So, the much-debated Risk Register for the NHS reforms has been leaked onto the Internet.
Personally, I’m still trying to interpret and digest its contents, and therefore my immediate thoughts aren’t more cogent than, “Wow, that’s a lot of stuff marked red!”
Some areas marked as red (i.e likely to happen, and would have a high impact) include, to take a couple of random examples:
By dismantling the current management structures and
controls, more failures, including financial, eg GP consortia
go bust or have to cut services, and credibility of the system
declines as a result.
Risk that transition is managed by people who are
themselves at risk, eg in organisations such as SHAs, PCTS,
may not be effectively managed, with risk of delays,
performance dips and key staff lost as a consequence.
There is a lack of clarity during the transition in terms of
accountability e.g. between board, PCTs, and Consortia
during the transition years and the first year of the new
system. This leads to delays and increased costs and poor
Okay, I know that the point of this risk register is to identify such risks and therefore work to eliminate them, but there really do seem to be a lot of them.
The Health and Social Care Bill currently limping through Parliament is a mess. Even though I try to take an active interest in its progress, even as someone who is desperately concerned and involved (working, as I do, in an NHS team), I lose heart at trudging my way through some of the details which have been changed, adjusted and repackaged beyond the level of human (oh, ok, maybe it’s just me!) comprehension.
I was baffled though by this piece which turned up on the Guardian website yesterday.
Announcing that Lansley, having been stung and having lost credibility as his health reforms (hopefully) hit the buffers, is going to be delaying his announcement of reform in social care.
Reflections on Bevan’s Run
Yesterday, I went to the Department of Health to watch the end of Bevan’s Run. If you haven’t come across ‘Bevan’s Run’ it involved two hospital consultants, Clive Peedell and David Wilson – both cancer specialists in Middlesborough, running from Aneurin Bevan’s statue in Cardiff to the Department of Health based at Richmond House in London – 160 miles in six days. They did this to raise awareness of public (and professional) opposition to the Health and Social Care Bill.
My reasons for going to meet the runners (with a few hundred others) in London was to express my support for what they had done and my agreement in the agenda which they were promoting – namely that there is no mandate for this coalition government to dismantle and privatise the NHS – because that is what they are doing.
While I was there, I both chatted and listened to chatter of those around me – many with much more experience than me in the sector (there seemed to be a lot of doctors milling around) about the wish to demonstrate opposition again and again. The phrase ‘lions led by donkeys’ raised its heads in reference to professional leadership which had not (with some notable exceptions) provided much leadership in opposing and disseminating the government’s plans.