Paul Corrigan: Darwin's theory on the NHS
The greatest truth in Darwin’s On the Origin of Species is that to survive in a rapidly changing environment, species must adapt. And for a species to be adaptable it needs to love diversity.
Lack of diversity does not matter if the environment does not change too much, but if the organism lives with fluctuations in heat, damp or predators, a lack of species diversity can mean that big environmental changes wipe them out.
NHS culture does not follow Darwinism. It feels that if we are worried about survival then the big fit organisms will see off the opposition. Strong organisms do not feel they have to understand the new messages coming from that new environment. They believe they are too big to be finished off by any change in it.
Darwin disagrees. To thrive and survive an organism must learn about the environmental change as quickly as possible, take that message to its brain and then change its behaviour to fit in with the new environment. Sometimes an organisation can pick up an environmental change, but the brain refuses to hear the message, or it may not change in response to it. Recognise any of this?
Pretend that public money is the lifeblood of the NHS. In 2009, our environment produces it in abundance, but there are signs everywhere that this will change significantly. If the NHS was a diverse species, with, for example, a diverse range of primary care trusts, some of those organisms would get this message and act on it. They would change their plans with, for example, a standstill budget for 2009-10. The rest of the species would look at the first few who set zero growth budgets and say that might be something to learn quickly.
If, however, there is insufficient diversity or the organisms ignore the changing environment, if they unthinkingly obey a single voice, the culture of the whole organisation does not pick up the change or act on the stimulus. This means the species is in big trouble.