Is the Ministerial Health Team in Need of a “Summer Signing”?

Guest Blog by Stuart Carroll 

In the world of professional football, it is that time of year again.  As pre-season fast approaches, football clubs continue afoot and apace to wheel and deal in the transfer market in order to land the next big summer signing.  In the case of the international giants, this invariably involves wafting cheque books worth millions of pounds to secure the services of the game’s globally enriched superstars.  Despite the mad money now crippling the economics of the not so “beautiful game”, in sporting terms these signings are executed for one simple reason – to strengthen the team, freshen and liven things up, and sharpen the competitive edge.  In other words, to increase the chances of success, i.e. to win more games, trophies and silverware.

As a football enthusiast, I have been following the feverish media speculation about player comings and goings with much interest.  And all of this got me thinking.  Is the Ministerial Health Team in need of a “summer signing” – an extra body in the changing room?  After all, a lot has happened in the world of health policy since May 12^th 2010 and in truth very little has been plain-sailing or something that can easily be filed under “public relations triumph”.  The Health and Social Care Bill (HSCB) may not have been “relegated” from DC’s policy league table, but it has certainly required some major “last minute substitutions”.  Enter Professor Steve Field – the Ole Gunnar Solskjaer of Westminster.

Moreover, on the NHS David Cameron simply has to win “Premiership titles” and guarantee “Champions League football” year in, year out – the public is a bit like Roman Abramovich in that regard!!  Having committed himself so personally and emotively to the health service, a perceived failure to deliver will leave the Prime Minister severely weakened and with a tarnished political legacy.  It will also undermine the so-called “detoxification strategy” – something Miliband et al have already set their sights on nuking.

It is not the purpose of my blog today to comment on the virtues of the current Ministerial Health Team.  For what it is worth and despite the PR disaster, I think Andrew Lansley’s position is tentatively safe and the Health Secretary deserves a chance to implement the Health and Social Care Bill (HSCB).  Rather, I want to point out what I consider to be a “human resource” (HR) problem in the Health Team.  I sense puzzled expressions, but give me a couple of extra paragraphs to explain.

Pre-May 12^th 2010, the Conservative Shadow Health team was composed of (no particular order):

1. Andrew Lansley – Shadow Health Secretary

2. Stephen O’Brien – Shadow Health Minister

3. Freddie Howe – Spokesperson Health and Social Services in the House of Lords

4. Anne Milton – Shadow Health Minister

5. Mark Simmonds – Shadow Health Minister

6. Mike Penning – Shadow Health Minister

Post-May 12^th 2010, the Coalition Government’s Ministerial Health Team has comprised:

1. Andrew Lansley – Secretary of State for Health

2. Simon Burns – Minister of State for Health

3. Anne Milton – Parliamentary Under Secretary of State for Health for Public Health

4. Paul Burstow – Minister of State for Care Services

5. Freddie Howe – Parliamentary Under Secretary of State for Health for Quality

You will notice a difference in head count of one (6 versus 5).  Although this “redundancy” cannot sensibly explain away the reasons for the Government’s HSCB troubles, it does go some way to contextualising the practical challenges confronting the beleaguered Ministerial Health Team.  For example, if you take Earl Howe’s workload alone, most would agree that the word “gargantuan” is not unreasonable as way of descriptor.  The likeable Lord covers not only all House of Lords legislation and all matters pertaining to health – a massive responsibility in its own right – but also commissioning reform, primary care, dentistry, NICE, medicines, pharmacy and industry, research and development, innovation, finance, and the review of Arm’s Length Bodies (aka QUANGOs).  A brief not just big, but also tricky.  As someone said to me the other day, “Do you think Freddie ever sleeps?”.  “May be under a mountain of DH papers”, I replied.  It’s too much, not least for a reforming Government changing the status quo.  After all, politicians are human beings.

Of course, this rationalisation of the Health Team since the election could be justified as a simple difference between government and opposition.  In government, you have the Civil Service machine and Richmond House in your camp.  In opposition, you have a few researchers and whatever the Party is willing/can afford to spend on advisers.  Hence, the need for only 5 rather than 6 ministers.  This may be true, but that does not explain the culling of a Ministerial position.  After all, civil servants are there to implement policy.  They are not there to formulate policy on the public’s cherished institution; report to Parliament and defend the Government’s position; or go out in front of the cameras to explain and communicate those policies to a concerned public.  Furthermore, Ministers should be busier than their shadows especially when you have a reformist agenda.

The truth is the Health Team lacks a communicator – someone who has an accessible way of verbalising things; an earthy and easy way of talking about the Government’s health reforms; and an ability to get the key points over on Newsnight, Question Time and in the studio with Jon Snow during tea time on Channel 4 news.  As I blogged a few weeks ago in my “depressed reformers” piece, being good on policy and wanting to get stuff done is not enough.  Governments have to be able to clearly and reassuringly explain the case for reform particularly when it is the NHS.  Failure to do so equals failure to persuade and reassure.

If I were David Cameron, I would therefore enter the summer transfer market and make a new signing.  It might be trendy to cut the cost of politics, but when it is your number one priority sometimes it is better to “invest to save”.  More to the point, we are not talking about duck houses, phantom mortgages and dog food here – just the small matter of the nation’s health.  The last few months will have shown Number 10 the risk of getting things wrong.  Of course, the Prime Minister has other “HR options” at his disposal, which at this point arguably lack political palatability at a time of perceived Government u-turns.  Recruitment rather than replacement therefore seems like the more acceptable “HR policy”.

Although I see no “Lionel Messi” primed to spring from the Government backbenches, I have already mind-mapped (a HR colleague reliably informed me “brainstormed” is a politically incorrect phrase these days – thanks European Union) a shortlist of 5 viable contenders that fit the job specification.  Star strikers?  Probably not.  Solid defenders?  Probably yes.  And who knows, with one extra team player in the mix Manager Cameron’s 2011/12 season might be a little more healthy and successful.