Over the years we have brought you exclusive access to the diaries of some of the most important people in the NHS, including Jeremy Hunt, Simon Stevens and Dame Sally Davies, so it didn’t take much to persuade newly installed secretary of state for health and social care Matt Hancock to let us publish the following extracts from his journal
Up early and into the office for a briefing on the day ahead. My new team are keen to cover everything as quickly as possible. All in good time, I tell them. It shouldn’t take me long to pick this up.
As well as health I’m in charge of something called social care. It sounds dull and there doesn’t appear to be a budget for it, so I’m parking it for now. In his handover note, JH said not to worry about social care but to keep it on the letterhead as the department’s stationery budget is already at full stretch.
Meet a man called Simon, who’s here to give me a high-level briefing. Can’t understand a word he says, just a lot of guff about flowers, renewable energy and sustainability. I explain to him patiently that it’s four years since I was at Energy and that if he wants to talk about fracking he’ll need to see Greg Clark. He seems bewildered and a bit cross when I ask him to leave.
More briefings from departmental officials and NHS managers, most of it baffling – referral to treatment targets, four hour waits, integrated care systems, delayed transfers of care, unwarranted procedures, control totals and other jargon.
Seems to me they’re making it far more complicated than it needs to be. In my experience, it comes down to five things: hospitals, doctors, nurses, ambulances and GPs. Should dentists be on the list – are they part of the NHS? Mine certainly isn’t, but I make a mental note to find out.
JH met with this lot every Monday. Not sure I can bear the thought of that after the weekend. Perhaps just start with 30 minutes once a month and see how it goes. My chief of staff Lucinda pulls a face and points out that the media would call it Hancock’s Half Hour, but what’s wrong with that? It’s all about building the MH brand.
A pair of pink socks arrives from an admirer, along with an invitation to take part in a “health chat” with a fellow who looks like a London cabbie. Bin the invitation – don’t need to spend my evenings talking about work in a taxi – but keep the socks. Not really my colour but I could always give them to Lucinda for Christmas.
Among other “welcome” gifts is a pair of underpants from a woman calling herself head of transformation. There’s a note pinned to them, which reads: “Ditch those negative knickers. These are your positive pants. Wear them and make change happen. Pants are changing!”
Lucinda tells me that gifts of underwear are common in the NHS change movement. I feel as if I’ve gained my first important insight to the NHS way of doing things.
Meet with earnest people from think-tanks. I listen patiently to what they have to say. A small chap with pastry crumbs on his lapel and coffee breath tells me the NHS needs to be more like Norway or New Zealand, which frankly sounds a bit far-fetched. They show me a lot of charts and infographics. The NHS is one of the best systems in the world, but also one of the worst, they explain. Typical academics: can’t make up their ruddy minds. Sounds to me as if they’re overcomplicating things. I’m beginning to see a pattern here.
The think-tank people hoover up an entire plate of pastries – including an apricot Danish I had earmarked for tea, so I don’t warm to their offer of an international review of best practice to help me formulate an integrated care policy. They look crestfallen when I suggest that they could pay for it themselves. The profs make their excuses, retrieve their duffel coats and shuffle out.
The fracking chap is back. He wants to talk about a 10-year plan. I buzz security. Lucinda whispers that Simon is in charge of the NHS, but that can’t be right. That’s me. Am I the only one who knows what’s going on? This department clearly needs a shake-up.
I decide to humour Simon, who says the existing NHS plan is running out and it’s time for a new one. I ask him why we need a plan at all. People get sick, go to hospital in an ambulance then get better, or not. How hard can it be?
He says funding doesn’t get to the right places, hospitals are running up huge debts, services aren’t organised properly, we’re short of tens of thousands of doctors and nurses, local GP surgeries are closing, thousands of people are waiting for urgent operations, government targets are being missed and so on. I zone out when he starts talking about people stuck in hospital – something to do with social care again. All seems a bit of a shambles. I’m starting to wonder what exactly JH did in his six years in office.
It’s more than an hour before Simon finally buggers off. I ask Lucinda if she can make sure he doesn’t get in the diary again this year. She says he’s in every week. Ruddy hell!
Diary editor: Julian Patterson
Reproduced at TrainingPrimaryCare.com by kind permission of Julian Patterson.