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Editor’s blog Tuesday 29 June 2010: Ooh dear. Tony Blair advises David Cameron to follow the political syllogism

There is the kernel of a good idea in ex-PM Tony Blair's advice to PM David Cameron, as reported by The Guardian.

The good idea in question is that government is so different from opposition - indeed, from anything else you encounter - that an incoming administration should properly have informal conversations with the outgoing government about its experiences, aims and the cultural challenges of the civil service

Blair also, however, draws a deeply unwise conclusion from his experience: that of the infamous political syllogism from Yes, Minister:

"Something must be done.

"This is something.

"Therefore this must be done".

He does so in the line (which I'm presuming Patrick Wintour reports correctly; I wasn't there)
about New Labour's developing after a few years in office a non-ideological focus on "getting things done".

Phew. It is quite something to hear a politician say so clearly that they're not really very into politics. Pragmatism is fine, and managerial competence is positively good.

This, however, speaks to something else. It is the redisorganising tendency of government - which confuses action with achievement.

In many areas of policy, but very noticably in health, the last government was insufficiently keen on learning the lessons of the past, and of its own reforms. Politicians are inevitably people in a five-year hurry to get re-elected.

Creating, abolishing or redisorganising the bureaucracy is a wonderful substitute from focusing on the value that is being added and the outcomes that are being achieved. Special interest groups and lobbyists also adore the redisorganisation approach. It is a wonderful way to mask bad performance (there was no small contribution from the merging of 4 PCTs into 1 to the Mid-Staffs debacle managing to stay unseen for so long) and to provide structural change as a placebo for really reconsidering how care is delivered to patients across systems, and what value that care adds.

Redisorganising the NHS under New Labour also brilliantly continued the tradition of disempowering patient and public involvement and engagement. The journey from arsey, activist, on-yer-toes Community Health Councils to the comedy farrago of PPI Forums and LINKs made it much easier for local and regional NHS bodies to sideline or ignore the public's views.

Now we have to take costs out at scale in the aftermath of a recession, and while the NHS budget is ring-fenced from cuts.

Hold tight.