When confronted with a policy problem, as senior ministers constantly are, Jeremy Hunt has an ingenious way of proceeding.
He starts by consulting something called his “Risk Cloud”. It must get a lot of use since barely a day seems to pass without the Department of Health being in the thick of battle.
I’ll come back to the Risk Cloud. First the latest tsunami of hostile headlines. Labour scored a hit at the weekend by unearthing a list of 17 English hospitals deemed “dangerously understaffed” by the Care Quality Commission (CQC), enabling shadow health secretary Andy Burnham to accuse David Cameron of imposing “a toxic medicine of spending cuts and reorganisation” on the NHS.
There’s some truth in that analysis, although the parallel confirmation that Mid Staffordshire Foundation Trust is still in scary trouble despite the millions thrown at it since the crisis – and ahead of the Francis II report – serves to underline that money and management-intensive care is never enough to fix things that have gone badly wrong in any institution.
‘For some politicians empathy comes naturally, others have to learn. It matters in the NHS family – at all levels’
Did I say fix it? The secretary of state had to take to the airwaves when the scale of Jimmy Savile’s career of high-profile manipulation and sexual abuse again engulfed the NHS for its failure to protect vulnerable patients in its care.
While the Department of Health’s Kate Lampard conducts her year-long review of what went wrong in places like Stoke Mandeville (did you spot that Sir Jim pulled string with Yorkshire copper chums to ensure that Surrey police interviewed him at his Stoke Mandeville lair?), the immediate priorities are twofold, Mr Hunt is saying.
They are to ensure that current safeguards guarantee it can’t happen today and to give Savile’s victims clear and simple procedures (apart from lawsuits) that help them “achieve closure”.
Hunt clearly means it, although his tone can sound too detached, lacking the easy empathy that Norman Lamb brings to any policy statement. Lamb did again this week when announcing Lady Julia (ex-King’s Fund) Neuberger’s investigation into the Liverpool care pathway, as it is unlikely to be called for much longer (Merseyside Care Pathway, anyone?).
For some politicians empathy comes naturally, others have to learn. It matters in the NHS family – at all levels.
Risk Cloud revealed
But these are legacy issues, none of them Mr Hunt’s fault, some not Andrew Lansley’s or Burnham’s either. But Hunt has to deal with them as well as make policy decisions which may – may – come back to haunt his successors, just as his decisions as culture secretary (2010-12) are his legacy there. Drastically cutting his civil service staff to impress the Treasury has left that department angry and hamstrung, say some.
Here’s where his Risk Cloud comes in. I first heard about it before Christmas and have since heard more. Apparently he has a board with clouds on it of different sizes and colours. It is produced at the start of any serious discussion of policy options with officials and used to identify risk, the starting point on the road to a decision.
All this sounds like management consultancy stuff which he has picked up on life’s journey, officials suspect. Odd? You decide. One person who occasionally glimpses the Risk Cloud in the inner sanctum briskly observes: “It works for him.”
Monitor’s imminent proposal that private sector health providers get tax breaks to rebalance the “unfair” advantage that public hospitals pay no VAT or corporation tax will clearly require the Risk Cloud ouija board. Labour is furious. I can see both sides.
But I also note that there seem to be profits in the Liverpool Care Pathway and that one accident and emergency consultant was paid £5,667 for 24 hours work at Mid Staffordshire. Money is part of the new NHS transparency regime.
Michael White writes about politics for The Guardian