White Paper morning after the night before

It’s funny how a night’s sleep can alter one’s perspective, but actually my perspective began to change last night as the cold head-analysis of the health White Paper began to be warmed by a heart-response. My thoughts had gone to those many friends I know working in PCTs, and the impact of effectively being told you were superfluous bureaucracy.

All those long years of trying to dance to the Government’s tune through policy changes, create the right environment, monitor progress, hold independent contractors and hospitals accountable for their spend and delivery, build relationships with patients and understanding with social care, top slice 3% of your budget at a moments notice and support front-line staff. None of them are perfect, but many of them highly motivated to improve the care of patients. Many have lived through huge reorganisations before and will philosophically accept that the structure is changing once again. But I think thousands will have felt hurt, let alone fearful for their futures. Doctors emerged as the heros coming to rescue us from the nasty managers who bore the brunt of blame for the areas in which the NHS has under performed.

The reality is that no GP consortium will be able to deliver improved care without good management. No one will be able to plan appropriate services without advice from those with strategic overview. No doctor wants to waste their time on administration, monitoring, enabling infrastructure, performance management, procedural meetings, implementing IT, data collection etc.

Management won’t miss having to produce and re-write endless documents justifying their existence and the endless top-down initiatives that stifled the one before. But there are many good people for whom today is a lot more uncertain than yesterday and without whom we would not have seen many of the improvements in care that have been achieved. The NHS will never be perfect, but it cannot thrive without good management, and they did not receive justice yesterday.


About Julia Manning

Julia Manning is a social entrepreneur, writer, campaigner and commentator. She is based in London and is the founder and Chief Executive of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal. Through networking, technology, research, relationships and campaigning 2020health has influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer at City University, a visiting clinician at the Royal Free Hospital, working with south London Primary Care Trusts and as a Director of the UK Institute of Optometry. She specialised in diabetes (University of Warwick Certificate in Diabetic Care) and founded Julia Manning Eyecare in 2004, a home and prison visiting practice for people with mental and physical disabilities using the latest digital technology, which she sold to Healthcall (now part of Specsavers) in 2009. Experiences of working in the NHS, contributing to policy development, raising two children in the inner-city and standing in the General Election in Bristol in 2005 led to Julia forming 2020health at the end of 2006. Julia is a regular guest on TV and radio shows such as BBC News, ITV’s Daybreak/ GMB, Channel 5 News, BBC 1′s The Big Questions, BBC Radio, LBC and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week. She is mum to a rugby-mad son, a daughter passionate about Shakespeare, and wife of a comprehensive school assistant head-teacher. She loves gardening, ballet, Zimbabwe, her Westies Skye and Angus, is an honorary research associate at UCL and a Fellow of the RSA.
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