Silence is Golden

Written by Gareth Young on . Posted in Our blog

‘What we talk about is what we care about’; a maxim that is fraught with inaccuracies but nonetheless can prove fairly helpful when understanding the priorities of your manager, your organisation or even your Government.

I was reflecting on this over the weekend whilst listening to the on-going debates about changes to the benefits system. These are massive changes and worthy of debate but I am left wondering why these have become the leading headlines whilst the equally, if not more, significant changes happening to the health service are hardly mentioned.

Whilst it is true that the Government have felt the need to respond to opposition attacks on benefits it is equally true that there has been next to no official comment or publicity surrounding the changes. I find this rather strange; so strange in fact that I decided to do a little research.

Question 1: How many speeches have DoH ministers made about the changes to the NHS in the past six months?

Answer: None

I did a quick search on the newly designed DoH website and despite some interesting speeches including topics such as ‘Innovation in the NHS and social care’ (16/3/13), ‘An NHS that treats people as individuals’ (12/2/13), ‘From notepad to iPad: technology and the NHS’ (16/1/13) there was nothing this year about the NHS transition.

Question 2: Ok, so what about news stories?


Answer: Despite going back to the beginning of the year I couldn’t find one; not one solitary announcement and that is from a department who has released news stories with such diverse topics as: ‘Responding to the threat of antimicrobial resistance’ (2/4/13), ‘Salt strategy aims to reduce our salt consumption by a quarter’ (22/3/13), Department seeks chair of the British Pharmacopoeia Commission (8/3/13), ‘NHS charges from April 2013 announced’ (1.3.13).

I only include that last one as I accidentally mis-read it as NHS changes rather than NHS charges.

I tried the same searches with press releases and other announcements and got nowhere. Which all leads to;

Question 3: Why, when these changes are so incredibly significant, has no-one from the Government been talking about them?

I don’t know the answer to that but can only make two suggestions.

Firstly, maybe the Government are sensibly trying to keep the public eye off of these changes for the moment. Anyone who has managed a change project, however small, will know that the benefits of that project will rarely be apparent straight away. Indeed, the benefits often come quite away down the line. In this case, just looking at the small element of the health changes that affected local authorities, it is clear that the re-integration of public health with local authorities will take time to bed in, let alone deliver lasting benefits. The logic would in all liklihood apply to the whole reorganisation.

Secondly, my impression is the transition has been much much harder than the Government anticipated and the less eyes on it right now is probably for the best. Linked to this there is probably an element to which it is not a good idea to shout about reforms that were this unpopular when they were passed until such a time as there is some positive news to tell. That news will not come on day one. Politically, my guess is that this is a case of tactical misdirection. This level of radio silence is never accidental.

I’m not surprised by the delays but I am surprised that the Government have been so disciplined in saying absolutely nothing about the reforms. I strongly hope that this is not a sign of the Government disassociating themselves from the reforms or of others taking their eyes off of them.

Whatever you think about the reforms I’m sure we can all agree that making a success of them is an absolute priority.

And it is still pretty weird that the DoH and all their ministers have said absolutely nothing about them.


Posted: 5 years 6 months ago by Krisw1 #23
Krisw1's Avatar
A think a few things are behind this:
1. The change in ministerial teams - everyone involved in the reforms got moved in the last reshuffle so none of the architects are still at DoH. This was clearly an attempt to take some of the heat out of the debate.
2. The focus has been on mid-Staffs - the Francis report has grabbed the headlines over the last month and the NHS has got an unusal amount of bad press. In particular the NHS establishment and the government has had to close ranks around Nicholson as one of a few people who actually understand these reforms.
3. The nature of the reforms - the total focus on the admin side, commissioning especially, is not very headline friendly. Most of the reforms involve placing one set of acronyms with another - PCTs become CCGs, SHAs become NHS CB, LINks become LHW.
4. The reforms miss the big issues - the overdue reconfigeration of hospitals, the building of decision making around consultants, the huge problems with quality assurance, and the lack of funding on preventative health services are all ignored and stored up for someone else to deal with at later stage.

In the main the reforms make an incredibly complex system a bit more complicated but what impact this will have on patient experience, and the stuff that does grab headlines, won't be clear for some time. Something to look forward to then.
Posted: 5 years 6 months ago by Glen #24
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Very good point about the Mid-Staffs issue; for it to make the headlines it needs to be sensationalist and immediate, preferably with a single individual or group accountable. The raft of changes taking place are neither, though they will have long lasting effects and huge implications.
Posted: 5 years 6 months ago by Gareth #27
Gareth's Avatar
I totally agree with all four points. (good points well made)

It just puzzles me that a party would spend a LOT of political capital to do something they obviously believed in and then not mention it at all when the reforms are implemented. I wonder if along with the other stuff there is an element of cold feet creeping in?

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