David Cameron, pre-election, told National Health Service staff there would be no more “top-down reorganisations”. The recent history of the organisation had been “like a bowl of alphabetty spaghetti“, he pointed out.
The government is getting rid of primary care trusts. At the same time it is creating a National Commissioning Board, Clinical Senates, Public Health England, Healthwatch England, Health Education England, Citizens’ Panels, Local Education and Training Boards and Health and Wellbeing Boards and shadow Clinical Commissioning Groups.
Even now Cameron has insisted that he has been “taking out” bureaucracy out of the National Health Service. These two graphics would suggest a rather different situation.
Here was the original NHS bureaucracy in graphic form (helpfully drawn up by Labour policy wonks).
Here is the new NHS bureaucracy in graphic form (source: ditto). Which seems the more complicated and bureaucratic to you?
One of Ed Miliband’s victories against David Cameron at PMQs earlier in the summer was in a debate over the NHS reorganisation – and how it was creating a morass of new bureaucracy. Miliband pointed out that the changes were increasing the number of quangos from 163 to 521, as we wrote at the time.