Adam Smith Institute

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Our Health in Safe Hands

39 Victoria Street 

 

“Humphrey.” 

“Yes, Minister?” 

“I want to develop a reputation for having a safe pair of hands.” 

“That would indeed be a welcome change.  Appointing Amanda Pritchard to succeed Sir Simon as Chief Executive of NHS England is an excellent start.” 

“Thank you.  I believe Lady Harding is now in the running to take charge of all our gas and electricity supplies in the run up to Zero Carbon 2050. Goodbye National Grid.” 

“I understand that there will be the politically appointed overall controller, but I could not possibly speculate as to who that might be, who will ‘help steer the country towards its climate targets, at the lowest cost to energy bill payers, by providing impartial data and advice after an overhaul of the rules governing the energy system to make it “fit for the future”.’ What could possibly go wrong?” 

“Quite right, Humphrey.  Nothing at all. Saving our NHS is far more important than protecting our energy supply.” 

“Indeed, Minister. Amanda Pritchard has worked in the NHS since she left Oxford nearly 25 years ago and her father was the Bishop of Oxford.  Thus our two national religions entwine as one.” 

“And you tell me that, apart from doling out the money once a year, she doesn’t really have anything to do.” 

“Correct. We have taken all the requisite steps to ensure that the Chief Executive is not over-burdened.  The hospitals are now mostly independent foundation trusts with their own governance, GPs have always been independent contractors and we are turning over the rest of the front line to Integrated Care Systems (ICSs) which, as you know Minister, are the 40 something independent partnerships linked to local authorities and dealing also with social care.” 

“Yes, that’s all in my predecessor’s Health and Care Bill which I seem to have been lumbered with.  A right old dog’s breakfast. Amanda has always been a manager in the NHS so excluding any responsibility for medical and care practices is not so daft.  Presumably she has charge of all the administration?” 

“We have been over this before, Minister, but legal, IT and business services are all outsourced to arm’s length bodies and we ourselves make the decisions on pay and staffing.” 

“That is also daft, Humphrey.  Now we are going to have all these local ICSs, why don’t they just pay the market rates in their own areas to get the staff they need?” 

“We have a National Health Service, Minister, and the unions would not like that at all. It would be a pay code lottery. We deal with the nation’s health, not with individuals.” 

“I expect you will tell me that our management of adult social care is not so much ‘safe hands’ as ‘hands off’.” 

“Yes, indeed, Minister.  We have a strict policy of non-interference.  We have been under pressure for some years to come up with a policy for adult social care, or a green paper, or something like that but, as Macbeth put it so neatly. ‘anticipation is better than realisation.’”  

“Yes, Macbeth was good on social care and I gather my predecessor had similar views. When the Treasury insisted, at the outset of the pandemic, that he reduced the pressure on hospital beds and the cost of social care, he solved both at a stroke by shipping all the bed-blockers, infected by Covid in the hospitals, out to care homes which speedily freed up beds there too.  Brilliant.” 

“Possibly, Minister, but it did incur a degree of odium.  Our policy of non-interference is far safer.  The local authorities have to deal with social care and receive financial support from the Ministry of Housing. The more affluent citizens pay for themselves.  We are not even contaminated by a single arm’s length body though we do provide a junior minister to express concern and sympathy on the Today programme when called upon to do so.” 

“Well, I’ll tell you where it does not cut the mustard, Humphrey, and that’s jabs, the pingdemic and travel quarantine. None of those make any sense to me.” 

“It is possible that our briefing has been inadequate, Minister. If something is self-evidently stupid, like insisting on self-isolation when the person pinged has had both jabs, we either say we are following the science, or provide an utterly irrelevant response, such giving our world-leading vaccination programme time to complete or proof that the test and trace system finally works or mentioning the ladies BMX gold medal.” 

“I took a lot of incoming last week, Humphrey, about making the French quarantine because of a few, and declining, Covid cases in La Réunion. At least, that’s what Dominic Raab said on the Today programme.  I’m all for sticking it to the Frogs but that does seem to be taking it too far.” 

“We are only following the science, Minister. The UK Biocentre advised it because France has a higher level than us of the Beta variant. They need time to study it and its resistance to vaccines.” 

“That’s piffle, Humphrey.  They’ve been studying the Beta variant since it emerged in South Africa last October so they must know all they need to know by now.  Furthermore, its prevalence in Metropolitan France is very low and a lot lower than Spain.” 

“I fear you are correct, Minister.  The truth is that we were put under pressure to do this by the Home Office.” 

“The Home Office?  What on earth does it have to do with them?”  

“It’s the migrants.  The Home Office is very embarrassed by all these migrants crossing the Channel in rubber boats.  They’d like to sink the boats and make them swim for it but they have to show compassion, pick them up and take care of them until some time in the next decade when they can be arsed, sorry Minister, find the resources to consider their asylum applications.” 

“I know all that but I don’t see the connection with Covid testing.” 

“The Home Office gave the French £114M to curb these crossings in the five years to 2020 and we’ve now promised them another £55M.  All that’s happened is that the numbers crossing have escalated and the French rubber boat business is soaring. I believe the manufacture of rubber boats, with our help, is the only growth sector in the French economy. No doubt the French coastguards have to push them off the beaches to make room for more.” 

“That’s a shocking thing to say, Minister, I am sure the French government is fully cooperating in their usual manner.” 

“The whole thing is a nonsense because asylum seekers are supposed to remain in the first safe country they reach and France is certainly safe.  Come to think of it, the whole population of La Réunion is under 900,000 and as that’s part of France they could send them there.” 

“Yes, I suggested that but my opposite number at the Home Office said it would be considered divisive.  We need another means of annoying them and especially drawing attention to their vaccination incompetence.  It would be safer, legally speaking, to play the health card.” 

“I take it that’s the joker?  Very droll, Humphrey, and the French are unlikely to see the humour.” 

“Indeed, indeed.  A safe pair of hands never drops the ball and the safest way of doing that is never trying to catch it in the first place.”