Editorial Thursday 15 October 2015: A Twitter chat with Andrew Lansley

Well, that was interesting.

Last night, Our Saviour And Liberator Andrew Lansley took exception to yesterday's post on feeling sympathy for Jeremy Hunt.

On Twitter.

Replying to my Tweeting the link. Mr Lansley wrote, "when you're not issuing childish abuse, do you think NHSE(ngland) should be independent; if so, why not offer credit?".

It's a perfectly fair question.

And I mean this absolutely straight: fair play to Mr Lansley for choosing to engage. (Naturally, I have updated my Twitter biography with his "childish abuse" phrase.)

Our exchange went as follows: I italicise Mr Lansley's responses for clarity.

AC: "When @NHSEngland has tax-raising powers, it'll be genuinely independent. NHS is now more captured by the Treasury than ever. Making @NHSEngland independent has same effect as making FTs independent: the telescopic nature of the arm that raises money or regulates money, as David Bennett admitted.

AL: "The Treasury can always call shots but it's transparent to do it."

AC: "Not trying to do so, but don't understand that point. You read Sally Gainsbury's first-rate piece?.

"There's also accountability: the NHS has never been great at this, but a quick-and-dirty version of local MP complaints used to work before, oh, the 2012 Act. Do you think the accountability of @NHSEngland's a strong point? Many system leaders don't.

"You had best NHS detail knowledge of any health/shadow health of our time. Only a fool (such as The Mascara Kid) would suggest your intent was privatisation/damaging the NHS.

"Weaknesses: getting people onside for huge structural reform; and an absolute faith you had the one correct system model, whereas NHS is a series of evolving problems, not a puzzle.

"Isn't it striking that almost everything @NHSEngland (Commissioning Board)'s been doing is about provision/Vanguards? It must be galling that Simon Stevens is in effect ignoring and undermining your architecture".

AL: "No he isn't; he's using the architecture, as it was intended, to speak for the NHS and develop its own solutions".

AC:"You thought NHS Commissioning Board should be focused on reforming & restricting transformation £ to provision? Didn't show."

Fin
That was the end of things, though some interesting comments were chipped in by other Tweeters.

I particularly enjoyed this one.

I'm not inclined to editorialise much under this exchange, which I genuinely welcomed. I even hope we might see Mr Lansley on Twitter more often.

I'll just conclude that there is a risk of being so far in denial that one becomes a riverbed in Cairo.