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Dr Michelle Tempest: Polyclinics could spell the end for health localism

Dr Michelle Tempest, a psychiatrist, blogger, and editor of the The Future of the NHS, fears Brown's Stalinist approach to the healthcare delivery.

‘The invisible hand’ metaphor was first coined by the economist Adam Smith, to demonstrate how in a free market, an individual pursuing his own self-interest, tends to also promote the good of his community, through a principle he called ‘the invisible hand’.  The clunking fist metaphor is an apt description for Gordon Brown, sapping up any individual instinct to do better, and replacing it with a state, ‘top-down’ approach.  This Labour ethos leaves a ‘tight bureaucratic straightjacket’ in its wake, and pervades everything Gordon Brown has put his hand to.  Schools and teachers lack the power to keep order, with legal bureaucracy preventing the exclusion of disruptive pupils, who consequently distract the rest of the class.  Even planning powers have succumbed to Labour micro-management.  Responsibility set to be transferred back more centrally, to unelected ‘Regional Development Agencies.’  One can almost see that clunking fist smashing down into the very heart of a local community, dispersing community spirit.   

And does the clunking fist ever learn?  Even after the unforgettable data scandal where 25 million private records went missing, following a systemic failure at HM Revenue and Customs (a body set up by Gordon Brown to ensure greater control over Britain’s tax system) the expensive ID card scheme still has the green light.  It seems to highlight a stark problem in Labour ideology, where focus is solely on data, rather than on people, or trying to solve problems.  As Nick Herbert MP summarised, “A Government which tries to control everything but cannot run anything.”

Dr Michelle Tempest: Can Gerry Robinson save the NHS?

Dr Michelle Tempest (blog) is a psychiatrist and editor of The Future of the NHS.

Management guru Sir Gerry Robinson was the star of a BBC 2 series last week when he was set his ‘biggest challenge’ - to reduce hospital waiting lists.

For those of us who work within NHS hospitals, the stories seemed all too familiar. Delays getting patients in and out of theatre (or in reality anywhere), different specialties not working in harmony, committees and sub-committee’s having endless meetings with no conclusions or outcomes. 

He admitted, that after spending just 2 days a week in a hospital environment, he returned home feeling “depressed”, “frustrated” and even doubting his own self-belief to make simple changes. Another familiar tale. In an interview, he said:

“It’s actually quite hard to explain, the psyche…you had any number of people saying well we’ve been talking about this for two years, or I’ve brought this up with this committee for the last 10 years.”