‘Simon Stevens wants to take us back to 1991 before the purchaser provider split. Jim Mackey wants to go back two years to when he was a trust CEO.’
To: Don Wise
From: Paul Servant
Re: NHS Retro
Everybody seems to be looking back these days for the answers for the future. Jeremy Hunt thinks we need to go back to before the 1983 Griffiths report created NHS management, and Simon Stevens wants to take us back to 1991 before the purchaser provider split. Jim Mackey without such a strong sense of history wants to go back two years to when he was a trust CEO.
And STPs have simply raided the retro strategy cupboard and dusted down every NHS reconfiguration programme that their predecessors haven’t managed to get through before.
The unsaid mournful glances that everyone is refusing to admit casting are to the days before Andrew Lansley decided to look forward with nothing in mind except no top down reorganisation of the NHS before launching the largest, most ineffectual one ever.
This decade of health will be characterised as the one where the first half was spent painfully constructing a system that was painfully dismantled in the second half. A decade when the entirely predictable and predicted surge of people living well into their 70s, 80s, 90s and beyond needed more health and social care from a system whose leadership kept on claiming it could reduce demand.
Back in 1983, Griffiths talked about Florence Nightingale finding no one in charge, and it’s difficult to know today who will claim to be, at least when accountability and responsibility are required. In 1991 launching the Patients Charter, in the same family of ground-breaking initiatives as the Cones Hotline, William Waldegrave, long-forgotten SoS of his day said, “Every household should know its rights under the NHS”. As Gorbachev proved with that other 80s retro classic, Glasnost, simply giving people the right to know how miserable they are doesn’t cure their misery.
Anyone with a real sense of history will want to avoid returning to days when there was little accountability, evidence of quality or effectiveness, nor two brass farthings to rub together. And no patient is looking back 30 years to find answers to their care needs today, though they are beginning to have a strange sense of 1990s déjà vu when faced with being on an A&E trolley for longer than 12 hour hours, waiting lists, and difficulty getting a GP appointment.