Swans, Portillo & NHS Reform. Mick James asks: "what is going on?"

Walkers along the Thames this week may be lucky enough to witness the ancient ceremony of “swan-upping”, in which members of livery companies and the Queen’s “Swan Marker” row up and down the river competing to put their dibs on any swans they encounter for future banqueting. But as no-one apart from the very poor actually eats swan any more, it’s just one one of those quaint British survivals.

What rituals from our day will survive the centuries? I have an image of quaintly-garbed individuals making their way across a post-apocalyptic landscape to some ancient centre of pilgrimage like Stonehenge or Bluewater.

“Members of the Worshipful Company of Management Consultants, are you ready to reorganise the NHS?” asks King Edward the 207th from his throne.

“Aye,” comes the reply from one group, followed by some mantra such as “devolved regional commissioning care trusts”.

All possible configurations of the NHS by now having been tried, the other group (there are only about 100 of them, but it’s still the fourth-largest employer in the world) quickly arrange themselves into the “new” configuration and march off. The King distributes the traditional bags of silver sixpences to the management consultants who depart in the opposite direction, their livelihood assured for another year.

Now cynics would argue that this is exactly what happens anyway. I don’t believe that, but I have to admit that I’m completely baffled by the latest proposal to reform the NHS, which has come completely out of the blue. Could they just not stop themselves?

I really have no idea as to whether it’s a good or a bad scheme - I haven’t had time to digest it. I certainly don’t believe the private sector or even consultancy in particular is “licking its lips” at the prospect, as the papers like to put it. I think we’ve all been wrongfooted, and that’s really my point.

There’s currently a bit of a democratic deficit in the UK, which is of course an inevitable consequence of Coalition government. In a coailtion no-one gets to implement everything they want, and a pure “pick’n’mix” to existing commitments might lead to some bizarre outcomes. So there’s clearly room for a bit of creativity. But you’d need to use anagrams to construct current health policy from Conservative and LibDem manifestos. So what is going on?

Some light was shed on this by Michael Portillo’s inaugural lecture at the recent Management Consultancies Association event. Sadly I never got to ask my question, which is “what have you done with the real Michael Portillo?” so different does this witty and charming man seem from the Marlovian anti-hero who terrified us all in the ‘80s and ‘90s.

His theme was the relationship between business and government, and although this was liberally diluted by a great many - admittedly hilarious - anecdotes, he did offer some valuable insights into what s happening in government at the moment.

“These people are really enjoying their release,” he said, and for a man who’s clearly still enjoying his own release from politics you had to believe him: “They’ve been released into this new world and they’ve all fallen in love with paradox - they’re never happier than when they are saying things people don’t expect.”

That explains the “creativity” but raises questions for voters and for business.

As Portillo pointed out, the LibDems have moved from a situation where they might never be in power to one where they mght always be in power. It’s unclear how voters might react to a situation where what happens on election night is less important than how Nick Clegg feels the next day - that’s taking one-man one-vote a bit too far. My own view is that we would quickly have to unpick the internal coalitions that define the major parties and move to a fully proportional system reflecting single issue groupings.

Voters have to sort this out for themselves. Business - and for that matter the NHS - is in a far worse position. While UK governments traditionally enjoy the in this case ironically named “doctor’s mandate" and can do what they want, manifesto commitments have always had a priviliged role. So businesses have been able to prepare for a relatively predictable contingency of dealing with “this lot” or “that lot”. Even the prospect of a hung Parliament didn’t threaten more than some mild concessions to “the other lot”

All that’s gone out of the window and may never going to be the case again. All we know is that Plans A and B are unlikely to go ahead without serious or even total revision, and that while Plan C offers us very few clues of how that might happen.

This is why I took issue with a recent piecewhich argued that, given the “business-friendly” nature of the current government the next Director General of the Confederation of British Industry need only be a relative pygmy compared to previous incumbents. Wrong, wrong, wrong. The next generation of leaders of the CBI and other lobbying groups will need to be Churchillian giants. They’ll need to be constantly lobbying government and reminding them that, no matter what noises you make, if you are capricious and unpredictable you are no friend to business.

That means, in my view, lobbying to get a lot more things nailed down before an election, establishing areas of consensus and no-go areas. That may sound like an argument for a corporatist state, but I believe this might lead to a renewed political debate, while at the same time allowing business to operate in more stable and predictable framework. The democratic deficit is currently made worse by the fact that the Labour party is currently leaderless and all the other people with experience of opposition are in government. Labour are in the position of a navy putting out a 30-year old battleship while their new dreadnoughts are still on the blocks, so we hear a lot about Thatcher and the battles of the past. In fact the ideological differences are tiny, as Tessa Jowell admitted when she accused David Cameron’s “Big Society speech of being a “shameless rebrand” of existing Labour measures.

The construction of this new political discourse might take some time though. Portillo’s take on the (male) Labour leadership contenders was that they had ‘nothing that gets them up in the morning”, that they were just waiting to resume their time in office: “I don’t see how you can work in politics unless you have a burning desire to change, if not the country, then your party,”

So the question I would really have liked to ask him - or anybody really - is where is the new poltical thought coming from? Who are the innovative thinkers we should be watching?”

I’m not sure he’d have had an answer. But if we can’t have innovation, can we at least not have surprises either?


All views expressed in this article are those of Mick James and do not necessarily reflect the views of Top-Consultant.com and Consultant-News.com.

Contact Mick with your views or suggestions at: mick.james@top-consultant.com.