Lansley’s lack of a plan for the NHS

Exposed by Richardblogger on the Channel 4 blog tonight. Richard is a hospital governor who has been meticulously dissecting NHS reform policy on his blog and on twitter @richardblogger.

He’s definitely one to follow.

There is a new comment on the post “Opponents of NHS reorganisation gather pace  “.

Author: Richard Blogger
It is too kind to Lansley to suggest that he knew exactly what the policy was going to be before the election, and so it is unlikely Cameron knew either. Journalists apply some kind of guru status on Lansley basically, because the journalists do not understand health policy and do not understand the nonsense coming out of Lansley’s mouth. Just because he’s spent 7 years in the position of health spokesman does not mean he actually knew what he was doing. Lansley does have an idea, but it is turning out to be the completely wrong idea and unworkable.

Take for example his idea of giving GPs more control. Nowhere in any of his policy documents before the election did he suggest commissioning consortia. Indeed, from what he was suggesting before the election it appeared he just wanted to go back to the bad old days of GP fundholding while retaining PCTs for doing commissioning that GPs really don’t want to, or shouldn’t do (midwives, for example, do not want to be commissioned by GPs, but then again it makes no sense to commission them on a national basis either).

Yet we find that in “late May, early June” Lansley suddenly found that his plans – remember, he had 7 years to work them out – could not work while keeping the PCTs. So then he decided to abolish them. That then presented a problem. GP practices are too small to do commissioning (as fundholding showed) so they had to be grouped into consortia. Where was that in Lansley’s plans? (It took him 7 years, remember…)

So what size should the consortia be? Lansley has not got a clue, he does not care. The pathfinders vary between 14k and 650k. International comparisons suggest that consortia should be no less than 300k. So Lansley has spent 7 years and never in this time has he come across the international studies of consortia sizes? Do you really think he is competent?

So what about the legal aspect? CIC, LLP, Ltd, or NHS body? Lansley initially refused to say, he did not care. Finally (a couple of weeks ago after much badgering from the journalist Andy Cowper) the DH have said that they will be NHS bodies. This is important, yet Lansley didn’t know and didn’t care. (He’s had 7 years to come up with this opinion.)

And what about the board of the consortia, who should sit on them? The Bill merely says that they have to have an accountable officer, but that was only put in because the Treasury insisted. If it was left to Lansley the boards would be stuffed full of business people, or scarecrows: Lansley did not know and did not care. (He’s had 7 years to come up with this opinion.) The Lib Dems want boards to be half Lib Dem councillors; Labour wants them to be stuffed full of clinicians and patient reps. Let’s hope we get the latter.

Lansley is quite clearly incompetent. His plan is full of holes and what remains of it he does not know how it will work. Its about time to get rid of him and his policy and start again.

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