134,318 members

Skip to content. | Skip to navigation


The innovation greenhouse

Thursday, 5 September 2019

The innovation greenhouse

Faced with ordinary problems that they cannot solve – lack of funds, staff shortages, rising demand, falling morale (you know the ones) – our leaders propose extraordinary solutions.

By “extraordinary” we do not mean imaginative or clever, but bizarrely disconnected from reality or designed to avoid it altogether.

Imagine a medieval scene in which the castle gates are soon to be breached and the besieged army has run out of arrows and boiling oil. Any sensible leader might resort to dropping lumps of stone from the ramparts, kitchen utensils, effluent from the latrine or the bodies of serfs on the enemy.

If this were an NHS England production, the commander would instead declare: “Fetch my spacecraft – you know, the one with the photon torpedoes!” 

“But sire, we have no such device.”

“Then fashion me one, sirrah, in yon innovation greenhouse.”

“You what, my liege?”

At this point in the medieval siege drama, the players would acknowledge that the king had lost his last marble, before lowering the drawbridge and throwing themselves on the mercy of the invading army.

But this is an NHS management production, so the plot just keeps getting sillier. And in case you’re not quite following this one, it was revealed this week by the soothsayers of the NHS England press office, who foretold a marvellous plan to build, yes, an “innovation greenhouse”, the precise nature of which we shall come to shortly.

First the dubious science.

In impossible situations, human beings often resort to the improbable.

Once upon a time it would have been a goat tethered to a tree or the ritual sacrifice of a virgin to placate the angry gods. But we no longer believe in gods and even if we did it’s unlikely that any serious placating would occur in the face of opposition from animal rights groups and militant virgins.

The only credible god for a rational age is technology and the new worship is called innovation. This is not to be confused with actual innovation, which proceeds quietly and results in things of benefit to humanity, such as penicillin, as well as things that probably weren’t an unqualified good idea, such as nuclear weapons.

Innovation in the NHS England sense of the word is a rite, an incantation, a whiff of incense here, a solemn vow by a very senior manager there; a mystery that is not meant to be comprehended but to be believed unquestioningly, like transubstantiation or Richard and Judy.

Innovation hovers just out of reach, promising relief from our earthly problems – crappy IT systems, dilapidated buildings, unfeasible staff rosters – and ultimately salvation.

It is an act of faith made necessary by the realisation that healthcare does not cure the sick but creates them. Just as building bigger roads gives people more reasons to travel, bigger hospitals encourage people to embrace ill-health. (Think about this carefully next time you feel the urge to complain about shortages of doctors and nurses. Could they be the problem?)

Healthy living may be a step in the right direction, but it is dull and takes a long time to work. 

Saint Simon promised Healthy New Towns, but everyone thought of Milton Keynes and Stevenage and stayed away. He had a vision in which there were five lean years, during which we would release the “untapped energy of people and communities”, though to what end was never clear. It was followed by a vision of ten still leaner but wonderfully integrated years, the so-called long-term dream. Then we knew for sure he was raving.

Only the innovation greenhouse can save us. On its elaborate frameworks and trellises will grow the artificially intelligent tomatoes and cucumbers on which the future of the NHS depends. They will taste like veg used to before it spent too long in cold storage en route to Tesco and Asda. They will have benefits we can only imagine. They will form part of our integrated five a day, the basis of a truly wholesome diet.

In this brave new world, weeds will grow in the decaying remains of hospitals and doctors’ surgeries, the fading memorials to our inefficient and unhealthy past. Everywhere innovation will flourish – and the bright-eyed, vigorous children of the future will abound with untapped energy.

Editor: Julian Patterson 


Steve Benjamin
Steve Benjamin says:
Sep 06, 2019 12:11 PM

Brilliant. How do you get away with saying the things we all think and feel and want to say? I think it is because the master of the universe (NHS) are too thick to realise that it refers to them ala Martin Packard et al

Julian Patterson
Julian Patterson says:
Sep 07, 2019 12:50 AM

Thanks Steve. I get away with it because nobody ever thinks it's about them. And of course it never is.

Anonymous says:
Sep 06, 2019 04:02 PM

Welcome back Julian. I see that 2 weeks away from the Madd(en)ing Crowd has certainly done you no end of good! To continue the space ship theme suspect the Innovation Greenhouse will doubtless prove to be the ultimate final frontier - somewhere you boldly go when you have finally run out of ideas around where to hide your overspend. Hope there's a decent pot of money associated with this particular rainbow (or is the point of the Innovation Greenhouse that there is no pot ….how zen?) – Mmmmm – on second thoughts maybe best to stay out of the Greenhouse and perhaps consider not mowing the lawn for a couple of months (again) and pray commissioners don’t notice :)

Julian Patterson
Julian Patterson says:
Sep 07, 2019 12:48 AM

Thank you, Anon. The beauty of this particular frontier is that it's always a few light years away, not unlike financial balance.

Alan Walshaw
Alan Walshaw says:
Sep 09, 2019 08:44 AM

Hi, I'm retiring in less than 3 weeks! Yippee, but just to let you know that your comments on the NHS etc. have kept me amused over the years. I'm constantly pleased and amazed by the quality of your humour and writing. Keep up the great work (even if I'm no longer reading it, 'cause let's face it who wants to still be attached to the NHS umbilical)! Many thanks and kind regards.

Julian Patterson
Julian Patterson says:
Sep 10, 2019 05:26 PM

Alan - thanks for your kind message and good wishes for a happy retirement

Anonymous says:
Sep 09, 2019 10:22 AM

Great metaphor! My heart sinks when the word 'innovative' is used as well as the magic world new technology will offer. My other related bugbear is the blind faith put in algorithms.

Julian Patterson
Julian Patterson says:
Sep 10, 2019 05:28 PM

I share your suspicion of algorithms. Nasty, unreliable things