The DHSC’s failure to publish the mandate for NHS England for 2019-20 on time is an act of avoidable disrespect, says Andy Cowper

“Man is born unto trouble, as the sparks fly upwards”

– Job 5:7 

Watching the roof of Notre Dame cathedral burn felt uncannily like Peak 2019.

And learning from my colleague Dave West that the Department For Health But Social Care had missed its deadline to publish the mandate for NHS England for 2019-20 felt uncannily like peak English NHS health policy.

One more missed NHS target

I mean, what’s one more missed NHS target between friends?

Regular readers are aware that five years ago, I was the first person to comment on the subtle subversion of the approach taken to the government’s legislation and health policy by the Sun King of Skipton House, NHS Commissioning Board boss Simon Stevens.

Mr Stevens has got the prime minister asking him to recommend which bits of the Health And Social Care Act 2012 he wants them to abolish – legislation for which every single member of the Cabinet, government and Parliamentary Conservative Party consistently voted.

(Yes, that sound you can hear is the Easter Bunny dying of laughter. In the last words of Edmund Kean, “dying is easy; comedy is hard”.)

He has his detractors, but when it comes to the politics of the NHS, as I wrote in 2015, Simon’s in charge.

I was ahead of everybody else in policyland in seeing and saying this stuff. And I was not wrong. It doesn’t keep me warm at night, but it has to be mentioned.

Mandate Tory, mandatory man date

The NHS mandate is, well, mandatory. It is painful to have to state so obvious a thing. And I like pain less and less these days. (I can think of things that I would like less than a man date with Secretary Of State For The Time Being Matt ’Ancock, but to be honest, I cannot think of many.)

Why has the poor man’s Chris Grayling with a PC World loyalty card failed to deliver the mandatory mandate?

(There is, of course, speculation that Mr ’Ancock fancies a crack at the top job. Did Dunning-Kruger die in vain?

I hate to disappoint fans of ’Ancock’s ’Alf ’Our, but it is obvious to members of the Reality-Based Community that the Brexitphile Conservative Party is vastly unlikely to elect a Remainer such as Mr ’Ancock as its next leader.)

This could be the only time in my life that I shall use the following words unironically: the answer is Brexit. I have previously commented that Brexit has been the bonfire of the sanities, using up all the oxygen in the room.

At this point, I could be fair, even if I’m often foul (if perhaps not fowl). There is a reasoned and reasonable argument that Mr ’Ancock has been playing an OK hand on Brexit, by keeping ultra-Remainers and ultra-Brexiters equally at bay. And by making sure that in his role as the world’s biggest fridge magnate, the NHS has been reasonably well-prepared for the evident catastrophe of a no-deal Brexit.

By this line of thinking, Mr ’Ancock has some good reasons to be distracted, as well as some bad ones.

Mmmmmm. Perhaps.

Nevertheless, there are real consequences for this act of omission by Mr ’Ancock and team. While the degree of difference which the Mandate makes in the operational short-term is rather limited by the lack of cash and staff and the abundance of demand, both the senior and front-line levels of the NHS will not fail to notice that, whatever the trigger, the Secretary Of State For The Time Being is a member of the Not Paying Attention Community.

Many NHS staff at national and local levels are working as hard as they can to keep the system upright. They have been working like that for some time. They will notice this act of avoidable disrespect, and they will note it.