It would be good to detect signs of humility and contrition in the healthcare community when the editors of three of the leading trade publications (including this one) launch a “never again” plea for more discussion and less prescriptive dogmatism next time there’s an NHS reorganisation.
Yes, there will be others – although we haven’t finished this one yet.
As the parliamentary end game approaches I detect little humility in either camp. Labour and rebel Lib Dems (take a bow, Shirley) have been briefing that Andrew Lansley’s latest batch of amendments to the Health Bill – clarifying his responsibility to sustain a national service and other opaque details – amount to what Labour’s Baroness Thornton calls a “massive climbdown”, while still promising to wage war against the competition regime.
Some senior Labour MPs hope to derail the bill at the final hurdle. Too late for that, I’d wager. Number 10 may have jitters after the peers’ Welfare Bill revolt, but David Cameron has too much invested in it – and in his old boss, Mr Lansley (although I don’t think he’ll be promoting him any time soon).
As for the secretary of state himself, he popped up in the weekend press in his familiar martyr’s guise complaining of misrepresentation by the unions (again) and the leftie BBC (again). Worries about the emerging trend among clinical commissioning groups (or primary care trusts as we used to call them) striking certain “routine” procedures off their NHS lists were breezily dismissed as evidence of greater “discernment” among GPs about what treatments work – or don’t. That’s fine, far too many doctors waste taxpayers’ money anyway, but I doubt that voters will see it that way.
“Hands Off” Lansley couldn’t refrain from interfering to tell hospitals to raise their weekend performance: Sunday is a dangerous time to fall ill. Surely, his bill puts control back in the hands of the professions – the very professions that enjoy a round of golf? That could explain the “five layers of management” memo unearthed by HSJ and trumpeted by Labour’s Liz Kendall.
One bit of suitable contrition I did spot was Tuesday’s speech by Andy Burnham, made at Iain Duncan Smith’s Centre for Social Justice think tank – a conciliatory venue. It amounted to an admission that as health secretary for the last 11 months of Gordon Brown’s era he’d been too focused on the (doomed) reform of social care to worry much about mental illness.
It’s been niggling him ever since because he’d read the Bradley report on offenders with mental health problems and was appalled. In the stressful 21st century where more of us will lead changeable, unstable lives – and the disease-centred NHS will evolve into a more preventive mode – mental health and “wellbeing’’ issues will finally move centre stage, Burnham now contends.
There’s certainly a lot going on in that respect: Mencap hammers away, Whitehall’s new dementia strategy was outlined only last month, and more and more GPs are referring NHS patients for “psychological therapies” – a policy advocated by Lord Layard, the happiness czar, and promoted by Burnham in office. And to top it off, Lord Stevenson has won government backing for his Mental Health Discrimination Bill to amend laws that allow people who have suffered such illness to be debarred as jurors, school governors or even as MPs.
Burnham prefers “resilience” – also known as the capacity to cope with life’s ups and downs – to “happiness” as a policy goal. At his side at Tuesday’s speech was Alastair Campbell, who has survived his share of those. Now that sports stars are able to talk openly about depression we can end the stigma, they argue. In recession we certainly need to.