So – there was a strategy after all
Only now is the wisdom of successive Secretaries of State for Health becoming clear to me. Who would have thought that quietly, in the background, the Department of Health was implementing a 30 year mastermind strategy to build stability into the NHS. Repeated re-organisations of the NHS have all been part of an incredible masterplan to embed organisational and personal resilience skills amongst the NHS management cadre.
As the pause becomes a hiatus becomes a temporary cessation becomes a 15 week summer recess, managers within the NHS are doing what they do so well, and as now becomes clear, what they have been cunningly prepared for – they are just getting on with running the whole system in the face of superficial intentions to change things.
Some people make the mistake of painting this as an in-bedded, institutional resistance to change but they are wrong. Without NHS management’s amazing, Darwinian adaptive qualities, endless political messing about would have done for the NHS long ago. Fortunately the powers that be recognised that we needed an undercover programme of skills development so that managers could cope with the endless machinations of the politicians and keep the whole thing running. Like London cabbies who can keep going safely while a party or a full scale fight is breaking out behind them, NHS managers are able to keep the whole shabang on the road. Just don’t ask them to go south of the river after dark.