Whistle While You Work – Lansley’s Disney NHS
In March this year, during his keynote speech to the Tory Spring Conference, Forum, Jamboree or whatever it is they call it now, David Cameron declared: War on Red Tape.
The expression of this principle when it comes to the NHS is the demonisation of “managers”; a nameless, useless, interfering layer of bureaucracy. “We will not cut front-line staff”, Lansley continues to shout at anyone who will listen, during his listening exercise.
The naive (and surprisingly “hippie”) implication is that entities from 20-strong GP practices to hospitals employing 3,000 workers, will somehow run themselves as utopian, medical practitioner communes. Appointments will be made, wages paid, staff hired and assessed, prices for medicines negotiated, a rota for the cleaners drawn up, stationery ordered, filing filed – all this will happen magically; perhaps by forest animals enlisted by whistling, like in a Disney movie. The reality, of course, is that front-line staff will be saddled with back-office duties (at which those hateful managers are actually better).
Of course nobody wants excessive regulation or management. The clue is in the adjective. It is excessive; redundant; superfluous; more than necessary. But the appropriate amount of regulation. the appropriate level of management is… well, appropriate.
Not to worry, however. Private companies will ride to the rescue – like they did with railways, utilities, aviation, roads, steel and coal. Look how well things have turned out in those areas! Because, everyone knows that private companies are better at cutting management; at squeezing the terms of the already underpaid and overworked; at being efficient; at obliterating Red Tape.
Here’s something about Red Tape, however, which is rarely said. It does not only define the areas within which we must operate. It also delineates the areas outside which we must not.
The inevitable result of its complete absense combined with the pressure of market forces can be summarised in two words: Winterbourne View.
A model of a company which focusses its resources on getting the contract, rather than fulfilling it. No unnecessary layers here. No cartoon birds. Also, no inconvenient ethics or expensive compassion. Just a bunch of unskilled, poorly trained, dehumanised, underpaid, unsupervised workers taking out their rage on the vulnerable people they are meant to be looking after.
Don’t be mad at Winterbourne View. They will probably post excellent profits come the end of the year – that is their job. They are “any willing provider” – no more, no less. They are the shape of things to come.
Welcome to Lansley’s no-frills, supermarket value range, model of care.