Emails: Lansley’s own advisers said the NHS Bill would increase bureaucracy


9:20 am - September 3rd 2012

by Richard Blogger    


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Remember that we were promised before the last election that a Conservative government would bring in the post-bureaucratic age?

Well, there is little evidence that is what we have got, and there is a lot of evidence that we are going in the opposite direction: getting more bureaucratic.

For example, the botched NHS reforms have created two new levels of bureaucracy.

It is interesting that at the time that the government were trying to push through the hideous monster of a bill that was the Health and Social Care Bill their main justification was that it would cut bureaucracy, yet their favourite management consultancy firm was saying the opposite.

Health Service Journal have published the results of a Freedom of Information request on the communications between Matthew Kershaw (Department of Health Director of Provider Delivery) and the main private providers (pdf).

If you set aside that the emails read like a bunch of giggly teenagers trying to set up a blind date for a love-lorn friend (“this is fun!!!”, “brilliant – it works!”), there are more serious concerns.

The document includes a slide deck from an event that McKinsey provided for stakeholders in London (the GLA, councils and NHS organisations).

In this deck is a slide that compares the NHS before the Bill with the NHS after the Bill:

As you can see, McKinsey were saying in March 2011 that the new NHS would have a “More complex partnership as GP commissioning consortia [CCGs] and clusters [Local Area Teams, part of the National Commissioning Board] replace 31 PCTs“.

If McKinsey could see that the Bill would complicate the NHS, and make it more bureaucratic, why were ministers claiming that the Bill would make it less bureaucratic? So much for the post-bureaucratic age.

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About the author
Richard is a regular contributor. He blogs more frequently at Conservative Policies Dissected.
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Reader comments


I think this article represents a rather desperate attempt to twist the meaning of the English language.

It seems clear that the word “complex” is being used in the literal sense and not as a synonym for “complicated”.

” A complex system is a system composed of interconnected parts that as a whole exhibit one or more properties (behavior among the possible properties) not obvious from the properties of the individual parts.”

http://en.wikipedia.org/wiki/Complex_system

Of course such a system is capable of being much LESS bureaucratic than a more simple, hierarchical system.

“Of course such a system is capable of being much LESS bureaucratic than a more simple, hierarchical system.”

But that doesn’t mean the actual proposals will be. The actual proposals will increase bureacracy, and linking to wikkipedia is hardly a rebuttal of that.

I’m extremely sceptical that libertarians such as yourself have actually any understanding of what is going to happen – all that has happened is you’ve heard ‘any willing provider’ and thought “markets? Yay!”. At the risk of repeating myself, Lansleys proposals are not anything to do with markets – they are just replacing one set of bureacrats with several more, including giving the most wasteful and bureacratic organisations – local authorities – specific responsibilities within the system (albiet the responsibilities tories generally don’t like – anyone would think they deliberately want to fuck this bit up)

There were and are substantive reasons for concerns about low level administration in the NHS. Readers may recall my own issues over hospital confusions over my right and left hips when I was asked to sign a surgery consent form for the wrong hip. Judging by media reports, the incidence of these confusions seems to be increasing:

– “A toddler who fractured her leg was sent home with a plaster cast – on the wrong limb. Lucy Rylatt hobbled on the broken leg for five days before her parents realised the mistake.”

– “A doctor who removed the wrong fallopian tube from a patient, leaving her unable to conceive naturally, has been allowed to continue practising.”

– “A surgeon is waiting to learn if he will be struck off for removing a healthy kidney instead of a cancerous one from a patient in Ayrshire. “

@ Planeshift

But that doesn’t mean the actual proposals will be.

Agreed.

The new system could be more or less bureaucratic than the old one- but the OP was using the fact that it was described as a complex system to argue it must be more bureaucratic.

That argument, as you concede, is fundamentally flawed.

Lansleys proposals are not anything to do with markets – they are just replacing one set of bureacrats with several more, including giving the most wasteful and bureacratic organisations – local authorities – specific responsibilities within the system.

Agreed again.

The bloated monster that the NHS has become is not capable of resuscitation or reform. We need to put it down and cremate the corpse.

Admin people don’t decide which leg top operate on on or which organ to remove. That’s the surgeon’s job to identify and correctly mark it.


Reactions: Twitter, blogs
  1. Jason Brickley

    Emails: Lansley’s own advisers said the NHS Bill would increase bureaucracy http://t.co/hZfYNkS3

  2. leftlinks

    Liberal Conspiracy – Emails: Lansley’s own advisers said the NHS Bill would increase bureaucracy http://t.co/Yr55oDVN

  3. BevR

    Emails: Lansley’s own advisers said the NHS Bill would increase bureaucracy | Liberal Conspiracy http://t.co/mQ3JQ23r via @libcon

  4. Alex Braithwaite

    Emails: Lansley’s own advisers said the NHS Bill would increase bureaucracy | Liberal Conspiracy http://t.co/iA81gng5 via @libcon

  5. Kyron Hodgetts

    Emails: Lansley’s own advisers said the NHS Bill would increase bureaucracy | Liberal Conspiracy http://t.co/mQ3JQ23r via @libcon

  6. Paul Trembath

    Emails: Lansley’s own advisers said the NHS Bill would increase bureaucracy | Liberal Conspiracy http://t.co/mQ3JQ23r via @libcon

  7. miss crazy

    Emails: Lansley’s own advisers said the NHS Bill would increase bureaucracy | Liberal Conspiracy http://t.co/iA81gng5 via @libcon

  8. Jane Young

    Emails: Lansley’s own advisers said the NHS Bill would increase bureaucracy | Liberal Conspiracy http://t.co/mMB8D2Un via @libcon

  9. Arun Mehta

    Richard Blogger: "Andrew Lansley’s own advisers said the #NHS Bill would increase bureaucracy." http://t.co/8N1CzLYw via @libcon #savetheNHS

  10. Natacha Kennedy

    Emails: #Lansley’s own advisers said the #NHS Bill would increase #bureaucracy http://t.co/BkSHBGGc Not what Lansley told us… #lies

  11. Dr Marc Bush

    RT @libcon: Emails: Lansley's own advisers said the NHS Bill would increase bureaucracy http://t.co/ZP0nLyQO





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