Gary's views

Gary's weekly views

Each week an article by Gary has appeared in the Plympton Plymstock and Ivybridge News in South West Devon. The articles are published here

FOUNDATION HOSPITALS

These words are being penned, in draft form, in committee room 14 at the House of Commons where for the past 6 weeks I have been closeted away with 21 colleagues going line by line through the government’s latest Health bill. It is as long as War and Peace, but nothing like as interesting. Only another week to go and I will be free.

But when all the fine words have ceased and the ink is dry, will the Health Service be any better – that’s the question? The bill ushers in Foundation Hospitals, the latest craze in the relentless quest for a better healthcare system.

But if I asked you to name the key ingredient to make our hospitals more effective, what would you say? More doctors, more nurses, better cleaning arrangements, more resources, real freedom from Whitehall, you may cry. But how many of you would plump for more democracy as being the solution? Nonetheless, that is broadly what is being suggested. Once this bill goes through Foundation Hospitals will be “owned” by those people living locally who register to become a member. There will be elections, run by the hospital, among that group of members to determine who gets on the Board of Governors who will in turn appoint the Board of Directors who will run the show. There will be inspectors galore armed with fine teeth combs.

I have pressed ministers in the past few weeks to spell out the extra red tape and costs that will flow from maintaining these new bureaucracies, registers of members, running the elections and providing information and accounts to all and sundry.

We will have to wait and see whether there is a long queue of people desperate to become members of the 10 new foundation hospitals about to be announced (Exeter being the closest to us). I rather doubt it.

So what is the right way forward? We all want a health service free at the point of need and open to all, but how we structure that system should be guided by the lessons of the last sixty years. For example, would you feel safe flying in an aeroplane designed and built during the Second World War? I suspect you might prefer a modern purpose built machine making best use of modern technology.

I suggest 3 guiding principles: trust the professionals; put in the resources and give patients choice. Other countries manage it, why can’t we?

posted by Nigel on Thursday, June 26, 2003

Gary's weekly views

Each week an article by Gary has appeared in the Plympton Plymstock and Ivybridge News in South West Devon. The articles are published here

THE VILLAGE FAIR

Over the weekend I had to undertake one of the most difficult duties asked of any politician. TV interview? Press conference? Prime Minister’s Question Time? No, all those are a piece of cake in comparison. Our challenge was far greater. My wife and I had been asked to judge the children’s fancy dress at Sparkwell village annual fair.

Picture the scene. Thirty young faces looking up at you, dripping with eager anticipation, silently begging you to make their day. Each one looked magnificent in costumes that ranged from creative to spectacular, many of them self made. They were all winners in my book, but I knew that I was there not to bring joy to the few but disappointment to the many.

But the children are not the trouble, they will have forgotten by Sunday morning. No, it was the parents I feared. They stood beyond the lines of feathers and breeches and smiled knowingly at us as we strolled up and down the impressive column. But was it just me, or was there more than a hint of steely-eyed determination behind those relaxed faces? After all, they had poured hours of their lives into producing this magnificent display, and here we were about to ruin everything. We skilfully drifted further into the field to finalise our decision, hoping that not many could not lip read.

I turned to the organisers and tentatively enquired whether they had thirty prizes. No, only three, came the firm response. Make a decision.
It was the only troublesome moment in an otherwise enjoyable afternoon. The whole village had turned out for their annual shindig and even the weather behaved itself. The school children did a traditional dance around the Maypole, and the animals carved out of vegetables by local youngsters were truly impressive. The community constable was there, but there was no trouble.

It was a welcome reminder of the success of village life. All ages, all shapes, all backgrounds, mucking in together, having fun, whilst supporting good causes. Every place has its own challenges, but Sparkwell has a pub, a church, a school and a hall that all help to foster a great community atmosphere. Designers of neighbourhoods of the future should take note: small communities work best.

In the end, the pirate, the panda and the birthday cake were deserved winners, and Jan and I escaped without injury.

posted by Nigel on Tuesday, June 17, 2003

Gary's weekly views

Each week an article by Gary has appeared in the Plympton Plymstock and Ivybridge News in South West Devon. The articles are published here

JOINED UP GOVERNMENT

For many years now we have been promised joined up government. We still don’t get it, either nationally or locally. Instead we get: money lavished on eye catching initiatives, but vital intervention on heroin addicts goes unfunded; decisions made to cut support by some wings of government that only increases the budget somewhere else in the system; absurd traffic calming in Woodford and Hooe, while social services faces a funding crisis.

This is largely due to the departmental nature of government. The primary focus of too many bureaucrats, it seems, is departmental. Too many separate agendas, and not enough focus on the big picture. They operate like lofty silos standing side by side, with only a small walkway between them, rather than a purpose built complex.

What are 3 of the most challenging issues facing this country right now? I would say: the scourge of drugs; the threat of terrorist attacks and our future relationship with Europe. Only in relation to the third of these is there anything like a coherent departmental approach.

Our response to the drugs epidemic is scattered between at least 3 departments: the Home Office, Health and Education, with the Deputy Prime Minister’s office chipping in with responsibility for social exclusion, and the police begging for extra funding. Each one has its own budget, its own agenda and its own back to protect. Oh yes there are committees at which ministers and officials meet, but they tend to be toothless talking shops.

The Americans, in response to the new threat of terror quickly appointed a new cabinet minister for Homeland Security, a high ranking politician in overall charge of keeping his country safe. Our Home Secretary, in comparison, has to grapple on a daily basis with prisons, asylum seekers and turbulent judges, hardly a good platform for rooting out the suicide bombers.

Our society does not develop in watertight historic compartments or according to Whitehall manuals. The issues change, but civil service organization lags behind. Who would have said drugs and terrorism were big issues 30 years ago? Time moves on and so should our structures.

What am I suggesting? A more flexible approach to government so that a decision is made every few years on priorities, and the shape of Whitehall follows that focus, with dedicated ministers at cabinet level and budgets in support. What, a departmental shift every Parliament? Why not if it brings joined up thinking and better government.

posted by Nigel on Tuesday, June 10, 2003