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Guest editorial Tuesday 14 December 2010: Sympathy for LaLa?

Irwin Brown of the Socialist Health Association argues, tongue firmly in cheek,  that we should be a little slower to condemn and a little quicker to sympathise with SoS Lansley

Are we getting to the point where we have to show some kind of sympathy for poor LaLa Lansley?

He had six years planning his programme, and expended endless charm on all parts of the NHS - but especially the GPs, and they are now turning against him

Even the GPs - about to be bribed to lead change yet again - are starting to rebel, even as they sign up for trials and pilots.  The BMA has shifted visibly towards resistance through constructive engagement!

The negotiations on changes to the GP contract are going to be about as productive as those around the BA cabin crews.  My money would be on the BMA, though.

LaLa must be in some kind of trouble, having already broken two of the promises made in the Coalition Agreement.  His advisors have implied that he showed an almost contemptuous attitude to the agreement; to the effect that he / they had never read the document and the bit about the NHS was slid by them.

Last Lib Dem policy jettisoned
The announcement that participation by local authorities in wellbeing boards is voluntary undermines the only remaining vestige of any trace of Lib Dem policy.

With the scrapping of restrictions on a two-tier workforce, we have everything in place for the full-scale privatisation of the NHS, to a bunch of quangos and wannabe John Lewises  – not exactly Lib Dem policy (editor’s note – actually, the Lib Dems were quite keen on co-ops).

His flagship bill is much delayed, apparently because of the volume of responses to the consultation.  Now he must have been shocked by the responses since just about every one questioned the approach.

Even supporters are pointing out putting a reorganisation of an unprecedented scale on top of expenditure reductions also on an unprecedented scale is risky!

Capacity to change
There is a very wide consensus that the scale of change is way beyond the capability of the NHS to manage.  Making efficiency gains on a scale never achieved before, accompanied by a huge reduction in management capacity (announced so the managers could all see the axe falling), was perhaps unwise?

His dreams are in the hands of an NHS chief executive who does not appear to share them.  Repeatedly, the man in charge of delivering the biggest and most complex programme in history anywhere has given the impression he does not think it can be done – and probably that it should not even be tried, there are better ways ... and anyway, his job won’t be there is a couple of years!

And LaLa should be worried about those being brought in to drive his changes. Some of the ‘top’ managers providing leadership left endangered posts and, without the unpleasantness of applying for a job, have wafted into the safety of the DH! These people have supported every other initiative to date, including those now rubbished to justify the latest redisorganisation.

Surely if you are SoS and want change, then you go to the people who argued against the previous changes? Not to those who were evangelists for the systems that you say have failed?

The studied brutality by understatement directed at his reform programme by the Health Committee was sad to behold.  Things were so bad that when the Report was released, a Lib Dem was deployed to go on the Today programme; a sure sign of desperation.

Whilst admitting that the NHS had never achieved a 4% productivity gain in any year, let along  four years on the trot, the Lansley-supporting Lib Dem came up with “no one says its impossible”,  it was just “extremely challenging”.

Are we sure he has got the right ministerial team to support him?

The challenging nature of the Committee Report was not surprising, given the lacklustre performances of Lansley and his colleagues in front of them.  Everyone thinks that LaLa is sincere and that he thinks he knows what is needed. However, as the committee has pointed out, there are no actual plans to deliver what he wants.  Leaving it to locals to come up with the answers is not a credible position when £80bn of public expenditure is involved.

The Treasury appear to incline to a similar view.

Anyway I think he has a lot to put up with and he should get our sympathy.  Anyone being overshadowed by Oliver Letwin deserves that at least.