Another week, another national strategy. Many will be slightly less excited than health ministers or the NHS Executive by the appearance of the first ever human resources strategy for the health service (See News, page 4). In this instance, however, they would be wrong.
New Labour has proved itself a prolific spawner of policies and cliches, but here at last is real evidence of what ardent Blairites would call joined-up thinking. This is not a strategy developed in isolation. Here are policies on human resources intended to support the effective development of primary care groups, clinical governance and health improvement programmes. Here is the promise that national service frameworks will be accompanied by the programmes on workforce planning, education and training, and personal and organisational development they will require to be effective. And here, too, is an obviously genuine and welcome attempt to improve the lot of NHS employees.
Many of the targets measure processes rather than outcomes, but this is inevitable in a strategy which seeks to create a balance between national direction and local initiative. And that said, the document is not dominated by platitudes and pious promises, as it might have been. It will be down to health authorities, PCGs and trusts to do their bit by translating the intentions of the document into local outcome targets - but they may rest assured that regional offices will be breathing down their necks if they don't. The sting in the tail of NHS chief executive Sir Alan Langlands' circular is all too clear: 'Failure to address these priorities and to achieve targeted progress will require attention.'
And yet there is a catch. All the good work put into this document will be imperilled if the government does not get it right on pay. This year may be no different from any other in its essentials: the British Medical Association has made a wildly optimistic pay claim, the chancellor has delivered his lecture on self-restraint, staff shortages are rampant, and a trust chief executive has been singled out, apparently at random, for a media bashing. But there is potential for things to be different this year. The government's exaggerated claims for the comprehensive spending review have raised staff expectations, a problem for which ministers have no one but themselves to blame. And for reasons best known to themselves, the powerful mid-market tabloids have decided that this time round NHS pay is a real story. When was the last time you saw a 'Daily Mail campaign' urging: 'Time to pay our nurses more'? If we are going to get some real joined-up solutions for the NHS, we will need to start getting some joined- up thinking on public sector pay.
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