Wednesday, January 03, 2007

Reality TV, changing mindsets and NHS reform

I am no fan of Reality TV. But I am looking forward to next week’s Can Gerry Robinson fix the NHS? In the series broadcast on three consecutive nights from Monday January 8, the ex Granada CEO trouble-shoots at a hospital struggling to get its waiting list down.

The series has already caused a stir. “Business boss blames weak managers and 'collective inertia' as he attempts to transform a struggling hospital” reported the Observer. While we have all met one or two uninspiring “leaders” in (or from) the NHS, the series is about more than leadership issues.

In an interview with Open University, Gerry Robinson comments on the ease of changing NHS mindsets:

Oh much more difficult than it would have been in any commercial organisation because there is a sense in a commercial organisation of a commercial, you know, imperative. People know what the object of the exercise is, and by and large people working in commercial organisations, have worked all their lives in commercial organisations, and they know that you need to make things happen and you need to make it happen now, otherwise in business you run the risk of dying on the vine. The Health Service, you’re very protected, so you can take your time, you don’t have to change, it’s all very casual and very, very different; much, much slower than it would have been in almost even the worst run commercial organisations.

I would suggest that this points to the need to think about the environment that NHS organisations work in. In fact, increasingly hospitals have to adjust to a more “commercial” imperative – with patient choice and Payment By Results as well as competition from the independent sector. This is painful but I welcome a move from the old command-and-control bureaucracies. The NHS must become more responsive to patients and communities – rather than constantly directed by politicians and bureaucrats.

On a similar theme, the think tank Reform have published their latest survey of the NHS. There has been a lot of media coverage of the suggested debt write-off. But the report also stresses the need for continuing reform - using patient choice and competition to redesign services around the needs of patients. A message not inconsistent with Gerry Robinson experience.

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