Posts Tagged ‘communications’
Back To The Future Of The NHS
I have grave concerns about the government’s NHS reforms. I feel like it’s Groundhog Day.
I was deeply involved in the last major health service reforms back in the 1990s. I am hearing exactly the same ideas, phrases and promises as we heard then. Haven’t we done this all before?
When the “internal market” was introduced and the first NHS Trusts were “founded”, the idea of marketing was introduced to the NHS for the first time. I saw the opportunity, organised a conference at the QEII conference centre and built a nice business, thank you very much, for several years as an expert in the field. I was an advisor to several health authorities and a number of the new NHS trusts. I undertook marketing and communications audits, ran training courses and I made something of a specialty of designing, writing and producing annual reports. I learned a lot and I felt I contributed a lot. Why is it all being done again?
Marketing is a perfect description of the way the health service should work. It is the management process responsible for anticipating, identifying and satisfying customer needs efficiently. The 1990s NHS model was that “purchasers”, health authorities and GP fundholders, would buy services from “providers”, hospitals and community health services. “Purchasing” was later renamed “commissioning” to reflect how complex the task is. It’s about understanding what services are required and making complex choices as well as actually contracting for them.
Strategic Health Authorities (SHAs) were always a redundant tier of bureaucracy in my view. District Health Authorities (DHAs) were to be the principal commissioners but the plan was that GP fundholders would eventually take over most of it with DHAs becoming centres of expertise rather than administration. Then there was a rather messy fudge between GPs and community health services and we ended up with Primary Care Trusts (PCTs).
There is a huge amount of expertise required in commissioning. The complexity of the tasks involved – understanding, assessing, testing, planning, choosing, contracting and much more, is enormous. GPs will have to buy in that expertise which will build a bureaucracy which we will call – what? We will have gone round in a circle.
One of the biggest mistakes made about the NHS is the endless stream of attacks on managers. Almost all the problems that the NHS has and that people complain about are management problems. NHS managers have a hugely demanding and thankless task for which they are regularly pilloried and censured. They are, actually, crucial to an effective NHS, just as much as the clinicians.
So now we are to have “Foundation Trusts” and GP commissioning. It is the same thing, yet again, under a slightly different name. The NHS is not broken. It is, in fact, greatly improved. It doesn’t need fixing.
We do not need more reform. We need some adjustments. There have been great achievements on waiting times. Now, we need to shift the emphasis towards outcomes. We need targets on quality rather than quantity. It’s a tweak rather than a revolution.
MPs Evading Justice
So are we supposed to be surprised that Gordon Brown is still clinging by his fingernails to the architrave at the door of number 10? They couldn’t organise a piss-up in a brewery, an orgy in an whorehouse or a coup in the Labour Party. Why? Because they all have nothing but their own interests at heart. Their last year in office, their pensions, their resettlement grants. These are not men. They are manipulative, morally microscopic mice.
Phwooaar! Gerrumorrf darlin'!
Plod PR, the go-getting communications agency, wholly owned by the police with exclusively the police as clients summoned all its collective intelligence and wisdom to determine that last Friday, the day after the European and local elections would be a busy news day, a perfect occasion to bury their cowardly, disgraceful announcement that MPs will not be prosecuted.
In fact, the expenses scandal has now morphed into an excuse for poor performance in the elections. This is a triumph of misinformation over truth. Over the weekend, we were asked to sympathise over the “assault on MPs about their expenses”. If what has happened has constitued assault then my feeling is that it’s time for some GBH with intent.
Everything has now been re-geared to enable them all to get away with it. Perhaps even more worrying is that this marks a new development in the politicisation of the police. Increasingly the police are being used to support and enforce the whim of government, irrespective of the law or justice.
The Taxpayers’ Alliance is still chasing down MPs (see here) but what has happened to the Telegraph? Have they had a visit in the middle of the night from the police or have big, fat, brown envelopes been distributed around Telegraph Towers – or both?
Welcome to my world!
Peter Reynolds is a writer, communications advisor and proud Welshman. He lives in a small town called Emsworth, between Portsmouth and Chichester on the south coast of England. After “dropping out” from life as a hippy musician, Peter experimented with direct sales and the motor trade before training as a copywriter and eventually making it to the top of his profession as a creative director with Saatchi & Saatchi. Along the way he developed special expertise in technology and healthcare working with clients such as IBM, Hewlett Packard, GSK and the Department of Health. He also worked as a freelance journalist writing for just about every PC magazine then on the market and had a weekly column in The Independent based on the simple idea of riding a bike but ranging across subjects such as politics, sport, technology and the media. Since the 1990s he has worked as a consultant to organisations such as Nokia, the British Army and Pinewood Studios. In 2004 he established Leading Edge Personal Technology as “the magazine for technology enthusiasts”. He continues to write on a wide range of subjects.
