IIt was probably a coincidence that last month highly critical report On the finances of the NHS of the Public Accounts Committee of the House of Commons (PAC), it was published a few hours before Amanda Pritchard, Director General of NHS in England, did not appear before the Health and Care Committee social. THE report The leaders accused of the organization and the department of health and social care of lacking “drive” and “ideas”. The same day, immediately after the evidence of Ms. Pritchard, the health committee published a statement. Echoing the CAP, he said that Mrs. Pritchard and her team lacked “drive” and “dynamism”.
The NHS in England retaliated with the CAP, claiming that the deputies did not understand entirely The financial processes in question. Wes Streting would have a “full confidence” in Ms. Pritchard, clearly indicating that her work is not at stake. But this two -component attack had to be bitten. Although critical reports and the PACs are an integral part of the parliamentary examination, it is very unusual that civil servants are reprimanded for their oral evidence.
Even Ms. Pritchard’s admirers would not claim that the presentation is her strongest costume. The frustration of deputies to the health committee in what they considered to be long -term responses was obvious to Whoever looks at. But Mrs. Pritchard is not a politician, and one of the reasons for a lack of clarity in her responses was that the publication of Crucial guidanceIncluding the updated targets, had been postponed by the ministers.
While deputies, like voters, are naturally Impatient for improvementThe expectations of people with operational responsibility for health services should be realistic. Given the financing constraints, and the fact that the structure of NHS England (with its 42 integrated care advice) is always in the running, we do not know what transformation requirements really mean – beyond a wish that things are better than they are. Julian Kelly, Mis. Pritchard’s deputy, explained that most of the 10.6 billion pound sterling in the organization’s budget in 2025-2026 will be absorbed by salary and national insurance increases, Inflation and the 3.5 billion sterling pounds authorized for the rise in costs caused by an aging and new treatments.
With a desperate government for progress and under a large profile and ambitious secretary of healthThe political pressure on the NHS will further increase. The CAP report has raised concerns about productivity objectives. Monday, the National Statistics Office published data showing a decrease In the last quarter of 2024, contradicting the claims of NHS England. These contradictory results, which are produced by different methodologies, are a concern in itself.
Sorting this confusion should be a priority for the new permanent secretary of the department of Mr. Streting, which should be appointed shortly, as well as a new president of NHS England. The filling of these two vacant posts means that Ms. Pritchard is likely to see that she has less room for maneuvering; The high level of autonomy granted to NHS England by the Conservatives is being reduced.
It is not the only fight for power. Another dynamic sees integrated care advice – with their tasks to improve public health in partnership with advice – in competition with Big Confidence in the hospital for influence and resources. A vision of Ms. Pritchard’s difficulties is that she is taken in the middle.
The holding of public sector bosses is the work of deputies and they are right to take it seriously. But undermine NHS Managers also include risks. Politicians should be aware of the forces as well as weaknesses.
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