It is musical chairs at the Department of Health again, as Andy Burnham becomes the sixth Secretary of State in 12 years.
Let us hope he will be able to bring some stability to the job. Apart from Alan Milburn, who resigned after three years and eight months in the role, the other four (Frank Dobson, John Reid, Patricia Hewitt and Alan Johnson) each lasted just two years.
The signs are good. Burnham was health minister between 2006 and 2007, during which time he actually went onto the shop floor, visiting various hospitals and shadowing a range of healthcare workers. He also worked for the NHS Confederation, which represents health service organisations, as parliamentary officer before becoming an MP.
Gillian Merron, who takes over from Dawn Primarolo as public health minister, also has a background in health. She worked for Unison, the largest union in the National Health Service, before becoming an MP. Ann Keen, under-secretary of state for health, is a former district nurse and nurse tutor and general secretary of the Community and District Nursing association.
So three ministers have an active link to health. They should make an intelligent trio dealing with the trials and tribulations of the NHS, all with first-hand experience of what staff and patients want and what works best.
Meanwhile, one of the most difficult jobs goes to new health minister Mike O’Brien, who moves from the relative comfort of energy and climate change to take responsibility for NHS Connecting for Health and NHS IT.
The agency – stated aim: “supporting the NHS in providing better, safer care by delivering computer systems and services which improve the way patient information is stored and accessed” – is struggling to deliver patient record systems to the health service and is seeing some of its other programmes curtailed by the worsening financial climate. Its public relations have just been taken over by the Department of Health in a bid to save money (several staff have been sacked) and ensure it is more “on message”.
But is it really good for the NHS to have to deal with a different Secretary of State on a regular basis? Just as trust managers, health authority bosses, professional bodies and the staff are making headway with one Health Secretary, it is all change at the top. Isn’t this frustrating? Continuing and joined-up care are NHS buzz-words, ensuring that patient treatment flows uninterrupted from primary care to secondary care, that the right hand always knows what the left hand is doing. So where is the continuity at the top? Just as everyone gets to know one Health Secretary he or she is moved and a new person drafted in.
What hope for the future of Andy Burnham, however good he is at his job? There will be a general election next year and even if Labour gets back into Government, which is highly debatable, there is sure to be a different Cabinet and a different Health Secretary.
Surely the moral of this is to take the NHS out of politics? Why not give the NHS independence from political control? Gordon Brown set the Bank of England free from Government interference, why not do the same for the health service? Why not set up an NHS independent committee to decide how it is run and how it will spend its money. This would give the NHS the continuity it needs to plan for the long-term future. Then it won’t matter if ministers change annually. It won’t matter who is in government.
On another issue, at the beginning of this month the Care Quality Commission, an independent regulator of all health and adult social care in England, was set up. It replaces the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission.
Its job is to “make sure better care is provided for everyone, whether that’s in hospital, in care homes, in people’s own homes, or elsewhere”.
The first thing on the CQC agenda is to put in place a registration system with 29 requirements that every health and adult social care service, whether public or independent, must meet. It has launched a “consultation document” inviting members of the public to comment on the draft guidance for these registration standards.
All well and good, but the draft guidance consultation document – which you can read and leave your comments online – is a staggering 262 pages long. The CQC tells us: “When you have read the draft guidance and responded to the questions in the consultation pack, please send us your feedback using the response sheet. You can do so by letter or emai.l”
No matter how well-intentioned we are about the NHS, how many of us have the time and inclination to strain our eyes reading 262 pages on a computer screen?
The registration system, “which will fundamentally change the way services are regulated and how regulation will be used to drive improvements in services”, is due to start in April 2010 – just in time for the next election. So what of its future if another government is in charge – or another Health Secretary? Only time will tell.
