Without the fanfare that accompanied its birth, the idea of the NHS University quietly faded away as 2004 drew to a close. It was always a barmy idea (this column, December 2001) that everyone from cleaners to consultants would be trained, if not under the same roof, then by the same organisation. The Guardian described the NHS University as a ‘brainchild’ of Alan Milburn, and the death of this child will, according to the Guardian's headline, be part of the health service's savings of £500 million per year. Which is all very well, but even more money would have been saved if sense had taken precedence over ill-judged enthusiasm in the first place. Other ‘savings’ will come from the axing (the Guardian's word) of the NHS Modernisation Agency. I visited the Agency's headquarters in Leicester a couple of years ago. They were impressive. Airy, smart, nice carpets, the latest computer publishing equipment: everything you could need for getting out the government's message. I was given a glossy booklet full of examples of how we could learn from examples of good practice. I was stirred by the story of a group of specialist diabetic nurses, who realised they would be more efficient if they had more than one blood sugar monitor between the eight of them.
Every political party in opposition draws up plans to ‘cut red tape’ only the government can create its own bureaucracy and then claim credit for cutting it. The remnants of the Modernisation Agency and the University will be incorporated in a new body, the NHS Institute for Learning Skills and Innovation. This body, lovingly known as NILSI, comes into being in July 2005. It will also subsume the NHS Leadership Centre, a body that I didn't know existed.
Are any of these bodies needed? I just don't know. But it does not give me confidence when health minister John Hutton, speaking of what NILSI will do, talks of ‘implementing the concept of the skills escalator’. Why only implement the concept? Why not implement the actual escalator? And I presume he means the up-escalator.
While we all want (though might phrase it differently) ‘a health service where everyone is allowed to learn, develop and progress to the best of their potential’, there is no getting away from the need for menial tasks. No matter how many degrees and NVQs our staff have, floors need cleaning and patients need moving. And those staff too must be valued, not made to think that, for them, it is progress or failure.
- © British Journal of General Practice, 2005.