Stuart Andrew

Give me time, give me time. “Well, indeed, Minister,” says Sir Humphrey. “I understand,” says the Secretary of State, “that abolishing NHS England will instantly reduce bureaucracy, improve accountability and unleash vast efficiencies.” “Well, Minister, it will certainly create a large number of meetings.” “And the single patient record will revolutionise healthcare, won’t it?” “Yes, Minister—assuming the NHS IT systems eventually stop communicating with each other via what appears to be medieval semaphore.” “But we have delivered 5 million more appointments.” “Certainly, Minister—only 1.5 million appointments behind the last Conservative Government.” “And integrated care boards now answer directly to Ministers.” “Yes, Minister.” “So accountability is now indisputable.” “Well, Minister, blame certainly is.” And so the conversation goes on. The Secretary of State asks, “And what about the workforce plan?” “Still developing, Minister.” “And social care?” “Still delayed, Minister.” “And mental health implementation?” “Still proceeding at approximately the speed of continental drift.” “And pharmacies?” “Still under pressure.” “And GP contracts?” “Still alarming GPs.” “And productivity?”, the Secretary of State asks desperately. “At present, Minister, the NHS measures productivity in the same way that astronomers in ancient Greece measured distant planets: with great optimism and very limited visibility.” At this point, the Health Secretary clearly begins searching the office for the exit map. “But Sir Humphrey,” he says, “surely my predecessor left me with a fully deliverable programme.” After a long pause, Sir Humphrey replies, “Well, your predecessor was primarily focused on a different pathway.” “A different pathway?”