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Rainbow coalition warns about section 75 NHS Regulations
The most unlikely “rainbow” Coalition of people has united against backdoor NHS privatisation by the Conservative Party.
On a day when Centrica/British Gas announced record profits, the issue came up again about how the business had made massive profits while putting its prices up, and how there was no real competition in this crowded, fragmented market of few suppliers. Such suppliers constitute an ‘oligopoly’ as the barriers-to-entry to competition are sufficiently high, meaning that the big players in it are able to return massive dividends year-on-year. (more…)
Blindness to the evidence-based change management advice from the NHS' own unit
Of course, the Government was free to consult any number of management consultancies about how to implement this complicated strategic change management. A recent ‘Mail on Sunday’ investigation based on hundreds of official documents disclosed under the Freedom of Information Act, has revealed the full extent of McKinsey’s links to the controversial Health and Social Care Bill. This newspaper alleges that many of the Bill’s proposals were drawn up by McKinsey, and outlines a number of other specific allegations. The irony is that the NHS has its own specialist unit which produces excellent advice about how to manage change in the NHS.
The NHS has in fact a specialist ‘Institute for Innovation and Improvement’. which is geared up to conduct change management throughout the NHS. Most independent experts feel that the way in which this strategic change has been implemented has been a disaster, and whoever advised on it does not appear to have acknowledged the advice from the NHS’ own change management unit as given on this webpage by Dr Helen Bevan. According to elsewhere on the website, “Helen has led change initiatives at local and national level which have created improvements for millions of patients. Her current role is to keep NHS improvement knowledge fresh, relevant, impactful at the leading edge.” It appears that the unit is heavily influenced by a paper from Harvard Business Review in October 2005 by Sirkin, Keenan and Jackson entitled, “The hard side of change management”.
Here are specific sections of Dr Bevan’s views on change management, and you can easily see why the NHS reforms will run into disaster.
The first factor is duration. An underpinning belief in many NHS change programmes is that we need to execute change quickly. Not necessarily so, say the authors. What really matters is having formal, senior management-led, review processes. A long project that is reviewed frequently and effectively is more likely to succeed than a short project that isn’t reviewed. The second factor is performance integrity. This means selecting the right mix of team members to deliver the change; the most results-orientated people with credibility and influence and effective change skills.
Today, a summit was held where a number of key stakeholders were not even invited. including the Royal College of General Practitioners, Royal College of Nurses, British Medical Association, Royal College of Psychiatrists, and the Faculty of Public Health. As Ben Goldacre has alluded to on his secondary blog, there appears to be a good correlation between those who were not invited to the emergency summit and called for the NHS Bill to be dropped. A recent headline in the Telegraph has provided, “Prime Minister David Cameron today insisted he was “committed” to pushing through the Government’s reforms to the NHS, as he met healthcare professionals in Downing Street.”
The next factor is commitment. The authors focus on two critical categories. There must be active, visible backing for the change from the most influential senior leaders. They say that if, as a senior leader, you feel you are talking up the change initiative at least three times as much as you need to, your organisation will feel you are backing the transformation. In addition, the change is unlikely to succeed if it is not enthusiastically supported by the people who will have to operate within the new structures and systems that it creates. Staff need to understand the reasons for the change and believe it is worthwhile.
This change does not have the backing of the majority of doctors and nurses, and there is absolutely no sense that the medical profession is backing this change. In fact, this BBC webpage gives details of who stands where on the change, and many professional bodies would like to “kill the bill”.
When an issue matters so much to the public, why has the Government accidentally or wilfully turned a blind eye to sound change management advice from its own unit?
David Cameron is wrong on the NHS corporate restructuring for these reasons
In an interview where David Cameron tried to tell John Humhrys he was wrong, Humphrys identified that Cameron was showing no leadership on the bankers.
The interview can be heard here:
http://news.bbc.co.uk/today/hi/today/newsid_9363000/9363655.stm
David Cameron is wrong about the NHS restructuring for the following:
It is wrong simply to focus on outcomes at the treatment end; much more could and should be done at the diagnosis end (health policy analysts find outcomes useful, but what they’re actually measuring are objective benefits). Much of the fundamental issue for the next decade will be the early diagnosis of the disease especially cancer, and there needs to be some focus on the efficacy of screening methods at the other end too (e.g.for colon cancer, breast cancer, COPD).
It is no good just talking about length of survival times, because there has to be a proper analysis of the quality-of-life and well being of patients with chronic morbidity including dementia.
The Doctors were not asking for the changes – the BMA is opposed to it, and to my knowledge the Royal College of Physicians shows little interest in it in a very positive direction. The King’s Fund certainly think it is a calamity.
2-3 years is a very short time to produce ‘the biggest reorganisation’ in the first time; it will involve £1.4 bn in the first year. John Humphrys was right to correct the figures that Cameron produced on the basis of actual evidence from the Kings Fund.
Satisfaction is at an all time high now with the NHS – this cannot be divorced from the record spending by Labour in the last parliament.
David Cameron denied the NHS IS getting better. This must means that he thinks that all aspects of it are getting worse. THIS IS A LIE.
John Humphrys asked that the NHS was in fact changing to a Federal Health Service. Cameron saying that there are already regional variations is frankly irrelevant. Humphrys is correct saying that an analogy between GPs and free schools is an extremely poor analogy; I am shocked that David Cameron is idiotic enough even to suggest it.
There’s no point Cameron trade-union bashing, as there are many ordinary nurses, doctors and other health-professionals who are non-Labour members who are highly critical of his insane policy.
If Andrew Lansley is so well respected, why does the whole of RCN disagree with him? The man is not well respected amongst the health professionals.
Dr Shibley Rahman Queen’s Scholar; BA (1st Class), MA, Bachelor of Medicine, Bachelor of Surgery, Doctor of Philosophy, Diploma of the Membership of the Royal College of Physicians (MRCP(UK)); FRSA, LLB(Hons).
Member of the Fabian Society.
