Save the NHS”. As the coalition government has discovered if the impression forms that the NHS is ‘under attack’ the consequent mobilisation of large numbers of people around the slogan ‘Save the NHS’ becomes an important part of the politics of the nation.

The NHS matters enormously to a very large proportion of the British – and in our specific case – English public.  A small but significant part of the population disagrees with a state funded health system and some power obtains to them in some of the right wing media, but as a proportion of the population it is difficult to see their point of view gaining much political traction over the next decade.

The breadth of meaning of both the slogan and the different things about the NHS that people want to ‘save’ give it and its politics a great deal of weight, and so long as the slogan continues to convey this breadth of meaning, it will remain powerful.

However my problem with it is that all slogans that want to save things are by definition conservative and seek to protect the status quo.  Slogans that ‘save’ are saving the ‘here and now’ – usually against arguments for change – and that ‘here and now’ usually needs some form of change rather than just being ‘saved’.

There are some things about the NHS that I really do want to save – and some that I really want to change.

What I want to do over the next few weeks is explore both the range of different things that people want to save, and the different things that people want to change when they ‘save the NHS’.

Why do I want to do this? Because I believe very strongly that the status quo is not sustainable and therefore that if the NHS doesn’t change it will find it very difficult to survive – let alone thrive.

So what do people want to save and what do they want to change?

This is an appropriate time to be asking this question because those who mobilised around the ‘Save the NHS’ slogan to try and stop the Government Bill becoming an Act, now want to make big changes to the status quo.

Many of those who mobilised behind the ‘Save the NHS’ slogan are now committed to repealing the Health and Social Care Act. There is therefore a substantial group of people arguing for changes in the NHS under the slogan of saving it.

This is much more than a semantic point. This substantial group of people are now arguing that to save the NHS there must be some changes in the way in which it is organised.

They are not alone in taking this position. As the Coalition Government struggled to find a rationale for their reforms, just before the end of the day (in terms of the passage of the Act), the Prime Minister began saying that he wanted the NHS to thrive beyond this decade and that he was therefore arguing for reform.

Which brings me to why I will be posting on the issue of saving the NHS through change over the next few weeks.

At the moment even the most conservative NHS ‘saviour’ recognises that it needs to change in some way or another.

So now is the time to explore what we want to save, and what we want to change.


2 Responses to “Save the NHS! But what if different people want to save different things?”

  1. Couldn’t agree more Paul. One of the frustrating things for the RCM was to be depicted as ‘luddites’ because we were opposed to tbe Bill. We have always accepted the need for change, which is why we support among other things, the extension of choice for users of maternity services, the development of a pathway tariff for maternity services and the development of outcomes measures around themes such as women’s experience of maternity care.

  2. I’m a GP – so have to just get on with whatever situation I find myself facing: and this is by no means the first major, top-down reorganisation I have faced!
    Every major reorganisation has changed the administration – and the organisations charged with that administration.
    Most proclaimed that they were devolving power to the front-line or Clinicians: I don’t think any have delivered this.
    None have successfully tackled the problem of managing the conflicts of interest when different organisations are fighting to increase their share of a fixed amount of resource in the local health economy.
    Looking forward to the next installment of your blog – but once a structure has been abolished and replaced with another (DH->SHA->PCT replaced by DH-> NHS CB ->regional outposts -> local offices -> CCGs) it is hard to see how the previous structure – and power relationships – can be restored – even if they functioned better than the last, triennial restructuring.
    Is repeal of the Act and a return to the status quo ante even a possibility?

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