Shirley Williams writes in the Times [£] today of her strong support for Future Forum’s recommendations for NHS reform, and suggests that listening exercises may be the way forward for future policy-setting:
Like many others, I was sceptical about the listening exercise. It seemed to me a way for the Government to win time so that it could rethink its proposals for NHS reform in the light of great scepticism from medical organisations, distinguished think-tanks, health service managers and staff, and, not least, doctors.
My concerns were not justified. The Future Forum, chaired by Professor Steve Field, himself for many years a GP, has proved to be a remarkable instrument for marshalling public and professional opinion, conducting a rapid but comprehensive study across the whole of England. Its report is sensible, accessible and driven by the ideals on which the NHS was founded. On one issue after another, I find its conclusions sound.
Professor Field and his colleagues have taken the whole troubled debate on to constructive, forward-looking territory, away from political point-scoring. Maybe in such listening exercises we have discovered a better way to make policy — not only on health but on other contentious areas.
Baroness Williams praises Nick Clegg, “for wrenching the Government’s proposals around in the light of professional and public criticism,” as well as “the handful of Liberal Democrat activists who first alerted their party”.
She outlines her support for several of Future Forum’s proposals:
…that clinical consortiums should not be compelled to accept commissioning responsibilities until they are ready to do so; that they should meet in public, declare any relevant personal or financial interests; and that their decisions should be made openly… the need for integrated care across the spectrum from hospital treatment to care at home.
…while also noting her concerns:
how to involve new providers without undermining NHS services; how to improve staff training; how to prevent advice on commissioning being outsourced to expensive private managers.
Read the full piece in the Times (subscription required).
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2 Comments
Where to next? The LibDems’ Achilles heel is their lack of a business model – not just for the NHS; but generally. They could not confront the Tories or Labour as they had no platform. I repeat what I wrote to Prospect: “a key Conservative observed that “. . . . they have no strong policy agenda. . . .The only way they can demonstrate their position is to block stuff.”
Well, just as you cannot defeat an ideology if you don’t have a better one, so you cannot stop what is a blatantly wrong intervention in the NHS unless you have better model of the way the organisation should work best.
My advice is to move the economists and management consultants out of way and go back to what rescued Japan in the 1950’s, i.e. quality improvement as advocated by Dr W Edwards Deming. Japan at that time an economic disaster and became, within a generation, a member of the “rich nations club”, the OECD, not least because they adopted a business model that surpassed anything the West had. The transformation was led by MITI (The Department for Trade and Industry). With Vince Cable in BIS and Nick Clegg as Deputy PM the LibDems can, with this model, rescue both the NHS and the economy. But really is the eleventh hour – for the institutions and the LibDem party.
While the Baronesses continued revisionism is concerning, there was far greater initial opposition to the reforms from the public than from the Lib Dems, it is likely a strategic error of some seriousness to seize complete ownership of the reforms for the Lib Dem leadership.
Any bump in the road, or the outright car crash predicted by Milburn, will be blamed on the compromise, and thus the Lib Dems. After alienating the entire education sector, students with tuition fees, academics with hamfisted approach to funding, the Lib Dems seem now intent on alienating workers in the public health system. This is odd, as these sectors represent a considerable swathe of (former) Lib Dem voters. It’s rare to see a party act so much against the interests of its electorate once in power.