Editor’s blog Tuesday 16 February 2010: Mutual incomprehension, and Barbara Young coughs about her exit

Hello. Hope you had a good weekend.

We have newly-minted Maynard Doctrine for you today. You may also be interested in ”>this piece on mutualism that I wrote for Guardian Public.

Mutualism appears to have become the new black for Conservative Party policy fashionistas. Which seems slightly surreal.

Should it? As Guido Fawkes suggests today, you can describe a lawyers’ chambers or a hedge fund as a mutual or a co-operative. The relatively obvious difference is that such organisations – including the John Lewis Partnership – are competing in a hotly-contested market with a clearly dominant for-profit ethos. This is not the case in public services.

Chris Ham and Jo Elias pointed out in their 2009 Nuffield Trust publication NHS Mutual, one of the reasons for the upswing in interest from the public sector is less a fascination with different forms of organisation and ownership, and more a question of how to achieve higher kevels of employee engagement and participation. The co-operative or mutual type of organisation appears to offer some advantages in this field.

Form – following function?
The risk is that the NHS grasps onto mutuality like a drowning man onto a lifeguard – gratitude and panic and thrashing about making it more difficult for any potential rescue.

It would be lovely to think that the NHS had learned the lesson that organisational forms are much less important than clarity of purpose, a positive and engaged culture and a core value to prove quality and outcomes rather than to assert them. Form should then follow function.

The weekend saw the ongoing political spat over care funding “>dominate the weekend politics shows, to no particularly clarifying effect. A cross-party consensus should clearly be the aim in such a crucial field, and Mr Lansley appears – from what we yet know – to have been the person who broke ranks.

It is not an encouraging sign – but then the whole debate thus far has involved thorougly incredible and fast-moving figures. Must. Do. Better.

Young and independent at heart
Meanwhile, The Times have got the first post-office interview with ex-NHS manager and ex- Care Quality Commission chair Baroness Young.

Oh dear, Andy Burnhoid. Oh dear, the diddy Department of Health. Oh dear ‘look out to your communities, not up to Whitehall’ (copyright Sir David Nicholson, NHS chief executive).

There is scant ambiguity in her phrases that “that government knew it should want an independent regulator but in practice didn’t feel very comfortable about that . . . Rugged independence is not what they are looking for, they are looking for something much more emollient and collaborative.
“[The CQC] is one of the few fields where the regulator — for saying anything that is unsatisfactory in terms of a service — is actually saying directly that the service being run by a minister is unsatisfactory, and ministers find that quite difficult”

Barbara Young had a reputation as an honourable woman and as a non-bullshitter. While there was scant surprise at her exit, it is intriguing to have her actual words about the reason why.

Her pay-off lines are poignant: “There’s so much crap talked about what’s going wrong with the NHS, and I just want people to talk about what’s going right with it,”.