Author: Warren Town, Director of Industrial Strategy
Just when you thought it was safe to come out from under the covers, along comes another reorganisation (sorry, transformation) of the NHS.
It is always déjà vu when some bright spark has yet another idea to save the NHS much needed cash and believes that by ‘transforming’ services we can improve and streamline the system.
Sustainability and Transformation Plans (STPs) are another reorganisation of the NHS and dressing it up as some grand idea with a fancy new title does not fool us one bit.
This is about hospital closures, staffing cuts and reductions in wards and clinics. But hark, this is not true because by consolidating services and doing more with less we are somehow improving the system for staff, the service and the patient.
£1.8bn was set aside to transition change. Sounds like a lot but, in truth, the money was already spent on deficits before it even left the electronic ether.
The major concern from the public, campaigners and even the King’s Fund has been the secrecy surrounding the proposed changes that have been designed by the great and the good. Plans that will address the need to save £20-odd billion by 2020 or, if they do not, the current head of the NHS had better find another job.
What these plans will say - there are 44 of them - and the impact on jobs and services, is yet to be fully appreciated and I cannot help but wonder if these ‘plans,’ whatever they are, have looked at the need to save money first and then decided what is acceptable and at some point, possibly, considered the needs of the patient.
The history of NHS reorganisation – sorry, transformation - is not good. Change takes time and change is more often opposed and change means delay. So much so that after every successive reorganisation there has been further and increasing delays in treatment and diagnosis and longer waiting times.
But yet another characteristic of change is opposition. No one likes change, even if it is for the good and the manner by which the STPs have been agreed and then consulted on is insulting to the electorate and ham-fisted to say the least.
Local opposition, oft supported by the local MP with a keen eye on the next election, can be effective. There are many changes that have been successfully opposed.
But why the STP groups could not take the inclusive approach and involve staff and the electorate from the outset, remains a mystery and smacks of arrogance. If we see the need for change, even if we are not happy with the prospect, to be informed and part of the solution can bring many rewards for policy formers and MPs alike.
It is yet another example of the NHS telling us what we will have, not what we want.