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What the Carillion collapse tells us about the unspoken truths governing public sector contracts

January 18, 2018 Leave a comment

Carillion

Carillion is the big news this week, and is likely to remain on the media radar for some time, given the impact that the collapse of a Company of this size is almost certain to have on commercial relationships that are now an integral part of the public sector.

Moments like this are important for reasons which go way beyond the impact that Monday’s announcement is already having on jobs and the potential closures of many small businesses.

It is providing one of those very rare opportunities to glance inside the incestuous workings of contract delivery on behalf of government and gain an invaluable insight into why private interests working at any level within the public sector is in clear conflict with very ideals of what public service delivery is fundamentally about.

Regrettably, the clear focus of the media and political classes has already fallen upon the question and avoidance of blame. Yet if they were to begin to look just a little further and be open with what have for too long been the unpalatable truths, there would be just the merest hope that questions such as whether there can be a future for the NHS when it remains in a perpetual state of financial crisis could perhaps be genuinely answered.

So why are contracts going to private companies outside the public sector?

The best place to begin thinking about the contracting or privatisation problem is to look at why private business is really even involved in the delivery of government services of any kind, when government exists to operate for, on behalf of and for the benefit of only the public.

Man can only ever have one true master after all, and if money is the true motivator, then public service will at best become an oversight – the unwelcome relative left trailing way behind.

Whilst it may feel counter-intuitive to believe or accept it for many of us, the ‘privatisation solution’ has been in the main part created by Conservative governments in response to the consequences of policies created typically by Labour in order to enhance the rights, working conditions and influence of public sector employees.

Positive discrimination and rights, enhanced working conditions, gold-plated pensions and union indulgence within public sector organisations all cost an ever evolving sum of money in an increasing number of different ways, which usually create even more roles and dilute responsibility further and further still.

The cost of employing people within the public sector on conditions which exceed those of the private sector outside – even when salaries appear to be less, has simply made the delivery of services too expensive for government itself to provide.

Against this backdrop, all areas of he public sector have had to go in search of more cost effective ways to deliver services, and have had to do so in ways which also meet the rigorous requirements of providing services and employing staff as a government based organisations.

This has made the ‘marketplace’ fertile for the entry of private contractors who don’t have the same considerations as these former public sector based service providers.

When you consider that private contractors are providing arguably the same level of service, just without the same levels of bureaucracy – whilst making what in some cases is an outrageous level of profit besides, you can soon begin to see that something is inherently wrong with the way that the government system is now designed.

So how does public sector contracting by private contractors become a problem?

Business loves a contract. Contracts give surety. Contracts themselves can be used as a solid-gold guarantee – and particularly so when they are agreed and signed with government. This gives business confidence which can be misplaced, misused, abused and is almost certain to breed a feeling of complacency.

After completing what should be a rigorous ‘tender process’ – the company will sign a contract with the government organisation which agrees what, when and how the ‘contractor’ will provide a service, whether that just be 1 person to sweep a street or 32 bin lorries to collect your rubbish every fortnight for 5 years. On signing this contract, the company will know exactly what it will be paid, know what it will in turn have to spend, will have worked out its costs and borrowing, should have kept back a little for a rainy day and then know what it will make in profit – from which it will pay bonuses to staff and dividends to shareholders after it has paid any tax requirement.

Good managers know that some things change during the lifetime of a contract – such as fuel prices going up, which would be a real concern for a bus service provider or a private ambulance services. But contractual devices or clauses that allow for some variation in charges are usually built in to any contract to allow for this.

As such, genuinely unforeseen events or those which could not have been predicted by anyone within the contracting company itself are very rare to find.

What government contracts don’t allow for however, are lack of knowledge or understanding of the service delivery area on the part of those designing and agreeing a contract. They don’t make allowance for unmitigated trust on the part of either party. They certainly don’t consider the potential greed or indeed malpractice of a contractor or its decision making staff, which cannot be planned for or predictably defined even within the scope of a government contract process.

When a contractor has only a single contract, transparency is bizarrely much clearer and for the management, much more important and kept clearly in mind.

But when you have many more and perhaps and ever increasing number of contracts, the potential for complacency and overconfidence can lead to otherwise unrealistic opportunities, which in more focused circumstances would have been denied.

It may be as simple as paying senior executives massive, over-inflated salaries. But it has the potential to be much much more in terms of investment, questionable projects and big payouts for shareholders when little in terms of adequate checks and balances has allowed an adequate safety blanket to be retained from payouts and quietly put aside.

The overriding problem with a company which has grown to the size, reach and responsibility of Carillion is there is so much in terms of questionable financial activity that it has the ability to very easily hide.

The responsibility for contract design and management doesn’t just fall on contractors themselves however.

In the background to all this and within the protectionist culture in which contemporary public sector commissioning is currently enshrined, purchasing officers simply don’t have the motivation or willingness to do their jobs as effectively as they should. When the money you are allocating isn’t yours, public service and best value isn’t always the overriding priority. Sometimes it’s all about doing anything which proves to be easier, and who gets what doesn’t always work out exactly as it should.

Whether its building maintenance, bin collections, public transport, prison management, forensic services or interim and temporary staff services that contractors provide, contractors are all making unnecessary profit at the ultimate cost to us as taxpayers.

So what can be done to solve the problem and when will anything happen?

What has been outlined here provides little more than a simple snapshot of a very big and complex problem, which those in power are through their actions are continuing to deny.

For these problems to be addressed, it would first be necessary for politicians to accept that the whole system of government delivery is broken, riddled with management focused upon self interest, making decisions based on theoretical premise, and that there are simply too many people operating within the system who are ultimately being allowed to take us all for a ride.

The ‘too big to fail’ mindset has now permeated through political thinking to a level where contracts are being awarded despite very clear warning signals which would tell even very junior civil service staff that something is not right.

This is no longer a question of let’s bail them out so that they don’t fail like Labour did with the Banks in 2008; this is all about awarding contracts because there is a view that they never will.

Solving this problem is far from simple. It is not just about political thinking. It’s about getting the market’s to think differently. But just as much, it’s about getting employees to see their roles differently; to accept that they have a part to play too.

In simple terms, the free for all has to stop.

This bonanza based on self-interest is no longer sustainable.

The perpetuation of the lie that government genuinely works selflessly for everyone has got to be stopped.

No business can perform effectively on the basis that it prioritises the working conditions and needs of its staff before the priorities upon which it was created to deliver. Yet this is how liberalism and rights culture has manifested itself within all parts of government and the public sector.

Not only has the NHS become hamstrung by lack of staff and inefficiency, it is being cut up by the cost of the staff it hires through contracts – thereby being destroyed by the supposed solution itself; by the very respite that additional money is supposed to provide.

Meanwhile local government has its own substantive bogeyman too, finding itself tied up in knots by the cost of the local government pension scheme – the destination of the better part of our council tax, in many of the Boroughs, Cities and Districts where most of us reside.

Then there are the PFI contracts upon which the last Labour Government so heavily relied. A coarse, deceptive instrument designed to hide public spending, whilst fire hosing cash at private contractors over 30 year terms. Just another financial time bomb legacy like the raid on pension funds by Gordon Brown which we overlook daily on the basis that out of sight is very much out of our minds.

The power rests with government to change all of this, if only they would try.

Regrettably, the will doesn’t even exist to even begin doing so today, even if the Government could begin doing so – something that a hung parliament which could last until 2022 will simply deny.

With a good chance that the next Government will be based upon or built around a militant form of Labour, the chances are that politicians will only continue to try and hide the truth thereafter, because action which doesn’t just look responsible is not a pathway to which they are inclined.

As Jeremy Corbyn made clear in his questioning of Theresa May at Wednesday’s PMQ’s, the answer is just to do everything to return everyone to employment in government jobs. No doubt based upon further borrowing, which to those who don’t understand business or economics is a perceived as a policy which when sold looks bullet proof.

images thanks to independent.co.uk, bbc.co.uk, wiltshiretimes.co.uk

New houses never lower prices within their local ‘market’ and the Persimmon CEO’s £110 Million Bonus gives our ‘housing crisis’ the lie

January 9, 2018 Leave a comment

Money HousesHousing has become one of the hot political issues of our time. To read and hear about it in the media, it has become easy to conclude that the Government, our Councils, Housing Associations and Builders alike all share the view that we are in a housing crisis. The picture they paint suggests that they are all doing everything that they possibly can. But should we all really believe?

Laid bare, the lack of housing really does look nothing like the story we are being presented. Immigration inflating real need exponentially has become as much an unspoken truth across the whole country, as it has that 2nd homeowners are leaving seaside and rural property empty for much of the year, whilst they add nothing financially to the communities in which they don’t have time to genuinely reside.

“We need to build more homes” has become the mantra of the many. Yet the real beneficiaries of this process will not be the people who will end up living in many of them. Nor will it be the Government which is operating on the premise that money is the only way to solve any problem, no matter what it might be.

The real beneficiaries of the push to create housing will be the builders and the bankers who finance them, whose real take from all the public money which is being fire-hosed at them is only too well illustrated by the bonus payment being made to the CEO of Persimmon Homes.

Under the auspices of self-serving government at all levels and the ineptitude of policy making and long term strategy which has been rolled out in real time within current planning policy, Builders and Developers of all kinds have found themselves within what can only be described as a smorgasbord of discount and profit and the epitome of the one-sided win-win.

Deals are and have been done, not on the basis of what is best for us all. For if that were the true intention, there would be little need for deals of this kind.

Deals are being done, because the focus of this housing crisis is little more than money and profit itself.

People young and old are being out priced in all parts of the housing market, not because prices reflect the true value of houses and the market, but because the system and government policy is facilitating house builders, mortgage lenders and private landlords to take us all on one massive, great big bubble-building ride.

The evidence is not difficult to find. Wherever we may live, new housing developments are never far away. Yet when homes are released, we never see prices being lowered nearby.

Lower house prices within the communities in which these additional homes are built would be the logical outcome within any localised market which was genuinely left to itself to determine and decide.

Instead this so-called ‘crisis’ continually goes on unsolved, whilst we are being sleepwalked into a national travesty in the shape of an unsustainable housing price bubble which is guaranteed to explode.

When it does, those profiteering and responsible now will be the first to run and hide.

image thanks to unknown

Brexit and the influence of Corporate Business: Money talks and the rest of the business community walks

Brexit 2The result of the European Referendum was a surprise to many, and that includes a substantial part of the leave side itself. Yet over a year on, with Article 50 Triggered over 3 Months ago and David Davies now participating in regular sessions of ‘negotiation’ with the European elite, nobody seems to know what impact Brexit will have on any of the key issues, and whether any of what are being considered as the obvious problems which led to the ‘No’ Vote will really have been resolved.

With Brexit constituting a polysemic reference point which in the imaginations of everyone will look as different as the number of people you might ask, it is perhaps no wonder that there really is as much confusion as there appears to be about the whole process.

Some do of course interpret what is already the natural anxiety which is accompanying these early stages of our departure from the European Union as change in the minds of the majority that initiated this whole process. Yet they would do well to remember that none of the reasons which prompted that significant choice on the part of so many have as yet been resolved, and especially so in the case of the many more beyond those generally accepted and not least of all the spectre of corporate and political self interest.

It should really be of little surprise that things have looked like such a mess in these circumstances and genuinely forgivable given the lack of pre-Referendum preparation for its outcome and the chain of events including a change of Prime Minister and an arguably unexpected General Election which has distributed power in peculiar directions.

What is less easy to overlook, and perhaps should be of great concern to us all, is the readiness of former remain-backing politicians to focus upon the opinion and input of sources from the corporate world who also sought the same outcome when considering what will or wont work for business-full-stop, when what they appear to hope will be an indefinite period of transition commences in March 2019 and we formally leave the Union.

Input of organisations such as the CBI, whilst important in its capacity as a member-based industry voice, is nonetheless representative only of the executives and companies for whom they work, and therefore the highly subjective and specifically profit-led interests that they all have in conjunction with their own trading arrangements with Europe – rather than what is objectively in the better interests of us all.

Whilst it may be to some degree inevitable that UK-European trade will come at a greater cost to all businesses in the future, these changes will in real or financial terms be no different than the changes in costs of manufacturing, supply and service provision which have accompanied change after change after change which have been instigated by a continual flow of new European Laws and Directives when they hit relevant businesses. In fact, it is only the fact that this is an industry-wide phenomenon, rather than just another hitting one sector or another, which really marks leaving the European Union itself as being markedly different from changes that to real business, would really be ‘just one of those things’.

It would be disingenuous to suggest that the Government is listening to the wrong people, but it certainly does not appear to be taking into account the realities facing the complete range of the right ones either, and when the views of Remain-lite big business are put into their true perspective, the news is arguably far from as bad as the comparatively few companies which are big enough to swim in the pool with the CBI and have influence on its own Policy would like us and the Government to think.

Motivation is regrettably key, and whilst it is considered normal to talk about the individuals who give voice to CBI membership and the corporate business community as being representative of the ‘business view’, very few, if indeed any of the people who have reached the top of these large Companies will have really cut their teeth in the furnace of SME business start-ups, development and management. It is here where you ultimately have no choice but to accept, get on and work with legislatory change, or get out of the market and let someone else have a go if you can no longer make it work.

Small business, which suggested by Federation of Small Business (FSB) figures makes up at least 60% of industry, thrives on being adaptable and embracing each and every change that it will face, which for most will come to them pretty much on almost daily basis. What it doesn’t have – even with membership organisations like the FSB  – which are again only technically representative of the views of their members with a voice – is a seat, or what should be a significant number of seats around the ‘top table’ when it comes to getting the ear of Ministers and indeed our Government.

This is a travesty, as the business environment which they inhabit is the real engine room of our economy, and the place where industry feedback is most open and reflective of the concerns and realities which really do face all businesses.

SME’s are the business equivalent of the electoral grassroots and the only place to go if Government really wants to establish the priorities of British Business to inform our negotiations with the EU as we transition through Brexit to what may then prove to be a much more productive world for the British economy beyond.

image thanks to news.sky.com 

The Living Wage is as much Labours’ child as it is the Conservatives’ and their MP’s Band Aid parody highlights the political culture of creating policies which deny the realities of consequence

December 21, 2016 Leave a comment

labour-band-aid

The principle of the Living Wage or rather the concept that everyone should at least earn enough to provide them with a basic standard of living is a good one for many reasons. But in isolation, the coercive nature of such a policy being unleashed upon business and industry was always going to be seriously flawed.

The indirect impact and ripple-effect of this Policy – which have led to consequences outside of political control, were as poorly considered when it was launched and implemented by former Chancellor George Osborne as it was when it was first mooted by Labour Leader Ed Milliband.

That big business has adopted a rationalisation of employee terms and conditions as a method of offsetting the additional expenditure which the Government has effectively imposed upon them should not come as any surprise.

Profit is for many organisations a god after all, and whilst to many the implementation of the Living Wage appears to be a highly positive step in making life better for the lowest paid, it also overlooks many facets of its knock-on effects or indirect impact upon those it was not designed to benefit. Above all, it fails to consider the responses and choices that employers of all kinds would make as a result.

Whilst the behaviour of successive Governments and the City would suggest otherwise, for the rest of us, money doesn’t simply grow on trees. The impact of paying employees more money has many effects besides using up a company profit margin and whilst it may be a principled idea to expect business to warmly welcome such an apparently altruistic move, it is also extremely naive. Would these very same companies not already be paying everything to staff that these politicians expect them to, if the owners or managers making the decisions already believed the idea or principle was right?

Perhaps most concerning when considered in this context, should be the fact that in April 2017, the Living wage will rise by another 30p to £7.50 an hour, and that a further rise will follow the next year. The consequential impact of the Living Wage will become continue to become worse as it becomes more widespread, and the economies and efficiencies that have been made to service the inflation-busting rise so far, will simply become unsustainable as the costs escalate beyond where they are today.

There are currently too many factors outside of the control of government, such as the escalating prices charged for services and goods that are essential to a basic standard of living, for isolated meddling to have a genuinely sustainable positive impact. And that is without even factoring in whether the many marketplaces in which different organisations operate can sustain low margin companies paying their staff more.

As things stand, MP’s and activists can bitch about the injustices of the Living Wage all they like, as the story they are telling will in some ways certainly ring true. But until they accept that they must all think differently about how they address the impact of all that they do, it will continue to be the very same people they are telling us they are going to help who will be the ones who will ultimately suffer as a result.

image thanks to http://www.totalpolitics.com

Festive Strikes defy sense and reason, but we should all be mindful of the unspoken issues behind them which serve as a warning for us all

December 14, 2016 1 comment

download-1We should all recognise the value that Unions historically had in influencing positive change in the workplace. But times change and the question over whether they have continued to provide a genuine voice for poor treatment or have simply become little more than an archaic nuisance to business and government alike will certainly lend legitimacy to the arguments against Union power by the more neoliberal within them.

The effect and reach of equalities legislation has permeated through every part of society and our lives to a point which has arguably gone well beyond its point of good, and to a level where its influence has become fundamentally regressive.

From this standpoint alone, you could make a reasoned and valuable argument against any organisation or movement which seeks to progress the work of the rights lobby further, and beyond that see the power of Union Leaders as the menacing anti-business device that the untimely raft of strikes by Southern Rail, Post Office and Argos Staff this December would ultimately suggest that they are.

It is certainly true that in relative terms, there is no difference between bankers creating profit-focused financial devices that speculate the cost of products or services, indirectly raising the cost of living for us all, and a self-serving union rep who places a stranglehold strike on an employer simply to get a pay rise or a perceived improvement in terms for their fellow staff.

But should we really dismiss any kind of industrial action by narrowing cases down and concluding that personal gain is simply what its all about?

On the face of it, it really doesn’t matter if a debate is framed as a matter of health and safety or fairness over holiday conditions and pay. Gain does play a significant part, but so does the fear of loss, and both these two debates are representative of much deeper seated root causes of problems at work around us which are building up as a significant time bomb, whilst they continue to go unchecked.

Union leaders do not help themselves by behaving as if business exists only to create and facilitate jobs. It doesn’t and never has. Yet the drive to pay less for the same work to be done or to do away with specific jobs entirely in order to cut costs when profits are maintained and prices are soaring, rather gives the lie to where a public service provider’s priorities focus. The more concerning element of the Southern Rail strike debate however, is what the introduction of technology which immediately halves the staffing requirement for managing just one train alone will mean or may have already meant when considered outside of this specific context and becomes representative of the impact its is having in every area of business and employment.

Immigration is blamed by many for the loss, or rather diversion of jobs to foreign and particularly Eastern European workers, with the caricature of the Bombay-based call centre worker being used to account for the export of many others. The inference being that jobs are in some way set in stone and that it is just the terms under which they are awarded to an employee or contractor that changes.

What it doesn’t account for is the genuine loss of jobs due to technological advances having literally removed the need for a particular role to exist.

We would perhaps like to think that his march of technology is researched, developed and delivered purely on the basis of improving many different aspects of production and service delivery. That is certainly how the benefits are sold.

What is rarely mentioned – the elephant in the room, is that jobs have been disappearing for a very long time as a result of this pathway of progress, whether it has been within manufacturing, agriculture, public transport or any one of a multitude of industries and skilled areas where services or production have been highly labour intensive.

Up until now, the change has not been noticed. Workers have retrained and like the once redundant miners who moved into call centres in the North, many manual jobs have been replaced by others within newly defined service industries which are focused on producing an experience, rather than some kind of definable or tangible product we can buy.

It sounds good, and little is said when jobs are there for those with apparently transferable skills when a factory closes. But what happens when the new jobs do themselves become the target of efficiencies and the technological breakthroughs which leave a machine doing the job of many different people over its amortised lifetime at a fraction of the cost?

This whole idea will to some sound far-fetched. But the change is very real and is now becoming present as a very clear danger to a broad spectrum of jobs.

Take for instance Amazon Go, which is set to be launched in the United States early in 2017. This forward looking and innovative Company is not standing still when it comes to the platforms from which it seeks to acquire new market share. Within weeks, it will move into location-based grocery stores which do not require shoppers to use tills or a check-out system when they visit. You simply use the smartphone based Amazon Go App which does the work for you and the system even knows and calculates the change when you put an item back.

We need only consider the number of tills at a standard sized Asda, Morrisons, Tesco or Sainsburys near to where we live and the inevitable irritation that queuing to pay causes us all to appreciate just how quickly this new way of shopping could explode, taking many jobs from any one or all of these stores as the concept is rolled out and goes viral throughout the retail industry – which it inevitably will.

In business terms, this development by Amazon can only be commended as the groundbreaking step that it actually is. But the dark realities behind this very appealing change for our instore shopping habits is that its true benefit will be profit to shareholders. It will be masked by a transient benefit to us all as shoppers, but it will ultimately lead to the loss of jobs which may simply never be replaced or made available elsewhere.

The very difficult message that needs to be swallowed, fully considered and then acted upon by policy makers as a whole is that the story which underlies comparatively simple squabbles with the Unions over pay and conditions do indeed relate to the range of still unanswered questions over the continuing cost of living crisis, but are in fact just the tip of a very large iceberg indeed.

In recent weeks, highly respected British Scientist Professor Stephen Hawking and US Tesla CEO Elon Musk have both alluded to these issues with Mr Musk going as far as to suggest that government may have to consider providing a basic income. He is absolutely right.

If industry continues to deliver efficiencies via technology in the way it that it is already doing so, whilst religiously maintaining or increasing margins and raising prices despite the savings being made, profit for the few and the effect it has on the many will unquestionably result in the Government paying the bill to finance a significant workforce which has become unemployable and left without choice.

Less people paying tax will exacerbate the difficulties that the Government faces and families in genuine need will not be sustained on a level of income which doesn’t meet the increase in the cost to maintain a basic standard of living which is being dictated by and large, by the very companies who will benefit from the implementation of the technology that enables them to shed so many staff.

The alternative will be that Government must take the concept of responsible capitalism seriously and consider the steps that may need to be taken to prevent businesses growing to a point where their market share enables them to become a monopolistic menace to the very society that buys its goods or services.

In the mean time, the methods, approach and lack of consideration for the impact of their actions upon people who are struggling in the very same ways as union members are themselves in the run up to Christmas may well make any feelings of support for the Strikes feel somewhat unpalatable. But we may all nonetheless do well to appreciate the value in the story which is not being spoken by the Unions, the media and Government when for far from obvious reasons, the voice of militancy leads an employee to act.

 

image from source unknown

 

Royal Mail & Privatisation: Its called privatisation for a good reason and politicians need to wake up and realise that privately owned business will never have the general public as its point of primary concern…

November 19, 2014 Leave a comment

The-true-cost-of-Royal-Mail-privatisation-820x615

In July 2013 – before the privatisation of Royal Mail took place, I wrote a blog about the process and discussed why it was a bad idea and briefly, what the implications would most likely be for the future of the universal delivery service.

Sadly, the news today that the privatised Company has experienced a £74 Million fall in profits and that it is already pointing the finger of blame at competition in profitable areas comes as little surprise.

We will no doubt soon experience further questions over the viability of rural and unprofitable delivery routes.

Whether the Government likes it or not, the reality of surrendering public ownership of a service which was created to ensure parity of service for all in the way that only a not-for-profit operation can do so, is soon going to bite.

It is simply impossible for Government to dictate the operational structure of a private business when profit is at risk – unless they choose to subsidise the service. If that happens, the question will surely yet again be why did they dispose of Royal Mail in the first place?

Whatever our politicians may think, privatisation of services which are there for the benefit of everyone is never a good idea; however hard to run; however much they cost; however much can be earned from their sale.

These services are essential to deliver a basic standard of living for all, which Government is currently failing to do by not dealing with the profit-led management policies of all the privatised services which the public once owned. What is more, it is set to continue compounding the problem by having so recently disposed of Royal Mail and by taking very big steps in the direction of privatisation of the NHS through the Commissioning Process.

It stands to reason that the managers of privately owned firms are going to focus on the practices and methods of working which deliver a good bottom line.

Whereas Government and Social Enterprise will be very happy if they are simply covering their costs, private owners simply don’t get up each day and think about how they can remove all their profits from one area of their business to subsidise the services they offer in another – when they cost them money to do so.

Sooner or later, someone – certainly not this Government – is going to have to begin picking up the pieces from what has been the serial offloading of a whole range of public services which once gave all British people unhindered access to the tools of a modern life which were once the envy of all.

The Country may already be secretly bankrupt. But selling up everything that we own is not the answer.

Top to bottom reform is now inevitable. It’s just a question of when; not if – and what the cost will be to us all whilst we wait for the leadership of politicians who are big enough to get all of the jobs done in the best interests of everyone and not just themselves.

 

image: europeanceo.com 

 

 

 

 

 

 

Politicians must acknowledge the problems within the NHS before any serious steps can be taken to save it…

November 13, 2014 Leave a comment

David Cameron And Jeremy Hunt Visit A Hospital To Mark The 65th Anniversary Of The NHS

It is because we can all identify or agree with the principles of our healthcare system – to meet the needs of everyone; to be free at the point of delivery; and that it be based on clinical need and not the ability to pay, that it has become such a focus and play thing for successive Governments and the politicians within.

It is also why the NHS now finds itself at a point in its history where these very Principles may have now placed it at the most significant risk.

In time, the size of the milestone which was the creation of the NHS, may be fully appreciated for the very rare moment in time that it was when the political classes delivered a set of policies and principals which were genuinely created to be in the best interests of all.

Such moments are extremely rare. Governments such as those led by Churchill and Thatcher created and determined legacies which still affect us now and which their successors may only ever hope to emulate.

But the arrival of the NHS, much like the formalisation of working democracy through the creation of our Parliament following the Civil War, has the power to touch us all – even if we don’t or won’t openly acknowledge it.

Sadly however, once the principles upon which the NHS was formed were agreed and indeed became cornerstones of both our culture and society; what were soon to become the long-term political arguments over how their processes should operate soon began.

Today, the NHS might be best described as a series of industries within industries; of silos within silos; business unit lapping up against business unit; as an entire ecosystem where ideas, concepts and yes – even Jeremy Hunt’s ‘innovation’ [aka ‘commissioning] are actively competing against and ultimately all working against each other with the regrettable endgame firmly in sight, when some future Government will have no choice but to admit to no longer being able to afford it. Funny perhaps that it’s never this particular one…

Generations of the political masters of the NHS do themselves carry much of the blame for the crisis which the Organisation is in, with it having become the ongoing vogue to stake ideological claim to ensuring the future of the service.

Ideologies are all well and good, but it is such a cultural reliance upon specialists for every function outside of medical practice itself that has bloated backroom functions and created an ideal climate for non-clinical managers to lay claim to the most important responsibilities within what should have always remained a predominantly clinical-led world.

Add the performance-choking and burdensome elements of protectionism which have been fuelled by European red-tape and employment legislation; litigation culture and the motivation of many to look for almost any reason to create blame, and you can soon see why temporary staff, commissioning and the recruitment of managers who can surely only manage if they have a degree or an MBA has become the norm.

The pseudo-sciences do indeed have a lot to answer for not only within the NHS. Somebody somewhere will soon need to realise that blue sky and out-of-the-box thinking are reflections upon the ability and understanding of an individual to apply what they know. It is something which itself can rarely be taught, and the way in which qualification is prioritised above experience is really quite perverse in the age of equal opportunities. The text book technocracy which is now populating all tiers of middle and upper management threatens whole industries, and not least of all the NHS.

As discussed in a previous blog about Government, the NHS is not a business and should not in any way be treated like it is one.

One of the greatest ironies of Jeremy Hunt’s plans for making savings by cutting the hire of temporary staff, is the fact that many of them have and are being employed to manage and grow the processes of commissioning which he himself is stewarding – attracting daily rates for self employed ‘consultants’ which can easily reach £400-500 per day; plus expenses; plus the fees which the Recruiters and Agents who facilitate their ‘employment’ will be charging themselves.

Whilst sold to us as the way to streamline and make healthcare more affordable, commissioning is not only an extremely expensive process to manage, drawing funds, staff and resources away from areas where they are needed most. It is also a major step in the direction of privatisation.

Health service providers – government, NGO, not-for-profit and privately owned alike – are invited to bid to provide services, and all of them will be primarily thinking about the bottom line, and not the holistic level of care they will be giving the end user – i.e. you and me, as they do so.

The Government itself usually recognises a bottom line from fee generation as profit, whatever the legal status of the organisation behind it. The biggest question about the future of the NHS must therefore be how it can possibly be so that other organisations can now provide better services at lower cost whilst they are also making a profit, when the Government itself cannot deliver the same directly and without the need to pay an additional premium fee?

The NHS, like Local Government and many of our NGO’s is in serious trouble, not just because the Country is now effectively bankrupt and cannot actually afford to continue providing the services that it already does. But because it is also incapable of addressing the fundamental need for transformation and use innovation in its real sense to enact top-to-bottom change in working practices and the legislative areas that support them.

Politicians are not prepared to talk about the real issues that the NHS faces, even when they are themselves cognizant of them, because they fear the electoral implications of actually being seen to do so.

Meanwhile, the default approach to making savings is being employed yet again, and whilst savings can almost certainly be made, the decisions which lead to them should be based on the knowledge and experience which comes from the clinical end of the scalpel, and not from the money-counters and political theorists that populate the very fat end of the other.

image: blogs.spectator.co.uk

 

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