I was prepared to dismiss No19, as an interim secretary of state, until a proper one came along.
He got the job by kissing-and-making-up will BoJo, having previously walked out on him.
There was no one else, with any senior ministerial experience ready to step-in, after No18 confused social mistressing with social distancing.
I thought no one will tear the roots up, or pile on more ‘stuff’ at a time when Covid infections and admissions are on the up, waiting lists are growing and the workforce is shrinking.
He’ll be sensible.
A bit like Labour’s health secretary Alan Johnson. He listened to leading surgeon, Ara Darzi had a bit of a skirmish with C.difficile, lost a battle with a Trust chief executive but basically, did no harm.
He knew, the NHS knew better than him and let them get on with it.
I was wrong. Now we’ve got an amateur with a ‘vision’. All ministers are amateur but they usually listen and settle down.
Amateurs with a vision are dangerous… to themselves, their Party and the public.
In his rambling speech at the Royal College of Physicians, (it went on so long, one of the people there told me, they thought he’d finish in time for him to collect his NHS pension), No19 said;
‘… his ambition is to ‘hardwire prevention into the NHS’… ICSs will face targets and financial incentives to deliver progress on the agenda…’
‘… my … commitment is to put prevention at the heart of how we hold our ICSs to account in the future.’
He plans an App that;
‘… [has] preventative tools and services like a new digital health check’.
Yes, it’s rubbish. But, should we blame No19? I’m tempted to say, no. He knows nothing about the health service.
However, he does have a SpAd, a health advisor and there are plenty of people around who could have a quiet word with him… presuming he is inclined to listen… that will stop him from making a fool of himself.
Let’s spell it out. A health check is not preventative, it just finds problems to be fixed. Often, too late. Screening might be. But…
… here’s the important bit. All of the major advances in preventative health have taken place outside the bailey-wick of the NHS.
Preventative health is about getting people to do things differently and it is the law that does that: Smoking in the workplace; Crash helmets for bikers; Seatbelts in cars; Health and safety legislation.
Laws save lives.
Don’t take my word for it. Here’s the Royal Society for Public Health’s top 20 public health measures.
- The smoking ban
- The sugar levy
- Sure-Start centres
- Minimum pricing on alcohol in Scotland
- HPV vaccination for boys and girls
- Congestion charge
- Abortion in NI, decriminalised
- Wellbeing of Future Generations Act, Wales
- Tobacco advertising bans
- Traffic-light labelling on food
- Transfer of PH to LAs – that produced an 80% improvement in the health outcomes framework
- ‘Scores-on-the-doors’ food hygiene ratings
- Fixed-odds betting terminals, stake reduced to £2
- Childhood flu-vaccine
- Supporting-People legislation, ring-fenced money reducing homelessness
- Junk-food advertising ban on TV
- Drug safety testing at festivals and nightclubs. At one event, in 2016, there was a 95% reduction in drug-related hospital admissions
- Cancer screening improvements
These 18, huge improvements, are the result of laws, regulations and government funding. Nothing to do with the NHS, GPs or hospitals.
If life is the Lord Mayor’s show, it is the NHS that comes behind, sweeping up.
I promised you 20. The other two on their list, and the only two without legislative backing or funding…
One; the Marmot Review that introduced us to the social determinants of health but I fear, the fabulous report, has become like the vicar reading the Bible to the choir. Government ignore it.
Two; The Time-to-Change campaign run by mental health charities. It has changed attitudes but NHS services are underfunded, understaffed and under-water… swamped.
A decent ministerial health advisor would have this sort of list for breakfast and know, it’s the law that changes stuff.
You can kick GPs and ICSs until yer-toe-drops-off, but they’ll never deliver No19’s ‘vision’, because the social determinants of health are not their job and anyway, are being shredded by fuel prices, food prices, shortages, NHS waiting and low wages.
Let me level with you; it’s called levelling up and this government will never create a level playing field.
The NHSE board should reject this ‘vision’ as a ‘policy’ and if they are in any doubt, ask Ari Darzi… because he is still around and sits on their Board.
Have the best weekend you can.
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.
