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Tony Hockley offers his view on the recently leaked draft white paper, suggesting that the government is planning major reforms in a proposed shake-up of NHS England.
Professor Alan Maynard once referred to successive governments’ health policies as ‘redisorganisation’. A leaked health white paper suggests that the latest episode of redisorganisation may be about to commence. Boris Johnson would be right to worry. The change that is needed is cultural not structural.
Since the 1960s, legislative change has been seen as the solution to the problems of the NHS. Eventually each change is unpicked. Centralisation appears the solution to the complexities of decentralisation, and vice versa. A step-change in public funding appears the solution to falling standards, then more measured spending growth appears the solution to falling productivity. The cycle of redisorganisation goes round and round, diverting resources and political capital as it does, and de