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 is a social pioneer, writer and campaigner. She studied visual science at City University and became a member of the College of Optometrists in 1991, later specialising in visual impairment and diabetes. During her career in optometry, she lectured at City University, was a visiting clinician at the Royal Free Hospital and worked with Primary Care Trusts. She ran a domiciliary practice across south London and was a Director of the UK Institute of Optometry. Julia formed 20/20Health in 2006. Becoming an expert in digital health solutions, she led on the NHS–USA Veterans’ Health Digital Health Exchange Programme and was co-founder of the Health Tech and You Awards with Axa PPP and the Design Museum. Her research interests are now in harnessing digital to improve personal health, and she is a PhD candidate in Human Computer Interaction (HCI) at UCL. She is also dedicated to creating a sustainable Whole School Wellbeing Community model for schools that builds relationships, discovers assets and develops life skills. She is a member of the Royal Society of Medicine’s Digital Health Council. Julia has shared 2020health's research widely in the media (BBC News, ITV, Channel 5 News, BBC 1′s The Big Questions & Victoria Derbyshire, BBC Radio 4 Today, PM and Woman's Hour, LBC) and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week.
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