In the film Wall Street, Gordon Gecko makes the famous speech “Greed is Good” to the shareholders of Teldar Paper.
You would have thought that the film maker, Oliver Stone, would be proud that the words he wrote have entered the common parlance of the English language, but Stone has always been discomforted by this film because the moral message he was preaching was overshadowed by the glamour of Gordon Gecko’s character.
The pay-off to the speech comes later in the film when Gecko speaks to Bud Fox of his frustration that the shares of Teldar Paper don’t rise after, “I’ve sacked half the management and still nothing.” His only strategy in taking over the company was to sack people in the belief that this would turn the company around. It didn’t.
When the Conservative led government tell us that they will improve the NHS by imposing a massive restructuring from above, by abolishing the Primary Care Trusts and having the ordinary GPs become the managers; we see a similar philosophy at work. They believe that all they have to do is sack all those useless managers and the NHS will be set free from the shackles of bureaucracy to achieve some wonderful efficiency.
The Conservatives do at least have a fashionable management principle to apply. They say that putting the GPs in charge will create a “bottom-up” organisation, where the decisions come from the place closest to the patients. In fact, this is a very flawed application of the bottom up theory.
Would our police force be better if only we could get rid of these borough commanders and (soon to be) directly elected commissioners and let the Bobbies on the beat and the PCSOs come together and collectively decide how to keep us safe? Would our streets be cleaner if we just let the road-sweepers be in charge? Would a big company like BP be better run if the petrol station owners came together to take over the management of this huge international concern? I think not.
The greatest flaw of David Cameron is his vanity. He desperately wants to be a leader with a vision, like Tony Blair. He wants to make some great radical change, but doesn’t have the intellectual resources to form a vision. We see this most clearly with his Big Society concept, which he continued to push on the Conservative Party even after it frustrated them on the doorstep throughout the 2010 election. The British people voted him in to sort out the deficit, but he desperately wants to be a master of great change.
If this were about allowing private companies to bid for NHS services, they could have allowed that to happen without abolishing the PCTs. If this were about ending postcode lotteries, then it will almost certainly cause a massive increase in postcode lotteries. If this was about achieving an economy of scale, then how will lots of small groups of GPs achieve this?
They kept this policy secret during the election. Why? What did they fear? Did they think that the scrutiny might scare the electorate? If so, they were probably right. Now they want to rush ahead with this huge reorganisation without study or scrutiny. Why? What do they fear?
Imagine the scene in a few years time, the scene from Wall Street where Gecko is frustrated with Teldar Paper, but imagine that Gordon Gecko is played by David Cameron with Andrew Lansley as Bud Fox. Cameron disparagingly tosses aside the report on the NHS, frustrated with the fact that sacking half the managers hasn’t turned the organisation around.
However, the big difference between this scene and the one in Wall Street is that Gordon Gecko only sacked half the managers of Teldar Paper, while David Cameron wants to sack ALL the managers of the NHS.
So much for David Cameron’s promise last year of, “No more top down reorganisation of the NHS.”