Here we go again…
Welcome to my 21st secretary of state for health…
… Dr Thérèse Coffey. I’m told she likes a cigar and a drop of scotch. She can’t be all bad!
She’s part-time, as she’s also Deputy Prime Minister, so we can’t take her too seriously.
She comes with some luggage.
No 21 was accused of being unwilling to disclose documents to the work and pensions Select Committee. There’s a very long letter here, explaining it all and it looks to me like she didn’t have to.
Coffey was also accused of saying something unpleasant, insulting really, about starving people. She didn’t.
She got into a tangle over snogging, covid and Xmas. Who hasn’t?
In 2013, she voted against same-sex marriage. She’s a catholic and entitled to her views. She did it again in 2019.
Coffey faced criticism from Suffolk residents over her support for the Government’s proposal to sell off forestry and woodland in public ownership, in 2011. In the end HMG backed down.
She backed BoJo to the point where she looked pretty stupid on the telly.
As for the health service? An ear infection spread to the left side of her brain, confining her to Ipswich Hospital for almost a month. She was full of praise.
Her Phd is in chemistry and she is a Liverpool fan. That’s about it.
What’s she going to do?
I’ve never met her but I’d guess, she’s not one for the ‘vision thing’.
Her job, undoubtedly, to figure out how to get elective waiting lists down and stop the pictures of ambulance queues outside hosptials…
...by the time of the next election. In terms of political optics, not much else matters.
This is a difficult time to take over at the DH+.
There is no easy way out of this mess. There’s no possibility of getting more staff, any time soon. Easing the regulations on overseas registrants might help at the margins.
There isn’t going to be any more money and by the looks of it, Dizzy Lizzie is going to take money from the NHS and give it to social care.
A bad winter will disrupt an all-out onslaught on elective operations.
What can No21 do? She could shout at everyone. She could threaten them. Or, she might stop and think.
Think about her span of influence… influence not control. There is very little she controls that will help her, right now.
The logic of the normal, won’t help. She has to figure out, not what an SoS usually does, through the familiar mechanisms of control.
She has to figure out what a SoS does, in these circumstances; no legislative time, no money, not enough people and too much demand.
What can she actually control?
Not the money. Not the staff numbers and not the numbers of people getting sick, needing an ambulance or a GP appointment.
She has two years before the election and has only influence.
You can’t influence what you don’t understand and you’ll need a fast track to understand it all.
The NHS is full of lobbyists, RCN, BMA, the Royal College of Blah-Blah. An alphabet soup of representation.
They’ll all say, give us this or that and everything will be lovely.
It won’t.
Don’t go where the DH+ want you to go. Get out from behind the desk, stick a pin in a map and go and talk to the front-line in the nearest hospital, GP practice and ambulance queue.
Then do it again somewhere else.
See them at work. Ask them what they’d fix and how.
You don’t need strategists, blue-sky thinkers, forecasters and all the hangers-on. You need five friends…
… ask ‘why’, five times and you’ll get to the root cause of most of the problems but…
… you don’t have much time.
Get time on your side with clear priorities; the root cause of ambulance queues, speeding up granny’s new hip and a GP appointment.
There will be other issues and competing priorities but the question for everyone, everywhere in the NHS is; what are we doing now, today to cut waiting?
Nothing else matters… to the public… your electors.
Invite challenge. Welcome it and encourage it. You know nothing about the NHS. It’s complex. Whatever decisions you make, test them for what’s missing.
The NHS is passion, theatre, drama, seductive, disaggregated, easily unravelled and intricate but it boils down to patients-in-patients-out, like a production line.
Focus on unblocking it, step back and it will deliver.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
