Andrew Lansley is facing a bit of a crisis. It turns out that not many people support his plans to reform the NHS. On the plus side, he’s managed to successfully unite MC NxtGenUK and Norman Tebbit. On the down side, he’s lost the support of clinical staff, patients and voters.
Facing this opposition, Cameron (ever the PR-man) announced a listening exercise. An opportunity to “Pause, Listen, Reflect and Improve” apparently. It doesn’t take a genius (or a cynic) to see just how much “listening” Lansley is doing. Faced with overwhelming opposition and a vote of no confidence from nurses, Lansley apologises for not communicating his message well enough. It’s an odd way of ‘listening’, but the best indicator of learning how much ‘listening’ Lansley and
the DoH are doing is to look at the questions they’re asking.
Open this document. Take a look at what the DoH are asking. The questions are all painfully leading, direct you towards the answer that the DoH wants you to give, and ignore large areas of public concern about the bill.
To give some examples:
“Which are the types of services where choice of provider is most likely to improve quality?”
“What else can be done to make patient choice a reality”
I don’t think it is possible to write more leading questions. Why not ask whether people want choice of provider? Given that 59% of people think they have too much, or enough choice in the NHS, lets not assume that everyone wants more choice. And lets not assume that more patient choice is necessarily beneficial. Lansley doesn’t want to ‘listen’ to that point of view, because it’s the wrong point of view.
“Are we doing enough to make sure the NHS at a local level has the freedom it needs to take locally-based decisions”
There are two possible answers to this question. Either you say the DoH are doing enough, and then they can write a press release saying “Our reforms supporting local decision making are supported by the population”.
The second option is to say that the DoH are not doing enough, and then the poor DoH interns can write a press release saying “The public want us to do more to remove centralised planning in the NHS”. Either way, Lansley is leading you to the answer that he wants to hear.
“What early action is being taken in your area to improve quality of services through clinically-led commissioning? What is working well?”
The DoH isn’t asking what is working badly. That’s not important. They don’t want to ‘listen’ to that. Again, you can see the press-release, half written already: “Doctors tell us that clinically-led commissioning improved services for diabetics in Milton Keynes” And Lansley can safely ignore any answers that criticize clinically led commissioning.
Andrew Lansley is not listening to the concerns of doctors. He’s not listening to the concerns of nurses. He’s not listening to the concerns of managers. He’s not listening to the concerns of his coalition partners. He’s not listening to the concerns of the general public. More importantly, he shows no indication that he wants to listen. I imagine Andrew Lansley sat with his fingers in his ears singing “la la la, I’m right and you’re wrong”. This sham of a “listening” exercise is lazy, poorly designed, and painfully transparent. And in the meantime, the DoH continue to charge ahead with their reform plans with all the subtlety of an oil company in Libya.