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Engaging with the evolving landscape and other stories


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Friday, 6 May 2011

Engaging with the evolving landscape and other stories

For reasons explored in a previous blog, the metaphorical NHS landscape has a peculiar attraction for journalists, civil servants and report writers.

MPs recently published an “NHS Landscape Review”, while various organisations offer guides for anyone impatient to “explore”, “navigate” or “reshape” the new landscape, which has been in the process of “emerging”, “evolving” and “transforming” for several months.

As Macbeth discovered, a landscape on the move is not to be trusted. He had visions of a former health secretary marching on his castle dressed as a tree.

"Macbeth shall never vanquished be until / Great Birnam wood to high Dunsinane hill / Shall come against him."

It sounded far-fetched to the Scots usurper’s pals, but ended in tragedy.

A recently published “Beginner’s Guide to Commissioning” advises charities about how to “engage with the commissioning landscape for the first time”, though this is not something that should be attempted by a novice and certainly not without appropriate protection.

A PCT chief executive has gone on record to reassure anxious citizens that “clusters may not be a permanent feature of the NHS landscape”.  This will come as a great relief to residents of the country’s leafy suburbs worried about ugly PCT clusters encroaching on their back gardens, frightening their children and upsetting their pets.

The natural world theme is not new. Previous descriptions of the NHS have also involved geographical, agricultural and animal imagery. The NHS has been compared to an eastern European tractor factory, imperial China, a dog with seven tails, Wayne Rooney and a large sow with many teats.

The biggest threat to the NHS landscape is the recent dry spell, or what meteorologists are referring to as the “pause” in rainfall. A brown and arid NHS is of no use to any one. Roll on the rainy season and a fresh growth of similes.