"Innovation" is an NHS buzzword. It shouldn't be.

Martha Gill's Irrational Animals column.

“Innovation” has been an NHS buzzword for quite some time. It’s how they think they are going to make money. The word peppers Andrew Lansley’s sentences and appears on every NHS website. It turns conference speeches into tongue twisters and makes job titles too long to fit on to name badges. But let’s cliché this down. Being innovative is like being a lady. If you have to tell people you are . . . you  aren’t. The NHS isn't.

Not that promoting innovation is a bad aim. One bright idea, one new drug and you can potentially generate billions. This is the thought in the minds of the policymakers who have directed several taxpayer billions to this end.

But here’s the problem. A great deal of the money has gone towards creating “facilitatory groups”, such as the National Institute for Health Research – boards that manage the interaction between NHS employees with the new ideas, and the companies that might want to invest in them. Yet the interaction is an unhappy one. The inventive employees must now fill out a vast amount of paperwork and jump over many more hurdles than they used to. The boards are large and unwieldy, absorb a huge amount of capital and are made up largely of ex-nurses, inexperienced in business and, by training, highly risk averse.

Being unwilling to take risks is all very well in patient care but it can lead to utter stupidity when it comes to investment decisions. This was perhaps best demonstrated in 2006 by the US economists Uri Gneezy and George Wu, in one simple, cruel experiment.

Participants were asked to state how much they would pay for a $50 book token, a $100 book token, and to take part in a lottery in which they would win one or the other. It turned out that on average they were willing to pay $45 for the $100 token, and $26 for the $50 token.

So far so predictable. But then, in the lottery, things became a little uncertain and the participants started acting ridiculously. Given a 50 per cent chance of winning the more expensive token and a 50 per cent chance of winning the cheaper one, subjects were only willing to pay an average of $16. This was a situation where the worst possible outcome was getting the less expensive book token, but they valued it less than one in which they were guaranteed to get that token. Madness. Unless people are experienced in business, the smallest whiff of uncertainty can completely unsettle them.

Selling out

But even when these inexperienced NHS boards do take a risk on an idea, they simply don’t have the capital to protect it properly. The new drug or surgical device is therefore sold off at a very early stage of development, relatively cheaply, to private companies. If it turns out to cure cancer, it is the that company profits, not the NHS.

Far from being a profit-generating “centre for innovation”, then, the NHS has become a feeding ground for lean, mean American companies who cherry-pick the best ideas and capitalise on the revenue. It’s time for the NHS to take a lead from the private sector where it counts. They need to stop investing in “facilitators” and start investing properly in ideas. That’s where the money is.

Photograph: Getty Images

Martha Gill writes the weekly Irrational Animals column. You can follow her on Twitter here: @Martha_Gill.

This article first appeared in the 23 July 2012 issue of the New Statesman, Israel: the future

Jeremy Corbyn delivers a speech on the arts in north London on September 1, 2015. Photograph: Getty Images.
Show Hide image

Can Labour MPs force Corbyn to bring back shadow cabinet elections?

It is not up to the parliamentary party whether the contests are reintroduced. 

Soon after Jeremy Corbyn became the frontrunner in the Labour leadership contest, it was reported that he intended to bring back shadow cabinet elections. But as I later wrote, that's not the case. Corbyn has resolved that he will maintain the right to appoint his own team, rather than having it elected by MPs (as was the case before Ed Miliband changed the system in 2011). As he wrote in the NS: "Whoever emerges as leader on 12 September needs a shadow cabinet in place as soon as possible. I will appoint a strong, diverse shadow cabinet to hold this government to account from day one."

Now, ahead of his likely victory a week on Saturday, Corbyn is under pressure from some MPs to reverse his stance. Barry Sheerman, the former education select commitee chair, told me that he wanted a "serious discussion" within the PLP about the return of the elections. While some support their reinstatement on principled grounds, others recognise that there is a tactical advantage in Corbyn's opponents winning a mandate from MPs. His hand would be further weakened (he has the declared support of just 14 of his Commons colleagues). 

But their reinstatement is not as simple as some suggest. One senior MP told me that those demanding their return "had not read the rule book". Miliband's decision to scrap the elections was subsequently approved at party conference meaning that only this body can revive them. A simple majority of MPs is not enough. 

With Corbyn planning to have a new team in place as soon as possible after his election, there is little prospect of him proposing such upheaval at this point. Meanwhile, Chuka Umunna has attracted much attention by refusing to rule out joining the left-winger's shadow cabinet if he changes his stances on nuclear disarmament, Nato, the EU and taxation (a lengthy list). Umunna is unlikely to remain on the frontbench but having previously pledged not to serve, he now recognises that there is value in being seen to at least engage with Corbyn. Were he to simply adopt a stance of aggression, he would risk being blamed if the backbencher failed. It is one example of how the party's modernisers recognise they need to play a smarter game. I explore this subject further in my column in tomorrow's NS

George Eaton is political editor of the New Statesman.