Change in the NHS

Did any voter in the recent UK election notice the profound and radical plans for the National Health Service that have just appeared in the coalition government's new White Paper? No, of course not...because these proposals appeared nowhere until they appeared in this form.

No manifesto made mention of these suggestions; no spokesperson made any utterance to indicate that there were proposals to dismantle a huge section of the NHS and transfer responsibility for spending a huge sum of tax-pounds to a group of professionals who have never shown any interest in (or talent for) taking up that challenge. Yet, here we are, looking at costly wholesale changes, with the potential to impact massively on the service and the people who work therein.

It is suggested that this is part of a wider political shift where it is increasingly assumed that the electorate simply "can't handle the truth". No political party could level with us prior to May 6 in terms of discussing the deficit. Now, we can't be trusted to vote sensibly when a radical proposal is table for the reform of the NHS.

But, actually, it's worse than that: Cameron and Lansley actually expressly criticised the permachange process that the NHS has been caught up in since the mid-1970s and which has accelerated massively under New Labour. It's not just that they failed to tell us of their intentions; they actually dissembled when they were expressly asked for their opinion on this matter.

So...here's a textbook example to leaders everywhere of how not (or, depending on their success, I fear) how to manage large-scale change:

First, keep your change proposal shrouded in utter secrecy.

Second, explicitly deny that you have any proposal for change.

Third, launch your proposal for change at a point where such an announcement will do you least harm. (This announcement comes more or less at the beginning of the five-year Parliament, giving plenty of the time for the electorate to forget this sneakiness - or, if it's successful, to forgive it.)

Finally, disregard all essential standards of veracity when then called upon the discuss the provenance of this proposal and the covert way in which it was smuggled into public discourse; where possible, link this with wider contextual issues - in this instance, the question of the deficit.

In the interests of good change management practice, we all have to hope that this subterfuge on the part of the coalition government is exposed and ultimately fails to gain any traction.