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Ed Miliband can easily deliver the renationalisation of the NHS, thus reviving Labour

September 14, 2012 3:37 pm / Leave a Comment

 

Forget ‘refounding Labour’, now’s a time for ‘reviving Labour’. Few expect that the substantial poll lead will survive the few months prior to the 2015 general election, whose date we already new due to the fixed term legislation. Ed Miliband can easily deliver the renationalisation of the NHS, thus reviving Labour’s popularity and sense of direction immediately. Indeed, the Hillsborough campaign by Andy Burnham MP has this week shown what a highly-focused, principled campaign, delivered with passion, can produce. In an opposition-led debate on the NHS on 16 July 2012, Mr Burnham renewed his attacks in a tour de force speech on the Health and Social Care Act [2012], which became law earlier this year having endured a tumultuous passage through Parliament. Opening the debate, Mr Burnham said: “We will repeal the bill, it is a defective, sub-optimal piece of legislation that is saddling the NHS with a complicated mess. The gap between ministers’ complacent statements and people’s real experience of the NHS gets wider every week. They are in denial about the effects of their reorganisation in the real world, it is dangerous complacency and it can’t be allowed to continue.” Burnham fundamentally holds the strong belief that the Act abolishes in its entirety the national nature of the NHS, and introduces an ‘unfettered market’, which he has consistently opposed even when being a Health Secretary for Labour.

 

"Call me Disraeli" – Cameron's failed legacy is though alive-and-well

July 8, 2012 4:50 am / Leave a Comment

“We can’t go on like this”, but we did, and it got worse. David Cameron is a cheap imitation of Benjamin Disraeli, a man whom David Willetts models himself on mysteriously. The problem is that ‘Call me Disraeli’ Dave shares none of the best of him, and possibly in fact the worst of him.

 

As a young man, Disraeli was disreputable, a dandy, a scoundrel and had dodgy friends. There’s a notion in politics that you can tell a person by the company he keeps – as Kevin Maguire opined, you wouldn’t want ‘to be in it together’ with somebody arrested for conspiracy to pervert the course of justice. Cameron has a rich heritage of people whom the media might label as “dodgy buddies”, including Peter Cruddas, Andy Coulson, Rebekah Brooks, Chris Huhne and Adam Werrity, to name just a few, and all innocent until proven guilty (if at all.) We’ve of course been here before with a sense of corruption of sleaze.  “A corrupt parliament; an unprincipled government; an economy sinking under a mountain of debt – and a people enraged” is the description to be found within in “Rural Rides”, which the radical journalist William Cobbett began writing in 1822 and published in 1830 portrayed a country groaning under the twin burdens of debt and sleaze. Of course, this government which wished to cure the deficit and impose swingeing cuts has actually seen the deficit and borrowing explode during this year because of the complete lack of growth (itself a direct result of the throttling of infrastructure investment in the UK). Cameron has attempted to articulate an argument that whilst these activities are immoral as such no laws cover them, which is clearly an argument which he has had to abort as we have very strong laws on phone hacking and criminal fraud. One is mindful of the Disraeli quotation, “”When men are pure, laws are useless; when men are corrupt, laws are broken.”

 

The Tories needed a story to tell with Disraeli, as they had not won an election for two decades. The best narrative that David Cameron could write is ‘The Big Society’, but with the departure of Steve Hilton, Andy Coulson, and Nat Wei, this is effectively dead. This is a narrative which has so many relaunches any further attempt to explain the concept would now be seen as a sick joke. The deficit narrative has also run into the buffers, with most sage economists now predicting that as a direct result of the Coalition’s policies the UK cannot expect to experience growth in GDP until 2018 at the earliest. If you had to identify the most spectacular failing of Cameron’s Britain, however, it is arguably how ‘one nation Toryism’ has been an overwhelming failure. This is not only a country which is not at ease with itself – it is reputed that many people on council estates in Paisley have never heard of Cameron – but we have a capital city in England, London, which has social, cultural and ideological rock-solid partitions.  This is partly because the City has allowed itself to award itself massive bonuses, while the sick, disabled and disadvantages feel that they are picking up the cost of the City’s ‘mistakes’. The term ‘one nation Toryism’ derives indirectly from one of Disraeli’s political novels, “Sybil, or The Two Nations” in which he described Britain as “Two nations between whom there is no intercourse and no sympathy; who are as ignorant of each other’s habits, thoughts, and feelings, as if they were dwellers in different zones, or inhabitants of different planets: the rich and the poor.” Cameron has tried to embark on a policy of ‘divide-and-rule’, but has ended up with a situation of ‘divide-and-unable-to-rule’ as a result of a sense of ‘it’s hurting and it’s not working’ – as Owen Jones pointed out in NetrootsUK last week this is a Government which has pitched the disabled against the non-disabled, the rich against the poor, the old against the young, those on benefits against those without, unemployed against those in work – the list just goes on, but it is entirely reminiscent of how Thatcher began to lose the popular support of Britain in the late 1980s, by picking off various areas of society which hated her policies.

 

Disraeli was able to put together a government programme to outmanoeuvre Gladstone, succeeding triumphantly in making Liberals look small and insignificant. Maybe Nick Clegg will make a comeback – never say never? He was also ‘master of the putdown’ – while these days we have to make do with the Michael Winner-esque ‘Calm down dear’ to Angela Eagle, which reeks of obnoxious arrogant élitist Bullingdon ‘Flashman behaviour’, Disraeli was able to demonstrate some elegance. For example, in response to a man who asked Disraeli “What is the difference between a misfortune and a calamity?” cited in Wilfrid Meynell, Benjamin Disraeli: An Unconventional Biography (1903), p. 146, Disraeli said, “If Gladstone fell into the Thames, that would be a misfortune; and if anybody pulled him out, that, I suppose, would be a calamity.” According to Peter Oborne, written at the time of the Coalition discussions,  Disraeli was able to act with immense political audacity for example, “in 1867, he trumped the timid proposals of Gladstone’s Liberal party by unveiling his much more radical proposals for voter enfranchisement through the Second Reform Act”.

 

 

In this Olympic year, David Cameron would like to capture ‘a national mood’, but the national mood is one that which strongly resents a failed economic policy culminating in a recession and Cameron’s perceived affiliation with corrupt crony corporatilist Britain. It was Disraeli who grasped that ‘jingoism’ – an explosive cocktail of popular patriotism and imperial expansionism – could win new voters among newly enfranchised groups such as artisans, skilled workers and shopkeepers: the Essex Men of the Victorian era, or the Andy Coulsons of the modern era. Cameron is obviously totally unable to pursue an expansionist foreign policy, not least as he cannot afford an army, but Disraeli is commonly viewed as the great pro-active imperialist who hoped to unite the classes under the banner of Empire. Such an attitude might be possibly seen as justified in the light of his glorious rhetoric, exemplified in the Manchester and Crystal Palace speeches of 1872. It is only fitting that images of Cameron at the Wimbledon final are beamed around the world by the Tory-led BBC; certainly makes a nice change of detailed coverage of the riots.

 

The economic fortunes of Britain worsened under Disraeli, and there was no resolution to the war in Afghanistan. Sound familiar? Disraeli was concerned also about Russia’s advance into Turkistan and Samarkand, which had led to British involvement in Afghanistan. Disraeli pressed British authorities in India to secure a defense against Russian expansion into Afghanistan. Eventually, the British decided where Afghanistan’s borders would be – borders that would, in fact, eventually be recognised by the Russians and remain into the 21st century. In summary, all of this is tragic and pitiful. Rest assured Cameron will be going into the history books, not least for having dismantled the National Health Service, shutting the libraries, taking disabled citizens off their benefits, and overseeing a disastrous economic policy. It has also succeeded in possibly surpassing the immoral repugnant nature of Thatcher’s government. You’re right David – “we can’t go on like this”. May 8th 2015 can’t come soon enough for me.

Blindness to the evidence-based change management advice from the NHS' own unit

February 20, 2012 8:10 pm / Leave a Comment

 

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?

Tony Blair – The Journey : A failure to tackle inequality is a dangerous precedent for Labour

September 5, 2010 3:55 pm / Leave a Comment

Actually, reading a book with such a careful index is like reading the abstract of a scientific paper. You can easily miss out the best bits, and get such a soupçon that you totally miss out on the real flavour. This could be the detriment of understanding Tony Blair, or possibly be an advantage. Despite my protestations which principally come from the Andrew Marr interview on the BBC, I went into the journey with an open mind, I hope..

The thing I instantly liked about “The Journey” is that it is easy to underestimate the nadir from which Labour actually came at the height of Margaret Thatcher’s popularity. I remember in my 20s what a disaster the Conservatives had become internally, and how they had virtually imploded on the issue of Europe (a topic which still threatens their infrastructure today). So, it was for me as Blair described indeed, having lived through the experience that Tony Blair talks about. I feel that I can actually empathise with his account, even though I have zero emotional intelligence, arguably, myself.

I had got used to defeat myself, I didn’t expect Blair to win, when I was at the age of 23, having experienced so many defeats in the past for me during the Thatcher generation. Quite early on in the book, Tony Blair seems to have an acknowledgement of not making his writing too self-congratulatory. Whether he’s actually succeeded on this I feel is a very tough call. His prosaic style varies from being candid emotionally, to being rather unemotional, as if he is talking in ‘legal speak’. However, the sense of excitement is there, as well as some sense of expectation management.

Some things in the book are pretty predictable. For example, the glowing reference of Alastair Campbell shines through. However, I find Blair very unclear on obvious certain failures of domestic policy. For example, I don’t feel that Tony Blair really tackles head-on the equality (inequality) divide. An epiphenomenon of this is that neither ‘poverty’ or ‘inequality’ are words are in the index, which I am sure that Tony Blair didn’t compile. There is an appearance of lip service to the Fabian Society, on a somewhat academic footing, with a surprising acknowledgement of Tony Benn and Tony Crossland at the University of Oxford. Blair seems to identify the problem:

“Once so altered, [Benn and Crossland] became staunch advocates of social action and of the party of the trade unions and the working class whose lives had to be liberated from the conditions of poor housing, poor education and poor health care.”

Critically, there is no explanation – or even an attempt at an explanation – of whether improvements in social indequality were achieved. However, it does seem that the culture of Blair, with the emphasis on September 11th, Gordon Brown, Alastair Campbell Iraq and Islam, seems to have somewhat overshadowed all this, and this really shows in the book. These topics have been described extensively elsewhere, so I won’t mention them. However what I did find incredibly interesting that a much publicised move was that of Gordon Brown to reduce the capital gains tax to a rate of 15%. Even Blair calls this move by Brown as heralded by politics than any real conviction, so the overwhelming impression for the reader like me is that Gordon Brown deliberately wished to court the city against any notion of anti-business rather than having thought carefully about the social and economic sequelae. Robert Peston has indeed cited this as a reason where the Blair/Brown axis failed, and I agree. Was the Labour government successful on this single issue, irrespective of Iraq or Afghanistan, more school and nurses, etc.? No.

This is a big deal, because parties tend to lose when they systematically alienate groups of people. I noticed this with Margaret Thatcher first of all, but I have latterly felt that Gordon Brown and Tony Blair did this with the working, middle and upper classes. “Somethings got to give” as Marilyn Monroe said, and it must before the next election, in addition to Labour formulating a coherent response to the effect of cuts on the economy and real people.

Is he a great leader? Well, he certainly achieved a lot, but it’s a moot point whether he made his domestic policies so toxic so as to make them rather uninspirational. Thankfully, there are other features of a good leader, such as intelligence, passion, focus, risk-taking and enthusiasm, and you can conceivably argue that Blair had all of these in abundance.

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