He demonstrated every day how important it was for a Secretary of State to not only have a narrative about why there needed to be change in the National Health Service but also to have the ability to communicate that narrative to the public and the NHS.
One of my most interesting experiences so far this year came in February when I went to talk with the College of Journalists at the BBC about the Coalition Government policy on NHS reform. These were proud and confident professionals who, over many years, have demonstrated their ability to distil very complex issues into something that could be more readily understood by the public. Their current task was to sum up in 200 words what the Government was trying to achieve with its NHS reforms…
It’s what they do, and they expected, as a group of 30 or 40 journalists, to be able to apply this skill to the task of explaining NHS reform.
But it defeated them. They had a rough idea that the reforms had originally been trying to move in the direction of greater decentralisation of the NHS to provide power to GP-led commissioning groups. They also had a rough idea that following the pause in Government policy in April 2011 there had been a dramatic ‘U’ turn in policy and an increase in centralisation of policy.
Understandably these BBC journalists had no clear idea how to turn this into a simple explanation for the public.
I couldn’t help pointing out in my talk that a request for assistance in carrying out the task of explaining policy was diametrically opposed to the position they had adopted when New Labour was in power. Back then they were angry that the Government had a narrative about why and how they were reforming the NHS. At the time they felt that by developing a narrative the Government were in some way trying to do journalists out of a job. The challenge for journalists, as they saw it, was to try and create a narrative about Government intentions that was in some way a better explanation than the one the Government were putting forward.
Andrew Lansley’s reforms defeated the media in this country. The media had no idea what the original reforms were intended to do and consequently had no idea what the 2011 ‘reform of the reforms’ were intended to achieve.
Every day of Andrew Lansley’s term of office as Secretary of State for Health demonstrated that it is the central task of a minister to effectively communicate what they are trying to achieve – and to deploy robust and capable arguments in making their case.
The clearest example of how bad Andrew Lansley at doing this came in April 2011 when he was sent to talk to nurses at the Royal College of Nursing. This was the same month in which the Prime Minister had called a pause to his Health and Social Care Reform Bill and given the future of his policy over to a random group of people called the ‘NHS Future Forum’.
Andrew Lansley was sent to the RCN to apologise for his failure to communicate why the Government policy mattered.
What he actually said demonstrated how far removed he was from understanding his personal responsibility. He said,
“I am sorry if my policy has failed to communicate itself to you”.
Think for a moment of the different meaning that might have been taken from the sentence,
“I am sorry that I did not communicate my policy to you”
The second sentence assumes that the responsibility for communication rests with him as Secretary of State, the first that the responsibility rests with an abstract thing call “the policy”.
And therefore not with him.
Apparently this reshuffle is aimed at bringing to the fore people who are capable of communicating the Government’s message.
Since he became Prime Minister one of the main lessons that David Cameron has learned is that there is a difference between developing and selling a policy as an idea in opposition, and the reality of turning that policy into practice in Government.
In opposition communication needs only to have some overall coherence between the different policies that are put forward.
In Government the communication of policies not only needs this overall coherence but also has to have some relationship with what you are achieving as a Government on the ground.
Relating their overall narrative to what is actually happening on the ground is proving a much harder task for this Government.
I look forward to how this will work with the NHS over the next 33 months.