Editorial Wednesday 26 March 2013: There'll always be an (NHS) England - decoding Chairman Mal's letter

It was a busy news day yesterday, during which HSJ editor Alastair McLellan's eagle eye spotted a significant letter to Jeremy 'Bellflinger' Hunt from Chairman Mal of NHS England (The Artist Formerly Known As The NHS Commissioning Board).

There's some rhetoric about how the name change is not going to enrich signmakers and stationers at all, and that it's "to connect more readily with patients and the public ... (and) to speak for the NHS ... to speak authoritatively about NHS delivery and performance".

How very revealing.

There is one reason this is happening: because Comrade Sir David wants it to.

It actually obfuscates NHS England's purpose, which is to be the independent commissioning board. 'NHS England' is no clearer at all.

Nor is it likely to be accurate in the public's perception. They believe that the NHS is essentially what they use: that's GPs and hospitals, mainly; nurses and doctors and other health professions. That's what the public experience as NHS England.

If they think about what 'NHS England' does at all, it's as back office. It's the sausage factory: most people don't think about what's going on there, because a) they don't have to and b) they don't want to.

As a means of connecting more readily with the public, Chairman Mal and Comrade Sir David might as well dance naked down Regent Street as change the NHSCB's name to NHS England.

The letter suggests that "we are clear that 'speaking for the NHS' does not imply any weakening of the commissioner-provider separation which is at the heart of the new system arrangements". Yet the name 'NHS England' looks pretty damn cover-all.

One voice for the NHS
What's much more interesting is the professed aim to "speak for the NHS", or as it's more accurately rendered, 'shut the fuck up, everybody else: we're in charge now'.

The notion of a more decentralised, locally autonomous system taking power and responsibility by locality disappears yet further over the horizon. Once a Stalinist, always a Stalinist.

The notion that in the NHS, the centralisation of power (and voice is a big part of power) has been an unalloyed good thing is hog-whimperingly daft.

There's an odd section on 'Handling communications and parliamentary business', which comes across as a bit of a 'piss off' to the DH. Hysterically, it promises that "in conjunction with experienced DH officials, we will test the robustness of these arrangements in the run-up to “go live” in April".

That's in five days' time. Some robustness testing.