The Health Secretary Sajid Javid has announced that there are to be reforms to the NHS. Do I hear a chorus of ‘hooray’, ‘at last’, ‘’not before time’ and other similar exclamations by those who do not go along with the general press-ganging that goes on to get people to genuflect before the Golden Calf that has been made of the NHS. I must admit that I cheered when I saw the headline that Mr Javid is going to reform Britain’s mediocre and badly run National Health Service and I suppose that others of like mind to me did also.

Unfortunately the more I and others dig into this loudly trumpeted reform the more I see these reforms as ‘Potemkin’ reforms, they appear to sound good but will not ultimately make a crap comprehensive health service like that of Britain’s into something more efficient and humane maybe something akin to what the Israelis, the Germans, Dutch and French get. I suspect that these reforms are going to end up as window dressing that will not tackle the root causes of NHS failure nor deal with the generationally institutionally inbred slothful, wasteful and often incompetent way that the NHS is managed.

Even reading the précis of Mr Javid’s reforms over at the Guido Fawkes site shows me that few people are going to benefit from any ‘choice’ in their healthcare. This is not choice for the many but a choice for the few and only for those for whom the NHS has already screwed up by sticking them on waiting lists of 18 months or more. What’s worse is this permission to choose is handed out by the Health Secretary as if it was some sort of valuable gift from the State rather than what should be an individual’s right to decide where to be treated.

Guido outlined the choice that a limited number of those who have been made to wait for outrageously long times to be treated by the NHS will get. They will get the right to choose an NHS hospital anywhere in the country or use a private health provider. Those able to exercise this right to choose will also be able to avail themselves of taxpayer funded transport to the hospital of choice.

As I said this is not healthcare choice for the many but healthcare choice for those relatively few of the nigh on 6 million or 8% of the population (as of Jan 22) who have been screwed over by the NHS with regards treatment. Such people have been especially disadvantaged over the last few years when the NHS almost completely abandoned the public with regards general healthcare and became a Covid only service. Covid showed up the monstrous incompetence of NHS management and planning and no amount of clapping or painting rainbows on kids faces or other Golden Calf worship activities could hide that.

I don’t believe that these reforms will help to deal with any of the NHS’s current problems and I look at what is proposed and I see not stuff that will properly deal, whether in the short or longer term with the poor management culture and the waste which the NHS is renowned for or the godawful service that many of the NHS’s customers get. I do however see ample opportunities to do little but spend a lot of money whilst doing so.

Here’s the short version of some Mr Javid’s reforms from Guido. Original source in italics, my comments in plain text.

Javid also announced a health disparities white paper is coming later this year, with multiple government departments and agencies including the NHS expected to be involved in developing a strategy for the health service’s new preventative focus.

Yes, preventative healthcare is important but focusing on it should not take interest or resources away from the job that the NHS has at its core which is treating the illnesses and injuries of the British people.

Javid claimed this will be achieved in four main ways:

• A ‘baselining exercise’ to work out how much the NHS currently spends on prevention
• Instructing NHS networks to commit to a delivery plan for common diseases
• A focus on tackling cardiovascular diseases
• Beefing up the role of the NHS app

I see massive opportunities for waste regarding the above. The baselining exercise alone is probably going to involve hundreds of staff trawling though the bureaucracy swamp that is the NHS for information that should be readily available to a well run organisation but is probably hard to find in the NHS systems.

I would not bet against the instruction to create and commit to a delivery plan for common diseases to end up in a wasteful, sclerotic mess either. There will of course in every healthcare management district be a Common Diseases Delivery Plan lead officer probably on £100k pa to be recruited along with a veritable empire of Delivery Plan managers, assistant managers, deputy assistant managers and numerous Delivery Plan clerical and administration staff. Following on in the rear of the Delivery Plan management empire will come the parasitical camp followers of HR, Diversity and ‘Net Zero’ staff who will of course want a piece of the Common Diseases Plan pie. How beneficial the expenditure that will inevitably occur to formulate this Common Diseases Plan will be for the end customers of the NHS that is you and me, is doubtful. But at least the most likely massive expenditure on the Common Diseases Plan would probably be enough to allow some members of the NHS Nomenklatura to take holidays in the sort of exotic and expensive places where it’s quite possible that they may pick up some rather uncommon disease venereal or otherwise.

If the Common Diseases plan looks like a splendid opportunity for NHS waste and resource diversion into the pockets of management and admin, then the lack of detail being given at this stage about the plan to reduce cardiovascular disease and beefing up the NHS app, have the capability to be much deeper money pits. A proper cardiovascular disease monitoring and reduction plan would I imagine if it was to be effective involve identifying all those at potential risk with a large scale screening service similar to what Britain had when we were in the process of eradicating TB. Does anyone truly believe that the NHS has the talent, the facilities and the managerial abilities to be able to do this in a cost effective way? I don’t. I suspect that as some CV disease has its roots in lifestyle factors then what may happen is that the NHS invests billions in healthy eating hectoring without considering whether such actions actually bring down the rates of CV disease. I suspect that in the area of cardiovascular disease the NHS will end up wasting money in a similar way to it probably will with the Common Diseases Plan.

As for beefing up the NHS App well that’s all well and good and could increase the efficiency with which the NHS communicates its long suffering (sometimes literally) customers. However it’s probably going to do little to stop GP’s hiding from patients and may make the current issues that Britons have in getting to see a GP, who are the gatekeepers of the NHS, much worse. It will give an extra excuse to not see patients as they will be able to point to information that is available on the app. We could have had a form of medical tech that put control into the hands of the patient, one where the patient’s medical records were the property of and in the electronic custody of the patient themselves. Or a system that allowed much greater choice for everyone about services such as those provided by GP’s and others which could make the customer i.e. the patient the king in the medical relationship instead of the patient having to behave like a supplicant in order to access a basic service such as that of seeing a GP. We won’t get that of course. I suspect that we will get an NHS app that is expensive and substandard and which will not do half of what it is supposed to do. Not all public sector IT is awful but some of it is and as the NHS has a horribly bad record for wasteful, ineffective and disastrous IT projects I dread to think what the upgraded NHS app will end up being.

I like the idea of reform of the NHS. It really needs reform. However, what Sajid Javid appears to be proposing will do nothing to tackle the NHS core problems. It won’t tackle the waste, it won’t remove one parasitical diversity or ‘Net Zero’ employee, it won’t abolish one surplus manager. It won’t tackle the poor resource management and it certainly will not make into humane heroes the sometimes inhumane and monstrously incompetent and arrogant staff.

This what Mr Javid is proposing is not the far reaching reform and rebuilding that the public healthcare system needs. This is just expensive tinkering around the edges. Sajid Javid is with this reform announcement acting like the equivalent of a car salesman boasting about the quality a car because of its fine paintwork but ignoring the fact that there’s a lawnmower engine under the bonnet and the interior stinks of vomit and piss.