Editorial Monday 13 February 2012: Andrew Lansley the technologist, slight return - mobile phones and the NHS

Something about the HSJ / Reform piece by Andrew Lansley (saviour, liberator) published today has been nagging at me.

It's something other than the confused reasoning.

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It's the curious technology reference: "in any other sector, it is the thousands of individual decisions to adopt a new technology – from, say, cassettes to compact discs to mp3 players – which combine to sweep away less effective services".

The penny dropped: it's reminiscent of his comments to the Kings Fund, at the wholly appropriate launch of the Fund's 'No More Heroes' report into NHS management last May.

In that speech, Mr Lansley was explaining integration and competition, using the metaphor of mobile phones: "I bet virtually everyone here today has a phone in their pocket or handbag.  Some of you will have more than one.  It might be a basic model where you can make calls and send texts and that’s about it.  Or it might be one of the latest smart phones that can do just about everything bar the washing up.

"Either way, you are enjoying the fruits of countless individual companies operating in a wide range of individual, highly competitive markets, all working together to deliver that one complex, ubiquitous product.

"Mining companies, designers, chip manufacturers, haulage companies, marketing agencies, precision engineers, logistics companies, data management, network providers, warehouses and, finally, the place that sold you the finished product.

"Each one competing fiercely for business at every step of the way.  Each one successful in large part because of the high degree of integration they can offer with the other parts of that supply chain. When organisations compete but don’t offer to integrate their services, the result is clear... they don’t get the business.

"It is in the interests of every provider to offer the greatest possible degree of integration.  Even with those they are competing directly against.  Vodafone and T-Mobile both rely on common standards.  Whether you have a Nokia, an iPhone or a Samsung, the same SIM card will work in all three.".

However, Mr Lansley went on to explain that "the NHS isn’t a mobile phone.  It’s infinitely more important than that.  If things go wrong on your phone, you can’t make a call.  If things go wrong in the Health Service, people’s lives are at stake".

Competition and integration are like mobile phones.

But the NHS isn't like a mobile phone.

I hope that's all perfectly clear.