I have a personal interest in the NHS. Aside from qualifying myself in medicine from Cambridge and doing a few years as a busy junior doctor in Cambridgeshire and London, my late father was a GP for three decades near Brighton. Furthermore, I owe my life to the NHS, as I became unconscious on June 1st 2007, due to bacterial meningitis – I woke up from a coma in the middle of July that year thanks entirely to the brilliant staff of the Royal Free. Through a diverse academic route, I came to complete a MBA last year at BPP Business School. Indeed, the case study for the organisations and leadership module was a case of change management in the NHS. I obtained 84%, and the pass mark was 50%.
To me, it’s clear what the problem is. Now is not the right time for the Government to have immersed itself in such a complicated strategic change management, when the country is doing extremely poorly. Indeed, only this morning the Bank of England confirmed missing its lending target to small businesses, and two surveys were published suggesting this morning that the UK economy outlook could even worsen. Steve Richards on BBC Radio 4’s Today described that even when the Coalition manage to get the ill-fated Bill this morning onto the Statute books it will almost certainly fail in its implementation. The Government had a critical role in encouraging a culture of cooperation over its reforms, and it failed over a number of fronts. It has failed to publish the Risk Registers which we now know contained information which severely undermined the Government’s case, the public do not seem in favour of the Bill (with over 66000 having signed the e-petition already), and the vast majority of the medical Royal Colleges have now declared that they have several reservations about the Bill or oppose it outright. The implementation of the Bill so far is completely apposite to what most management consultants would advise at this point; most would recommend active focus groups to seek the opinions of those who work in the NHS, particularly doctors, nurses and healthcare professionals to overcome the barriers to cultural change posed by the Bill. Instead, there seems to have been expensive active consultation from management consultancy firms and private healthcare insurance companies instead, which could further compound resentment.
The solution therefore to me is clear. There is no point this being enacted in its current form, and there needs to be a mature development of the Bill which does take into account the difference between price, cost, value and quality of different health ‘products’ such as goods and services. Not only that, it would be critical for the Presidents of the Royal Colleges of medicine, including RCP, RCGP, RCN, RCOG, and RCS to help to develop policy, and to be engaged in genuine consultations with their members about how to progress with the public. The only solution is therefore to rip up the Bill, and start again, as this is the only way to avoid resentment and a doomed implementation of the NHS strategic change. It will be far less costly in the long-term. David Cameron, through his charisma, may feel that he is able to last the course, but I actually severe doubt this. With all the best will in the world, I feel that his transformative leadership will fail as shown by the results from the change, and the Bill could even make Cameron known for toxic leadership rather than charismatic leadership. To add insult to injury, satisfaction ratings were at an all-time high, and the Lancet debunked the myth that productivity had been adversely affected under Labour too.
Currently the Coalition are trying desperately to present this as outright opposition to modernisation; this is a blatant lie, as they are denying the chief stakeholders a say in any ‘bottom-up organisation’. The implementation of this Bill is doomed to fail. I bet my life on it.
The author is President of the BPP Legal Awareness Society, and this article does not represent the views of the Society, nor of BPP.
