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Phil Barber   08/09/2016 at 14:34

Yes, this follows a familiar pattern, where inadequacies in healthcare delivery are to be addressed by remedial action in the form of a 'transformation', of which the first element is - wait for it - re-structuring. Expect a long and expensive round of proposals, option appraisals, management-consultant advice, and a healthy (or unhealthy) dose of medical vested interest, the outcome of which will be a new 'Board' in around two years' time, discussing how best to re-configure everything in the teeth of opposition, most of it entirely reasonable, from the de-stabilised hospitals and localities adversely affected. While this is going on there will be planning blight on all imminent developments, and a media free-for-all. No additional resource will be directed to the clinical coalface while all this is working through, probably not even then. In our own locality, North Manchester General Hospital is a good example of a casualty of this kind of process - the once-proud medical powerhouse of the north of the city, restructured in a fanfare of publicity in 2002 as part of 'Pennine Acute', the largest non-teaching Trust in the UK, and a predictable car-crash. NMGH has suffered years of deprivation and planning blight ever since (along with the other components of Pennine, which unfortunately can't be talked right), and has been recently threatened with transfer-out of its elective surgery, a death-knell indeed. There has been a recent attempt to try to pluck it from Pennine into a new Manchester conglomerate as part of the DevoManc ambitions of the City Council, for which the political climate is suddenly not quite so favourable, but the very latest move has been to re-position it yet again under the wing of Sir David Dalton in - Salford. How can effective healthcare be delivered and developed in this climate of political re-structuring chaos? NMGH is an extreme example, but we all suffer from it. I would suggest a re-think in Birmingham, a change of emphasis perhaps, with the immediate re-direction of any re-structuring budget towards direct patient care, guided by Brailsford-type principles rather than management Motherhood and Apple Pie and, of course, the Big Picture. It’s the small picture, that of everyday patient journeys, which needs focus.