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Whistle While You Work – Lansley’s Disney NHS

June 3, 2011

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.

7 Comments leave one →
  1. Simon permalink
    June 3, 2011 2:15 pm

    Thanks for writing your blog. I forget how I came across it, a link on twitter I think, but I am so glad I did, it is one of the few where i read every post. I look forward to all your new posts as they articulate very well a lot of my own frustrations with the way things are going at the moment.

    And this one is especially good! I have been working in the private sector for over a year now after about 6 in the public sector and I can confirm there is a place for both sectors, and both sectors have good and bad organisations, both employ numpites and both have pointless processes and both have different motivations. Both are necessary.

    It pains me when I speak to apparently bright friends in the private sector who decry the public sector as spending ‘our money’ as if that’s all they do and as though this fact is simply and only a drain on the ‘hard working taxpayer’ (as if no-one in the public sector pays taxes!)

    To which I reply: sure it spends your money – educating people who work in the private sector, healing people who work in the private sector, managing and spending money to repair roads so private sector firms can drive on them…. and so on and so forth.

    Anyway, I digress! Please keep up the good work, you have one satisfied reader here!


  2. Itsmotherswork permalink
    June 4, 2011 9:06 am

    And another satisfied reader here, as you know! I’m sure the day will come when I don’t agree whole-heartedly with one of your blogs, but it hasn’t yet. Thanks for another good one, which once again articulates so much of what I am feeling.

  3. Jamie permalink
    June 4, 2011 11:31 am

    I work for the current Government (I am a policy adviser in the Treasury). Since Cameron labelled us “enemies of enterprise” at the same time as freezing our pay, attacking our pensions and making over a third of us redundant, moral has been the lowest I have ever seen.

    They have done very long term damage to the capability of the civil service and doing this lowers their chances of delivering any if their other objectives to around zero.

    Watch put for lower productivity, poor quality briefing, leaks, and keystone cop like

    • June 4, 2011 12:39 pm

      That’s fascinating stuff. And put together with the revision of all their project plans which came out of no.10 two weeks ago, makes perfect sense.

  4. Neil permalink
    June 7, 2011 8:18 pm

    What you say cannot be repeated enough. It makes me shudder when Cameron and Lansley praise the benefits of the private sector. Something else made me shudder yesterday too. On the Today programme they were discussing the drug companies’ decision to cut vaccine prices to the developing world. Though this was good news for humanity, the finance expert from Standard Life was not impressed and said “putting people before profits is not a viable business model”. So there you have it, the markets would rather people died than take a hit on their bottom line.

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