In the same way that dogs mark their territory, there is a type of bureaucrat/’manager’ who has to make changes for the sake of making changes, to prove that they own this particular patch of pavement. It is not helpful.
There is a crisis in governance in England that has profound implications for public health, Prof Martin McKee told delegates at this year’s Dare lecture.
‘As many in this audience will be only too aware, ministers can turn the NHS upside down on a whim,’ he said. ‘They can decide to strip primary care trust of their ability to deliver services one week and then go back to it the next. They can split health authorities into smaller organisations to make them locally responsive, and then amalgamate them to make them more managerially efficient. And they need never explain to anyone.’
All this was done without any need to convince anyone that policies or restructuring had any merit or even coherence, he continued, causing relentless and needless upheaval. ‘Ministers and their advisers,’ he said, ‘most of whom have no experience of the world outside Whitehall, are determined to be seen to have changed something. It doesn’t matter that their successor will change it again. They can tick the box labelled ‘modernisation’ on their CV and move on to higher things. They need never wait for the results of their bright ideas. ‘
Public Health News 19 June 2006 (Public Health News is now sadly kaput. T’was good)
