Perhaps David Cameron was worried about the dissonance between his pre-election pledge to put an end to top-down reorganisations of the NHS and the post-election labelling of his government’s proposed changes as the biggest reorganisation that the service has ever seen. Perhaps Nick Clegg was unhappy that two months after the key Lib Dem health policy – elected representatives on Primary Care Trusts – was written into the coalition agreement, he was being asked to support the abolition of the PCTs. Who knows, but they must have been pretty unhappy with the politics of NHS reform to have ordered a pause in the progress of the bill to allow for a ‘listening exercise’.
There was some initial scepticism. At the PR launch last month, Andrew Lansley seemed to be apologising only for the public’s failure to recognise the wisdom of his proposals. Clegg and Cameron gave the impression that the exercise was about persuading people of the merits of the changes, not about opening them up for revision. Besides, planning for the future is what managers do and PCTs have been planning their future non-existence since July last year: as a leaked email from the NHS chief executive makes clear, there is much in the White Paper that will now have to happen.
Still, the listening exercise is going ahead. There is a website. You can join the conversation. Except that it isn’t a conversation so much as a series of outrageously leading questions.
How can we best ensure that competition and patient choice drives NHS improvement?
Which are the types of services where choice of provider is most likely to improve quality?
What is the best way to ensure a level playing field between the different kinds of provider who could be involved?
What else can be done to make patient choice a reality?
A few hundred people have taken the trouble to respond.
But there’s more to the listening exercise than a website. Paul Burstow, the care services minister, announced last month that 119 listening events had been planned. 119? Impressive. It would be nice to see a list. Apparently if you ask for the list you are told to contact NHS Future Forum. But it turns out that NHS Future Forum does not take incoming calls. Not, it would seem, that kind of listening exercise.