13th June 2016

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What is the future for Public Health and the Public's health?
From pork sausages to Porton Down.
Come and join me in conversation with PHE boss Duncan Sell-by (ho-ho)
King's Fund - June 21st, 5.30pm - Drinks, some larfs, some policy, a conversation and networking 
A work in progress 
News and Comment from Roy Lilley
Well, let's get over it.  This ain't the best time for the NHS.
At last we have admitted (well, the Jim Reaper has)... we ain't gonna balance the books. 

At last we have admitted (well Tarzan has)... it'll be five years before we sort out delayed transfers of care.
At last we have recognised (well the Gooroo has), for the foreseeable... targets about targets are going to be wide of the mark.
At last we can say the unsayable about Lansley's dog's breath reforms.  At last, without permission, regulation or fresh law we are redesigning care on an industrial scale.  Doing what's right.
It is interesting that the so-called reforms of the NHS were so destructive and dismantled so much of the vital frameworks of care that there is no appetite to embark on another upheaval to put Humpty-Dumpty back together again.
No huge Bill for Parliament to debate, argue and fiddle with, to reassemble the demolition.
People seem to be finding ways to work around the wreckage.  Mainly by ignoring it.  New structures are emerging, they have to;  force-majeure.  The NHS is starting to resemble an old a car with after-market add-on's... to keep it running.

Dad's Army, at the Tory-Confed, who completely misunderstand what is going on, are grizzling that STP controls totals could undermine the planning and delivery process.  They seem not to realise, the STPs are a very smart move to put some strategy back into the NHS, by people working together - now there's a thought!  
Chaos?  Anarchy, turmoil, pandemonium?  Beyond repair? Broken? A lost cause? No...
People say the NHS has to change...  I like to think of the NHS as a work in progress.  A constant search to find the Holy Grail of making resources fit the ambition.
Arthur Greenwood, a Labour politician, pushed the post-war Cabinet into commissioning the Beveridge Report, in which the NHS was first described.  On the 5th July 1948, politicians, struggling with post war austerity, nationalised the existing flimsy health provision infrastructure, rebranded it and despite huge opposition, set the fledgling NHS to work.
Since that day, every day, people have found reasons, often with justification, to criticise it, be disappointed with it and to condemn it.  Others have found reason to be thankful, be grateful, admire it and use their skills, energy and talent to make it work... despite itself.
The NHS is a work in progress.  Will it ever be perfect?  I doubt it.  Will there be people who have the verve, the will and vocation to struggle for perfection... yes.
Will it ever be like a Swiss watch?  No, but in your hour of need, you know it will be there.
Will it be like a well-oiled machine?  No, but it will click into action when you are in trouble.
The affection for the NHS derives from the '40's when working men and women were left to their own devices to manage their health problems.  The arrival of the NHS lifted from their shoulders the worry and anxiety about maternity, accident, illness and disease.  The NHS made a huge and defining change to the lives of working people. 
Over time the NHS has become part of the British way of life.  Featured, affectionately, in the Carry-On movies and feted before the world at the launch of our Olympic Games.
Now we take it for granted that it will be there, all things to all men and women.
Except... it may not be.  Two forces are redefining what we can do; funding falling back to 2000 levels (something which the Tory-Confed appear silent about) and inexplicable demand going through the roof.
Once, in pursuit of excellence, services were coalesced.  Today, in pursuit of balancing the books and needs-must, services are coalesced, merged, taken over and bashed together.  

With no one willing to take on the task of running them, we pretend good people can become heroes, running Hospitals like chain-stores.  A vacuum of leadership the Tory-Confed are eerily silent about.
Cut training places, keep money short, increase expectations for delivery and standards.  What happens?  Good people fail; singled out for ridicule by senseless regulation.  They leave.

Leave in their droves.  New figures show 14,000 staff left the NHS last year, in search of a better work life balance.  The Tory-Confed remain silent on this, too.
Inside a year from the birth of the NHS, costs were getting out of control; the NHS Amendment Act 1949, factored in charges for prescriptions, eye tests and dental work.  Two years later, the father of the NHS, Aneurin Bevan, resigned, in protest.
It fell to the subsequent Tory government in 1952, the year Queen Elizabeth came to the throne, to introduce charges; one shilling per prescription.
Change the NHS?  You are who you hang-out with.  Be careful what you wish for. 
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