NHS – a ‘sick’ future

 First published on Brand Republic 6 June 2011

I have a dilemma. As ‘A Different Hat’ on www.BrandRepublic.com, this is my 100th post. So I want to make it really special. I want to write about the NHS. Because the NHS is really, really special. And I have an ‘upstream’ creative solution that may secure its future.

But I saw a full-page article on the NHS this week. Even I could not face reading a full page of political treacle. This is my dilemma. 

So here goes.

I know a lot about the NHS – personally and professionally. I was paid to do a project on the NHS brand. A summary of my solution is on Page 5 of this document: A Different Hat.  

It wasn’t my highest-paid gig. But it was possibly my most important. Because I value the NHS. And I did a great job (as you can see).

But the Department of Health were a tricky client. One of them said I didn’t understand the NHS brand (yes, me). ’Why?’ I asked. ‘Because you have the wrong pantone colour on your rough layouts’. I’m not joking. Civil servants as ignorant this manage the biggest ‘brand’ in the country.

The NHS employs over a million people. Although that figure may have been cut by the Government by now. Ah, the Government. Within a few weeks of Coalescing, they announced dramatic NHS reforms. Or, rather, the Right Honourable Andrew Lansley CBE MP did. On 10 July 2010 he launched ‘Equity and Excellence: Liberating the NHS’.

There was no research and no ‘piloting’. Why bother? 

Mr Lansley’s dad worked for the NHS for 30 years. So he just did it. Except he didn’t. On 4 April 2011, he was ‘isolated’ (another medical term). His reforms were put on ‘pause’. That’s a weird way to manage a business let alone a country. 

And certainly not ‘progressive’. By the way, what is ‘progressive’? How can ‘pause’ be ‘progressive’? Doesn’t the word ‘progressive’ imply some sort of forward movement?

Anyway, this week, Mr Lansley tried to rescue (‘progress’?) his career. He wrote an article called ‘Why the health service needs surgery’. Note the word ‘why’ – not ‘how’. 

‘How’ will come from some people called the NHS Future Forum. They have conducted ‘an intensive period of listening and engagement’. For which read ‘we’ve done what we should have done in the first place’.

Their report is due this month. They have a big problem to overcome. The cost of the NHS will increase from £130bn in 2015 to £260bn in 2030.

Let me make you a promise. Whatever the NHS Future Forum says, one outcome is guaranteed. This is the important bit.

The solution will require ‘competition’ – which some will call ‘privatisation’. For some, especially Old Labour, NHS ‘privatisation’ is not acceptable. They will make a hell of a fuss (except they won’t be able to, see below).

There’s an American billionaire called Stephen Schwarzman. He made his money from a private equity company called Blackstone. Blackstone bought Southern Cross, the UK’s biggest care home operator. Southern Cross is in financial doo-doo. But not Mr Schwarzman.

This is why private companies making money out of sick Brits just isn’t on. This is the dogma.

People cannot get rich on our getting sick (I sympathise with this). Especially as it is a marketing (perception/creative) not a ‘policy’ issue. But, as I will show, this dogma is out-dated and irrelevant.

The Right Honourable Andrew Lansley CBE MP didn’t work this out. Which is why he was sent to the isolation ward last year.

Like Ms Spelman and her forests, he was too thick to think it through.

Having gathered the Future Forum evidence, what will Government do? What will be their creative solution? Well, without knowing it, the last Labour Government had the answer. First, let’s step back and look at the bigger picture.

Socialism, like the Berlin Wall, has bitten the dust. We live in a world of ‘free market economies’. But we now know that we cannot let ‘free’ markets run uncontrolled.

As we have seen in the banking crisis, there is a Role for Government. I bank with NatWest, owned by RBS, 84% owned the taxpayer (us).

But do I blame the Government for any issues with NatWest? Of course not. I go to my local Manager. Unlike the NHS, the Government do not manage NatWest. We – you and me – just own it. And it seems to be doing OK (now).

So here is my solution.

Let private companies manage NHS services. Feel free. Tender. 

In return, we want 30% of the equity and a seat on the board. Our directors will not be civil servants but experienced businessmen. They will abide by a strict public-service code. And be accountable for our best interests, financially and in delivery.

It is pretty much what the Labour Government did with the banks. By their own actions, Labour have overcome their old socialist position. This will make ‘NHS privatisation’ easier to sell to the country at large. Because we can make 30% of the money Mr Schwarzman has earnt. And then pay less tax.

Did you watch those New Bounce kids on Britain’s Got Talent? They said meeting the Queen would be ‘sick’.

Apparently, in the modern vernacular, ‘sick’ is good.

So let’s look forward to a sick future for the NHS.

About Hugh Salmon

Business leader. Adman. Writer.
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One Response to NHS – a ‘sick’ future

  1. Hugh Salmon says:

    By way of clarification (in response to a Comment on Brand Republic):

    Many people think the introduction of ‘competition’ into the NHS would result in greater efficiencies and an improved quality of service. However, others are concerned that the profit motive will over-ride patient care.

    I am proposing a business model in which we continue to provide the best health service in the world and – at the same time – ensure that, within a more competitive framework, delivery is more important than profit.

    I totally agree that, in this context, quality of service is a more important objective than reducing tax (95). Thank you for emphasising this point.

    My own over-arching message is that the introduction of competition seems inevitable and, if anyone is going to make a profit out of the NHS, then we want a cut – and, as the banks have shown, this is a deliverable objective.

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