Light side: Straight-talking Carter, Wizard of Riding, Carrots and sticks

Modern-day illusionists
NHS efficiency tsar Lord Carter may be unpopular in some quarters for his loyal service to the NHS “efficiency” agenda, which many translate as cuts (although few would question that savings could be made within our health system).

That said, this straight-talking reviewer-in-residence at the Department of Health will win new friends among hospital doctors for his assessment of the “management consultancy” trend.

Redoubtable Shaun Lintern of the Health Service Journal caught the Lord at a Royal College of Anaesthetists event advocating a clinically led approach to “change” and revealing his “bugbears” with the consultancy industry.

“The year before last we spent £640m on them. I asked each of them to come in and tell me where not only had they analysed an issue but they had solved it, and would they come back to me and explain how they had solved it,” Carter declared. “I am still waiting for the calls.”

To paraphrase, management consultants are modern-day illusionists, who promise much but deliver little that is real before disappearing in a puff of smoke with your cash.

Wizard of East Riding
Talking of illusionists, in case you haven’t heard, it seems that a 21st century reimagining of the Wizard of Oz is set to take place in East Riding of Yorkshire.

For, in the face of growing concern about cuts and the risks of its sustainability and transformation plan, Humber, Coast and Vale STP is looking for a marketing firm to “turn down the noise” through a “social media and guerrilla marketing” campaign.

While the motivation is undoubtedly as pure of heart as Dorothy herself, the metaphorical Oz hiding behind the curtain here is the little matter of a £420 million savings target by 2021 – from a total budget of £3bn.

Nice try, folks, but you’re going to need a bigger curtain.

Is the carrot really a stick?
Sometimes it’s hard to work out whether NHS policy is based on a system of carrots and sticks – or given recent events if the carrot is really a carrot.

Those holding the purse strings would argue the former, of course, but the surreal case of poor University Hospitals of Leicester trust is the perfect example of the vegetable-based update to snakes and ladders devised by NHS England.

The trust spent more than planned in a bid to meet waiting targets by sending patients private amid the winter A&E sqeeze. Result? It will miss its deficit “control total” – and therefore lose another £12.4m in central funding.

Hey presto, le voilà! The carrot becomes a stick.