The Lansley debacle will take years to scrape off our boots. We are still wading through the mess he left us with.
Politicians embrace LaLa with all the enthusiasm of Hamlet's father as he wanders in purgatory, friendless, even after having received the ordinances of ermine.
The Vanguards are doing their best to take off and rise above the debris. The new duo in-charge of Monitor-lite have changed Doc Martin for Jimmy Cho but we know they still have size ten feet. CCGs are disappearing into a gas-lamp memory. The CQC, cast as Mercutio, thrashes in its quoniam tenent me mortem.
You'd think the Tinkerman would try and stuff the whole misbegotten adventure down the back of the sofa and sit on it. No... He's still palavering about with a Lansley relic, the 'Mandate'; the linking piece between the DH and the Carbuncle. A to-do-list for NHS England to get on with next year.
There is a consultation document. You have to have the determination of an archaeologist to find it and dig it up.
The list of NHS woes is pages long; two thirds can't balance the books. Targets missed, half in 'quality problems', 33 Trusts with interim or acting-up leadership, Doc's walking away from CCGs, GPs in crisis, austerity crippling budgets, not enough nurses... shall I go on?
So what is the mandate solution? Helpful, problem solving, and visionary? Here it is:
Maintaining and improving performance against core standards while achieving financial balance, by ensuring the NHS meets the needs of patients and operates within its budget.
We are in the grip of genius...
Page 5... there is more:
Preventing ill health and supporting people to live healthier lives.
Cuts to PHE budget and the management muddle in which they find themselves, stuffed up the back passage of the local councils, along with government reluctance to act on the food industry means chocolate muffins, a full fat latte and 42 inch waist-lines will be on the menu for a while yet.
Creating the safest, highest quality health and care service, by securing high quality health and care services and 7-day hospital care to improve clinical outcomes.
I'm not going to rehearse the dodgy-data argument again, nor the fact we are facing a full blown strike over doctors hours.
Transforming out-of-hospital care, ensuring services outside hospital settings are more integrated and accessible.
Routine access to GPs, evenings and weekends, means we all play a new game; hunt the GP.
Driving improvements in efficiency and productivity.
Lord Carter of Bog Roll is yet to discover 'the curse of the on-cost' and St David Dalton has to learn; even with a desk the size of Wembley Stadium, you can run the NHS from Whitehall.
Supporting research, innovation and growth, and influencing global health priorities.
Perhaps we could start nearer to home with local health priorities; inequalities across Manchester, London and Birmingham and getting a grip on antibiotic prescribing.
This is a depressing, miserable, inspiration-free, dull, boring, fag-end of a document; oblivious to the real issues the NHS is facing and wilfully ignorant of what needs to be done.
A document that smacks of being written by a spikey haired SPAD, with a lap-top, intent on pleasing the boss, no thought of the service that will have to deliver it. It is written in that half-English, half-automaton management-speak that most people ignore and the rest deride.
The presence, or otherwise, of a Mandate adds nothing to healthcare, nor outcomes. Can you remember what was in the last one? Could you find a copy? Did you know you have about 5 days to respond to the consultation on this one?
We all know the NHS faces the challenges of a lifetime; the innovation and improvements we need to move forward will come from the people working in it, doing it, facing the challenges, head on, day-in day-out. People who work 12hr shifts back-to-back. Not people who sign off at five o'clock.
It won't come from badges, mandates, bits of paper or contracts. It will come from the heart and you can't mandate that.
