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Author Archives: Lyn Whitfield
A ‘gateway’ for Winchester: nice gate, needs to go somewhere
A ‘drop in’ event organised by Winchester City Council, Lifshutz Davidson-Sandilands and other experts showed a model and plans for the Station Approach in Winchester, including (clockwise from left) an office block divided by a colonnaded walkway, a plaza into Station Hill flanked by a micro brewery, Gladstone Street, level access across the site, and a ‘gateway’ from the tracks to the town.
Winchester has been struggling with two, large development sites. The first was at the ‘bottom’ of the High Street, where an area called Silverhill. This was earmarked for 74 shops with single aspect flats hung around a car park above them; but it fortunately collapsed in the face of widespread public disquiet (and the online revolution/retail downturn/coming recession that has collapsed demand for shops).
The other is up around the station, where there is a proposal for offices on what is currently a temporary car park, albeit with some trees on it. A proposal a couple of years back for huge, glass faced, blocks was abandoned. Since then, architects, public realm and movement experts have been in and trying to come up with something better.
Which, to be fair, they have. Local residents had the chance to look at the ideas – and rather a nice little plywood model – last weekend. And there’s a fair bit to like. The offices are still very, very big, and there’s no doubt they will impose on the street scene, even if Winchester’s hills mean they don’t impose on longer views.
But the latest proposals are for two blocks, rather than a single one, in natural materials, separated by rather a clever, flat walkway through the site flanked by colonnades (the view coming out of the station will be not dissimilar to the one you get coming out of Turin railway station, which would be a novelty for the south of England).
Also, the plans retain rather a sweet ex-pub and ex-register office (the architects would like am micro-brewery: wouldn’t we all?) and create a new public space/café with terrace at the bottom of the site, where it lets out onto the Sussex Street/main road (this looks a bit yummy mummies do Costa outside Waitrose, but we can’t have everything).
However, the constrictions of the site mean that a lot of the public realm proposals, while nice in themselves, don’t really go anywhere. So, there’s a new plaza outside the station. But there’s nothing to connect it with a ropy walkway over to a car park to the north east, which actually functions as the main route into town for a new student block and people living at that end of town. Or with an even more ropy underpass that takes people to the London side of the station.
The plaza lets down to a road called Station Hill, where there are some decent trees. That should at least give bewildered tourists some idea of how they are supposed to get into town, which is not at all clear at the moment (although it’s not the most direct route to the catehdral or military museums).
However, at the bottom of the hill they will still be faced by a scrubby set of lights that only occasionally and grudgingly let people through traffic that comes from all directions. While anybody who uses that nice, flat pedestrian route through the development will similarly find themselves at a road which, if they can get across it, leads only to the dead bulk of the county council’s offices.
The experts at last week’s event seemed well aware of, and frustrated by these problems; which require engagement from Network Rail and Hampshire County Council if they are going to be addressed (neither body is known it town as a model of responsive citizenship). The advice of local councillors was to keep going and to keep raising the issues
Because we now have plans for a city gateway. And it’s quite a nice gateway. But it’s in danger of not leading anywhere…
Here IT goes, again
Health and social care secretary Matt Hancock has announced that he is setting up a new unit to shake up #HealthTech. It says a lot about the man and the team around him that he’s called it #NHSX (you know, like SpaceX, it’s all about one guy and his gang, shooting for Mars).
So, I was putting together some analysis of this development for Highland Marketing this week, and it made me think about all the other, similar, ventures that I’ve seen come and go over something like twenty years of reporting on the NHS and its IT (yes, it’s really that long… and the analysis file is here).
The first NHS IT strategy I ever covered was Information for Health, back in 1998. There’s another blog post to be written about how what it was trying to do is remarkably similar to what NHS IT is still trying to do, but that’s for another day.
For the moment, the point is that IfH led to the creation of a properly constituted arms-length body, the NHS Information Authority, led by a chief executive, Gwyn Thomas, to deliver infrastructure and run model projects for trusts to follow.
The IfH approach struggled, not least because trusts went and spent the cash they were meant to spend on IT on other stuff. So, prime minister Tony Blair himself convened a seminar at Number 10 Downing Street that led to the creation of the National Programme for IT in the NHS.
This was supposed to sort things out by getting in big consultancies, that were supposed to know about project management, to contract with big IT companies, that were supposed to know about electronic patient records, to deploy on a regional basis.
The National Programme was led by a new director general for NHS IT, at the Department of Health. The first director general (2002) was Richard Granger, a bullish consultant who had led the successful roll-out of the London congestion charge. Granger placed some huge contracts, but it turned out that accountancy companies and US tech firms knew less about NHS IT than had been hoped, and NPfIT failed to deliver, at least for trusts.
So when Granger left, a more ‘NHS’, more conservative approach was tried. Matthew Swindells, a former trust chief executive and political advisor, was stepped in as interim chief information officer, to define a ‘clinical five’ or core set of functions that would get medics back on board with IT.
And then, when Swindells left for EPR vendor Cerner, a substantive chief information officer was appointed, Christine Connelly from Cadbury Schweppes (2008). I was going to write that Connelly lasted barely any time at all, but in fact she was in post for three years, before she left in a bout of DH infighting.
After Connelly’s departure, the government decided that what the NHS needed was some of the rigour that the Cabinet Office was trying to bring to the wider government digital agenda. So Katie Davis, executive director of the efficiency and reform group, was brought in (2011).
Davis really did last barely any time at all. She was gone in barely a year, as Andrew Lansley’s contested and misguided reforms of the NHS arrived in 2012. The Lansley reforms divided responsibility for NHS IT between the DH, which was meant to set policy, the NHS commissioning board / NHS England, which was meant to buy programmes, services and products to enact it, and a bunch of delivery organisations.
Despite all the other changes, the NHSIA had sort of continued up to this point, under a variety of names, and latterly alongside a data collection, analysis and publication outfit called NHS Information for Health. The two eventually emerged, as the Health and Social Care Information Centre, which is now called NHS Digital.
Around this point, another prime minister, David Cameron, decided he was very interested in health IT. In particular, he liked the idea of giving data to patients so they could vote with their feet if their local NHS wasn’t up to snuff, while ‘taking responsibility’ for their own health. To promote this ‘transparency’ agenda, he personally appointed Tim Kelsey, a former journalist and government transparency tsar as national information director (2014).
Kelsey then got to head up the national information board, a supposedly powerful co-ordination group to bring together all those post-Lansley bodies. The NIB issued the health service’s current IT strategy, Personalised Health and Care 2020, and also rebooted the NHS Choices website.
But amid the care.data debacle, and the growing realisation that serious competition within the NHS was not going to withstand the massive financial and demand challenges the service was facing, Kelsey left for Australia.
Fortunately for health tech, the health secretary who replaced Lansley, Jeremy Hunt, was into IT, and came up with a plan for the NHS to go ‘paperless’ by 2018. To deliver on this agenda, Kelsey’s replacement, Beverly Bryant (2016) was given a ‘wider remit’ as chief information and technology officer, reporting into Matthew Swindells, who was back as NHS England’s national director of commissioning, operations and information, and is now its deputy chief executive.
However, she was effectively side-lined into the struggling NHS Digital, as Swindells effectively took control of some key elements of the paperless agenda, such as the establishment of a global digital exemplar programme to complete the digitisation of trusts that was still outstanding from IfH and CfH, the Clinical 5 days and, indeed, Paperless2020… I did say there was another blog post to be written.
When Bryant understandably left, again for a supplier, this time System C, she was replaced by another central government recruit, Sarah Wilkinson from the Home Office (2017). But Wilkinson has been all-but invisible, and seems to have spent more of her time slimming down NHS Digital than doing much with the agency.
Instead, it is NHS England that has implemented the Wachter Review‘s recommendations to appoint a chief information and a chief clinical information officer and to run the GDE programme. And it is NHS England that has pursued the Empower the Patient programme to come up with a new NHS App.
Now, though, Hancock has arrived at the DHSC with a reputation for ‘digital’ and a determination to be seen to be ‘doing something’. NHSX is clearly a manifestation of that, and it looks set to be led by yet another government digital tsar, this time Matthew Gould from Hancock’s former department, Culture, Media and Sport.
Health tech journalists often say, when a prime minister or a health secretary with an interest in IT moves on, that the NHS was fortunate to have someone with that interest in charge of it. The quick review above suggests that’s correct, in that health tech policy and initiatives are closely associated with specific incumbents of Number 10 Downing Street and Number 18 Whitehall.
However, once they move on, so does the persistence and attention that might make them successful. This effect is magnified by the tendency of prime ministers and health secretaries to bring in their own, supposedly charismatic, leaders to head up their agendas. Because once their sponsors go, they tend to go as well.
Over the past twenty years, the cycle has got faster. Tony Blair was associated with NPfIT, and Richard Granger led CfH for at least five years. His substantive appointment, Christine Connelly, lasted three. David Cameron’s tsar, Tim Kelsey, did about the same, but his successors barely registered before they left. Hunt’s paperless agenda has had stable leadership within NHS England but not outside it; and it’s now being challenged by Hancock’s media savvy, app happy team.
This is destabilising. Many health tech vendors find Hancock a breath of fresh air, but they realise his impact will last only as long as he does, which may not be long, given Brexit and his own CV of rarely staying in ministerial or cabinet jobs for long.
It’s also complicating. Each abandoned approach leaves behind another layer of complexity to the health tech scene. Across the piste, some of NHSIA’s functions are still going within NHS Digital, while some of CfH’s contracts are still running. The GDEs are well entrenched, but non-exemplary trusts were told in the NHS Long Term Plan to continue to aspire to a ‘core’ level of digital maturity.
There’s the wreckage of the ‘transparency’ agenda in NHS England’s attempts to make local health and care records fit for population health management. The NHS is still running NHS Choices, albeit under a new name, to feed that whizzy NHS App. And now Hancock wants cloud-first, internet-first, digital-first services.
It’s possible that NHSX will turn out to be a bold initiative that cuts through all this clutter, comes up with a rationalised IT strategy for the NHS that can be funded, prioritised and delivered, and that Hancock and his preferred X-man will stick about to see it done.
It’s just that you wouldn’t bet on it. Which is unfortunate. Over twenty years, health tech has been too dependent on politicians looking for an eye catching initiative with which they can be personally associated, and with outsiders brought in to enthuse or shake-up the troops. It’s not worked, and it’s not what got man to the moon.
Lovely morning for it…
It’s a bright, spring morning here in Winchester; which wouldn’t be worth commenting on if it wasn’t also the last week of February. It’s so nice, in fact, that many of the runners gathered outside the Guildhall for the city’s annual 10k were in T-shirts rather than long sleeve tops or jackets.
And there were a lot of runners. The event has grown hugely over the years, and one of the most striking things is how many of the additional participants are women. Back in the ’round about an hour or thereabouts’ finishing slot where I started from, there were probably more women than men.
There was a new course as well. No Nations Hill, which was a nice surprise for those of us who have wept, slogged, sleeted and boiled our way up it in previous years. But a long loop back towards the finish, which wasn’t great for morale.
And a new finish over a narrow bridge by the leisure centre, which totally didn’t work, and will hopefully be tweaked again in future. Flash medal, though. Very 1990s retro…
Health Chat with Matt Hancock
At the start of February, I went to see health and social care secretary Matt Hancock interviewed by veteran NHS commentator Roy Lilley, who runs a distinctive and lively newsletter about the healthcare scene and its many challenges.
It’s hard to believe Hancock will be around long, given the government’s own challenges over Brexit, and his own track-record of staying in ministerial jobs just long-enough to deliver one headline-grabbing initiative before heading off on and up. But he has been greeted as a breath of fresh air by many working in the health tech space.
I wrote up the Health Chat for Highland Marketing, adding value by giving a flavour of the occasion, and what Hancock’s replies might mean for healthcare IT particularly (word file here, and original link here, which may break over time). This also featured in Roy Lilley’s newsletter, which claims a readership of some 300,000 people.
Where is the exit from Brexit?
Saturday (9 February 2019) saw another day of action against Brexit, with the People’s Vote and other campaign groups encouraging local marches in support of a second referendum, with revoke article 50 as an option.
Winchester had a short march, which started at the top of the High Street, wove its way past the buskers and market stalls that proliferate at the weekend, sidestepped the increasing number of empty shops, and finished outside the Guildhall.
Around 2,500 people took part, according to the organisers and the local paper, the Hampshire Chronicle. Around 50 pro-leave protesters heckled speakers Vince Cable and Andrew Adonis. And a few people yelled “you lost, get over it” at stragglers blocking the way to the bus station and its adjacent betting shop.
Is there any point to such marches, with just 50 days or so to go until the UK leaves or, as things are going, crashes out of the EU? Necessarily, the crowd and speakers found reasons for optimism: the polls have moved in favour of remain (perhaps marginally); the small band of hecklers notwithstanding, there are no ongoing, spontaneous rallies for leave; and it has to be possible for Parliament to find some way to reflect the new reality – or just what it has learned about what exit will really mean.
However, if the Brexit referendum and its outcome was the result of a series of accidents (prime minister David Cameron lazily offering his right wing an in/out vote, the blocking Lib Dems being kicked out of the coalition in the general election of 2015, a poor remain campaign failing to get its boots on while a corrupt leave block made off with the truth) then another series of accidents (May triggering article 50 immediately, while laying down red-lines that the country failed to back in a general election that cost her the authority to face down the ever-more extreme ERG) has ensured that little has gone right since.
In fact, the past two years have been a depressing round of elected leaders failing to heed Pierre Mendes-France’s dictum that “to govern is to choose” and to admit that the UK can either remain, or leave with a worse deal than it has at the moment (with some kind of guarantee for our treaty commitments in Ireland) or crash out (and still risk smashing the Good Friday agreement).
It’s not just been Theresa May, much as she has been responsible for article 50 being triggered when it was, for the red lines, and for being willing to argue against her own positions whenever it will buy her time. Other members of the Tory party have been a disgrace. Boris Johnson and Jacob Rees-Mogg, obviously, but also the likes of Jeremy Hunt, who has proved willing to go along with the charade in return for a promotion and the honour of being spoken of as a potential future leader (we might also mention Winchester’s own MP, who has been silent on the clear views of his constituents since being made public health minister).
Jeremy Corbyn has been, at best, missing in action, to the deep disappointment of the non-Momentum wing of his party and its supporters. At worst, he’s been on board with the May project as a not-so-secret leaver. Parliament whiffed badly on the chance to try and divide along Brexit rather than party lines when given the chance a couple of weeks back.
And we won’t mention the BBC, which has shifted from tacitly supporting Leave by failing to document properly its consequences, to quoting people who “just want to get on with it” and giving airtime to those who seriously seem to think that subjecting a first-world economy to an enormous economic and cultural shock will be “good” for the place and a chance for everyone to show “Dunkirk spirit” (when there is no war… and Dunkirk was on all rational analysis a disaster).
Given all this, the chances of getting to a People’s Vote, or even May’s deal, and avoiding the disaster of no-deal or hard-Brexit don’t look good. But the arguments against May’s deal remain (it fails to protect even our services sector, never mind the educational, cultural, legal or political benefits of EU membership). And crashing out isn’t seriously countenanced by anyone with any knowledge of what it could really mean (the government itself is drawing up plans to stockpile medicines, prioritise drugs over food, get the Navy to take over cross-channel ferry duties, put troops on the street and evacuate the queen as its ‘contingency planning’ gets more gob-smackingly surreal by the day).
In which vein, many of us marching in Winchester were doing so in what might be called the Galaxy Quest spirit: it’s not over until it’s over, so “never give up, never surrender”. And failing that, channelling the Iraq War mantra: you might do this, but “not in my name.”
An interview is worth 1,000 words (three examples)
Highland Marketing conducts interviews with leading figures in the healthcare IT industry. Why? Well, they inform our understanding of the health tech market. And they provide valuable information for clients and non-clients; who, by and large, can no longer read long-form content on under-resourced and under-staffed B2B websites.
One recent interview was with Stephen Dobson, the chief digital officer for the Greater Manchester Health and Social Care Partnership, which is taking forward the ambitious DevoManc agenda (Word file here). Dobson’s interview is interesting, because it shows just how much basic infrastructure is needed to join up health and care IT systems (original on HM website, link may break over time).
Two further recent interviews have been with Richard Corbridge, a high-profile chief information officer in Leeds (Word file) and Rachel Dunscombe, an equally high profile chief digital officer in Salford and chief executive of the NHS Digital Academy (Word file). Both are interesting for their views on what needs to be done to complete the digitisation of their trusts: while getting into the more current agenda of integrated care and population health management (originals here and here).
The office has survived January: and that calls for a celebration cake…
It has been a long January, and there are still two days to payday. The office has demanded cake!
Recipe: for the Victoria sponge: Cream together six ounces of butter (or margarine) and six ounces of sugar (I’ve used white and golden caster sugar). Beat in three eggs. Fold in six ounces of self-raising flour and one ounce of chocolate shreds. Bake at 180c for half an hour, or until golden and a skewer comes out clean.
For the filling: Leave the cake to cool, then fill with butter cream made of one ounce of butter and eight ounces of icing sugar, beaten with a teaspoon of cream, and jam of choice…
The Budget and the NHS Long Term Plan: briefings and feature coverage
The October 2018 Budget and the January 2019 NHS Long Term Plan will have a significant impact on health and care; and on their tech markets.
I wrote a detailed briefing about the impact of the Budget for Highland Marketing’s clients and prospects (Word doc here), and a shorter feature for the HM website (Word doc here).
Chancellor Philip Hammond moved his statement to the Commons from its usual slot to try and avoid Halloween – but the temptation to use ghoulish imagery was too much. We had him looking particularly Lurch-like on the original feature (website link, may break in time).
I also wrote a briefing to help HM clients through the 134 pages of the plan (Word doc here), and where the technology impacts sit; with a similar feature for the website (Word doc here).
The NHS’ own plan 2.0
Jeremy Hunt on an NHS protest poster (picture: Rohin Francis on Flikr: https://www.flickr.com/photos/rohinfrancis/22277630191/in/photostream)
I’m going to a health conference on Thursday that has been organised by the think-tank Reform. Health secretary Jeremy Hunt is the keynote speaker.
If we find ourselves playing conference bingo, we can expect to hear him say that “we gave the NHS £10 billion” (depends how you count), “that was more than the NHS asked for” (nope, it definitely wasn’t), and “we’re funding the NHS’ own plan” (erm…)
If he has something more substantial to say, then there’s a lot for him to talk about; most of it stemming from the progress or otherwise of ‘the NHS’ own plan’.
The NHS’ own plan
This is the ‘Five Year Forward View’ project, drawn up by NHS England’s chief executive, Simon Stevens, to close a gap between flat NHS funding and rising demand and costs that could reach £30 billion by 2020-21.
It worked on the basis that, if the government put in £8 billion, and social care and public health funding was maintained, and the NHS was able to keep on top of its efficiency agenda, and it used some cash to ‘pump prime’ new ways of doing things… it should be able to find the other £22 billion.
The Forward View only came out in October 2014, but a fair bit of this is already off track (see posts below). The government did announce £8 billion for the NHS in its 2014 budget (and then back-counted another £2 billion, to get to the £10 billion figure).
But as Stevens has told several Parliamentary enquiries now, the money is not going in smoothly (it doesn’t feel like it, but this year is a relative ‘year of plenty’ – there will be virtually no funding increases in the next two years). To make things worse, the acute sector has fallen over a cliff.
The King’s Fund, another think-tank that tracks NHS finances closely, reported in February that hospitals will miss their £580 million deficit target this year, and are likely to overspend by £820-920 million.
Director of policy Richard Murray argued that, at best, this will wipe out the ‘sustainability and transformation fund’ money that would otherwise be available to ‘kick-start’ change. At worst, it could eat up reserves and even push the NHS overall into the red.
Meanwhile, investment in public health by a Conservative government always sounded like a non-starter and, as major news outlets have been pointing out, social care faces a crisis all its own.
In fact, it’s so bad that the King’s Fund’s pre-budget statement reckons that if Chancellor Philip Hammond has any money that he doesn’t need for his Brexit fund, it should go into social care.
STPs: neither sustainable nor transformative?
So, the mood music against which the Forward View has to be taken forward isn’t promising. But what about the plan itself? Ideas for turning the Forward View into reality have been put forward in 44 ‘sustainability and transformation plans’.
These got off to a bad start. NHS England tried to hold them back so its comms teams could vet them for ‘positive messages’, but councils went ahead and published them anyway.
This led to accusations that the plans had been drawn up “in secret” that have proved hard to shake off. Not least because papers and activists have picked over them looking for hospital closures and job losses – and these are easy to find.
Just this week, the BMA put out a blog post arguing that without more money, the plans were not only “doomed” but “a way to dress up cuts to public services.” Saying that plans that have yet to start have already “failed” seems a bit much. But there are reasons to worry about the STPs.
Reorganisation by stealth
For a start, there are signs that NHS managers are doing what comes most naturally, which is to focus on management.
Stevens told his most recent appearance at the Public Accounts Committee that the STP ‘footprints’, which are rapidly acquiring the accoutrements of administrative areas, such as leaders and key performance indicators, would in due course become ‘accountable care organisations.’
In other words, bodies that take responsibility for the health (treatment or long term care) of a local community, and get paid according to the size and health profile of that community (rather than services run or treatments delivered).
Stevens admitted this would end the purchaser/provider split for the first time since the internal market was introduced by the Tories in the 1990s; which is a big thing in health policy circles.
All of this is happening without the centrally-dictated reorganisation that has been repeatedly inflicted on the NHS, most recently by former health secretary Andrew Lansley.
Most people in the NHS would say “and thank goodness for that.” However, the fact that the latest reorganisation of the health service is less visible than most doesn’t mean that managers are not being distracted by it.
Fuelling public anxiety?
Also, the lack of public clarity on what is happening seems to be adding to public concern. Just this weekend, there was a huge march in support of the NHS at which there were many cheers for speakers who claimed that it was being ‘privatised.’
Yet the STP changes are, if anything, moving in the opposite direction (unless the conspiracy theorists are correct, and the ultimate ambition is to create ACOs that can be taken over by US corporations – which is frankly unlikely, given the margins and more likely losses on offer).
Be bolder, people
More substantively, the STPs are big and complex; and yet it’s hard to escape the feeling that they are nothing like bold enough. As I live in the county, take Hampshire’s STP.
It talks about the need to: resolve long-standing issues with care on the Isle of Wight, sort out Portsmouth’s struggling A&E, resolve the very public crisis at Southern Health and Care NHS Trust (which suffered another blow this week when the CQC announced it was going to prosecute), and work out what to do with the small district general hospitals in Winchester and Basingstoke.
Also, about the need to: keep these organisations on top of their efficiency savings agendas, while introducing new, more integrated ways of working underpinned by a big expansion of its existing shared care record / IT platform.
Delivering on any one of these imperatives would be a major achievement in five years, but there is neither time nor money to treat them as sequential issues. And what the STP lacks is a sense of how its different elements can be done at once, to support each other.
Never mind a vision of what a safe, modern service, with a digital front-end and highly trained staff in expensive buildings only where they are really needed, might look like – for the available money.
IT’s just not happening…
Just to stress, Hampshire’s STP is not alone in this. Kingsley Manning, the former chair of NHS Digital, wrote a column for HSJ recently in which he argued that the STPs generally fail to engage properly with productivity, and with how IT might drive that.
Instead, he noted, they tend to tick off analytics, shared care records, and digital services as nice things to have, rather than as programmes that will deliver the kinds of improvement in workforce productivity that have been seen in other service industries.
Mind you, when it comes to IT, it’s not just the STPs that are struggling. Last week, my former employer, digitalhealth.net reported that one of the biggest trusts in the country, University Hospitals of Leicester NHS Foundation Trust, had been unable to get its electronic patient record plans past NHS Improvement.
It wanted to spend around £25 million on a US system called Cerner Millennium and, while that’s a lot, it seems incredible that neither the company, nor the trust’s IT department, nor its general management, could get together a business case for it in an organisation spending £860 million a year, and employing 14,000 people.
(Of course, NHS England might have helped, but it seems to have become hopelessly distracted by trying to get a handful of ‘global digital exemplars’ up to snuff with £100 million that, HSJ reported this week, the Treasury probably wants back).
The NHS’ own plan 2.0
As commentator Roy Lilley noted in his newsletter this week, this kind of thing does not tend to worry the activists and medical staff who joined last weekend’s NHS march. They just want more money for the NHS and for their local services to be ‘saved’.
It would be unreasonable to expect otherwise. But Lilley is right; even if this government was going to find more money for the NHS (and all the pre-budget briefing is that it won’t – although social care might, might just get something) it needs to be spent effectively – and that means differently.
Stevens is working on a big reboot of the Forward View. So, if Hunt is going to do more than play conference bingo on Thursday, he’ll need to say something about what ‘the NHS own plan 2.0’ looks like.
Also, how the NHS’ regulatory structures are going to get behind it and start getting managers to think like, well, managers; and how politicians are going to sell all this to a hostile staff body and a very worried public. What’s the betting?
Lyn Whitfield - Journalist-Editor-Project Manager 