Editorial Tuesday 4 September 2012: A last view on puzzle-thinker Andrew Lansley
I have written more than enough about Our Saviour And Liberator Andrew Lansley. The time has come to bid him adieu.
Leader of the House is an insulting demotion; there is no call to speak ill of the politically dead.
I have written too often of his anti-communication skills; remember "I'm sorry if what I'm setting out to do hasn't communicated itself" to the RCN Congress?
......................................................................
Click here for details of The red ties that bind Comrade Sir David: postmodern NHSCB to commission itself (oh yeah, and what cowboy drafted this mandate?), the new issue of subscription-based Health Policy Intelligence.
......................................................................
One final view on Mr Lansley: he was a puzzle-thinker about the NHS.
I borrow the categorisation from health policy journalist Steve Ainsworth, whom I used to publish in a previous job. Steve proposed that there are two cognitive approaches to challenges: puzzle-thinking and problem-thinking.
Puzzle issues admit only one possible solution that is correct. Problem issues can plausibly be solved in a number of ways. And it's vital to work out which you are addressing.
Mr Lansley was a puzzle-thinker about the NHS. He came up with a rigorous conceptual framework to solve the puzzle, and immersed himself in detail to the point where there were few questions he could not answer.
Thus Mr Lansley's solutions were "absolutely right"; opposition to them was "completely wrong".
Being a complex adaptive system which is all about motivating people, the NHS is uniquely not a puzzle. It is a problem, or more accurately a complex set of problems. Some of these are wicked issues, some are easy.
One size does not fit all.
The NHS requires judgment and wisdom. Mr Lansley had detail and puzzle-thinking.
I have no doubt Mr Lansley was sincere when he told Gavin Esler, "I'm not in this for the politics; I'm in this for the NHS".
But detail and puzzle-thinking were never enough.