Our new government could do worse than to engage in a little strategic planning.
Good strategic plans follow a simple structure. There are three questions. Where do we want to be? Where are we now? How do we get from where we are to where we want to be?
Let us hope that we will all have the chance to influence the vision of the future and to describe an NHS based on outcomes, humanity and respect
The first one should be the easiest. It is always easier to describe the future than to create it; an NHS in which patients come first, where humanity is more important than absurd targets such as the accident and emergency four hour rule. An NHS in which trusts could negotiate local standards with the people they serve and with GPs, local authorities and other partners. A world in which trusts are receiving many good applications for chief executive posts because the candidates know that they will not be bullied but valued. An NHS where professional standards and development are celebrated and where staff at all levels are respected.
The second question is much more difficult because it requires courage and the willingness to see the NHS as it is rather than as the politicians would like it to be. It requires a world in which the emperor knows that he is not wearing any clothes because people are allowed to tell him. Now that really is difficult to achieve because it requires honesty and integrity.
Those who have read NHS 2010-2015: from good to great will have choked on your gruel (standard rations in these hard times) when you reached paragraph 1.32: “By putting power in the hands of the people we have created a powerful engine for reform. Where once we had to rely on national targets to drive improvements, we can now drive change through the influence of patients. This will be the basis on which we renew our vision for the future.”
Please note that this is not an aspiration. It is supposed to be a description of the NHS of today. Does this ring true to you? There is a total air of unreality about this statement. It seems as though those who approved the draft have reached the dangerous stage of believing that they only have to say that something is true for it to become a reality. This is not the only departure from the real world. We are also treated to the view that “over 125 foundation trusts have been set free from central government control”. I wonder how many of the trusts would agree with that one.
The third stage - getting from where we are to where we want to be - should be relatively easy if we have a clear vision of where we want to be and if we are honest about where we are. It becomes extremely difficult if there is no acceptance of present realities. Courageous patience will be needed if we are to move towards an NHS that we can be truly proud of.
Let us hope that we will all have the chance to influence the vision of the future and to describe an NHS based on outcomes, humanity and respect. Let us hope that the new government will have the courage and honesty to see the present as it is. Only then can we plot the course to get us to where we need to be. Clarity of aspiration, a realistic view of where we are, and courageous patience on our journey - that is what we need.