"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan

Saturday, 1 September 2012

Cutting Bureaucracy

Remember that we were promised before the last election that a Conservative government would bring in the post-bureaucratic age? Well, there is little evidence that is what we have got, and there is a lot of evidence that we are going in the opposite direction: getting more bureaucratic.

For example, the botched NHS reforms have created two new levels of bureaucracy. It is interesting that at the time that the government were trying to push through the hideous monster of a bill that was the Health and Social Care Bill their main justification was that it would cut bureaucracy, yet their favourite management consultancy firm was saying the opposite.

Health Service Journal have published the results of a Freedom of Information request on the communications between Matthew Kershaw (Department of Health Director of Provider Delivery) and the main private providers (pdf). If you set aside that the emails read like a bunch of giggly teenagers trying to set up a blind date for a love-lorn friend ("this is fun!!!", "brilliant - it works!"), there are more serious concerns.

The document includes a slide deck from an event that McKinsey provided for stakeholders in London (the GLA, councils and NHS organisations). In this deck is a slide that compares the NHS before the Bill with the NHS after the Bill:

As you can see, McKinsey were saying in March 2011 that the new NHS would have a "More complex partnership as GP commissioning consortia [CCGs] and clusters [Local Area Teams, part of the National Commissioning Board] replace 31 PCTs". If McKinsey could see that the Bill would complicate the NHS, and make it more bureaucratic, why were ministers claiming that the Bill would make it less bureaucratic? So much for the post-bureaucratic age.

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