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Changes So Big You Can See Them From Space

Most people in politics, and indeed most people in the health sector, have generally good things to say about Stephen Dorrell. He was a Health Minister and member of the Cabinet under John Major, and then a very successful and influential chair of the powerful health select committee.

He is standing down from parliament this year, but has said some very interesting things about the Conservatives health reforms in the Guardian recently.

His point seems to be that while there were real advantages to the 2012 Heath and Social Care Act that introduced Clinical Commissioning Groups and Commissioning Support and transferred the majority of the NHS budget to GP led organisations, there were also problems. He believes that the advantages could have been achieved without the huge fallout of the biggest restructure we have seen for a long time. Changes so big that in the famous words of then Chief Executive David Nicholson: “you can see them from space”.

Dorrell says that in such big restructures people can take their eyes off the ball. In his words quoted in The Guardian: “There is no such thing as a perfect management structure, but the irony is that every time you change the management structure, the managers focus on changing management. What they don’t do is focus on changing healthcare.”

Of course he’s right. We have all been in the middle of a restructure, with people more concerned – inevitably and naturally – with their own future and role, rather than remaining determinedly focussed on delivery. Dorrell says he tried to persuade his party that the act was misjudged, but was not successful.

What is really interesting is where he is going after he leaves parliament. What is the choice of career for a politician who wants to influence and bring about change but is not convinced politicians always get it right? He is off to be a private sector consultant specialising in health reform and change!

So the message seems to be that change, restructure, reorganisations are inevitable in the health business, and can bring about positive change. But we need to be better at them; we need to be streamlined and concentrate on the outcome, not the process.

Sirius Partners have never been in government, nor sat round the Cabinet table, but we know change and we know the NHS. If you want to discuss how to make the change work for you, call us for a chat.

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