Friday, 25 February 2011

Pipe dreams

The latest government cock-up regarding the evacuation of British subjects from Libya causes me to wonder just what thought has gone into the background planning for all the wonderful things they propose to do. The recovery of our Nationals from Libya showed just how faulty was the Defence review. What we needed to do was almost exactly what the MOD thought was it's most likely scenario. Yet it all fell apart from the moment the commercial airlines decided that the air space over Benghazi and Tripoli was just too dangerous to venture into. We didn't have a plan B; Plan A was useless anyway. When it was appreciated that civilian planes do not fly schedules in what amounts to war-time, MOD was forced to seek a charter flight at we do not know how eye-watering cost. We ended up with one that had a fault that kept it on the ground for hours. The charter company should have been told that it was 'their' plane with the fault and 'ours' needed to be wheeled out of a hanger somewhere.
The antique ship HMS Cumberland was lauded by the Men from The Ministry as part of their 'Plan' At the time of it's being drafted into a PR cum rescue role it was steaming home to be broken up. What would have been useful was something such as HMS Ark Royal but that had already berthed at Scrap Yard Quay.
My concern is that the evacuation farce is merely indicative of the organisational capability of this government. I get an image of them in opposition in the last days of Brown. Realising that after so long on the wrong side of the House their turn might come. In amongst their dreams for bigger and better duck accommodation and real estate finagling was the attitude 'what I will do when I am a boss' It is a heady moment - and I speak from experience. Sell off the forests and woodlands. Increase university fees. Get rid of the NHS as we know it. Sort out the police, Immigration. Get a grip on the Army. And, of course, the Big Society. All in broad brush sweeps with, it seems, a lack of detail in the 'nuts and bolts department' as some turnip Tory will have described it. Well, the chickens are coming home to roost; chicken or vulture?
Such club smoking room plans as have been exposed to the light seem to have gone tits up. Policies dropped, delayed as too difficult or radically changed on a cut to fit basis. Some of the broad brush ideas were so thin on substance that there is a risk we will thrown baby out with the bath water. The intent would seem that outsourcing works wonders. The plan included
Allow independent healthcare providers, as well as NHS Foundation Trusts and other NHS providers, the freedom to supply services to the NHS, if they can do so at the NHS price and NHS standards. Commissioning of NHS services will be separate from healthcare providers and overseen by the independent NHS Board. An independent regulatory structure will ensure high standards of service and care.
But the organisation is to be radically revised so any NHS prices or standards will be out of date. The new framework is also supposed to lead to improvements so these prices and standards will change as time progresses. The new supervisory and commissioning bodies will be set up and would appear to be the top heavt bureaucracy we complain of now. There is an added factor - the Government plans refer to :
Reverse the top-down power relationship governing the NHS, putting patients, not politicians, in the driving seat. Patients will have a real power of choice over their care: which GP or other healthcare provider they want to use, which hospital they go to and even whether they want the privacy of a single room, rather than a ward.
This idea of choose where you sit is associated with an environment where many hospitals still have Bedlam era mixed-sex wards. There seem to be issues over morale of nursing staff and these are unlikely to be addressed by the changes - no one likes change. So, that is the NHS; looks like a real dog's dinner and the other 'radical improvements' are no more appetising.
And our PM spends much time flying hither and yon worldwide advocating new ideas and ways and means. Rather as if he thinks the globe still has large patches of red and we are a nation of power and importance in the scheme of things.