Chris Lancelot on... where did it all go wrong?

Think back to 2 May 1997. New Labour had just won the election and Tony Blair took office with a cheery smile, riding a huge wave of public support and promising an end to 13 years of Tory mismanagement.

Ten years later things are quite different. Everything that New Labour has touched in the NHS has turned to ashes. The catastrophe of ‘Modernising Medical Careers’ is just the latest in a long line of failures which are destroying the NHS from within — Connecting for Health, Choose and Book, PCTs, trust deficits… Where did it all go wrong?

It seems to be a tenet of most left-of-centre parties that a lack of money is the root of all evil: therefore, if there is a problem, throw money at it. (This explains Patricia Hewitt’s notorious statement about 2006 being the best year ever for the NHS.)

Next pitfall: New Labour is notorious for its control freakery, the obvious symptom of which is micro-management through setting targets.

Yet by its very nature professional work is too complex to be controlled by such simplistic means: indeed, the work of professionals is totally disrupted by their imposition. The cure: trust professionals to organise their work themselves.

Control freakery encourages centralisation. It is no coincidence that the most expensive failures of New Labour’s NHS have been the ‘big’ projects: Connecting for Health, Modernising Medical Careers for example. The moral is that big-bang projects make good PR when first announced, but seldom deliver. Slow evolution is reliable and delivers more.

Tony Blair is about to move off stage, and with him will go Patricia Hewitt, who as a Blairite is unlikely to remain in office. Now is the time to warn those who will be running the next administration that the present mess which is the NHS has been brought about through centralisation, overcontrol, the belittling of professionals’ opinions and frequent reorganisations. These have demoralised staff and wrecked the delivery of healthcare, and all despite a truly unprecedented increase in government spending on the NHS. 

Dr Lancelot is a GP from Lancashire.
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