At my works Christmas do this year I found myself in a long queue at the bar in Brighton. I was also bursting for the toilet. To distract myself from this classic conundrum I found myself imagining what the Department of Health Christmas looks like, and whether it looks anything like mine…
It's been a tough year for the NHS so Jeremy Hunt has brought together NHS movers and shakers to let off a bit of steam. What better than a few drinks down the local ten pin bowling alley? Hunt’s heading up the government team, pitted against a team from Monitor, one from the Care Quality Commission (CQC), a team of junior doctors, a team from NHS England, one from United Health, the Healthwatch team and a 'consultancy all-Stars' team with players drawn from international consultancy firms like KPMG and PWC.
It's kicked off by Jeremy who thanks everyone for their hard work this year. They all toast their White Russians (dude, even privatising health bureaucrats have seen the 'Big Lebowski'). Jeremy enters the team names into the computer with a hearty 'May the best team win!'
First up are the government team - Jeremy Hunt, Oliver Letwin, Lord Lansley and George Osborne. As they wait for Jeremy to go first, Lansley is sharing with George his utter disbelief that he received a peerage. To be honest George is thinking the same, but he's not had any Babycham and Pernod chasers yet so he's managing to keep a straight face.
But straight away there's a problem. Rather than just running up and trying to knock the pins down, it occurs to Jeremy and his team that it would be better if each pin had its own lane with separate ownership. This whole 'all the pins together' set-up just doesn't make sense to them. So Lansley comes up with a detailed plan for how they might change this – but it’s so complicated that nobody understands it. As they mull over Lansley’s plan, the other teams start getting frustrated.
Now it’s the turn of Simon Stevens and his NHS England team. Rather than just start trying to knock the pins down they develop a holistic five year plan for knocking pins down that doesn't once mention knocking the pins down but does talk a lot about the importance of integrated pathways through the skittle alley. There's a few details they get stuck on but luckily the consultancy all-stars are there to help them iron them out.
Monitor, the NHS regulators are up next but it turns out that nobody has given them a bowling ball. They hope that their close links to the consultancy allstars may mean that the all-star team might lend them one of theirs but that's not really how consultants work. So they just sit on the sidelines, marginalised from the game, occasionally making comments about other teams. Nobody is really listening because they’re all trying to figure out if Lansley’s rules are going to ruin the whole game.
The Babycham and Pernods are starting to kick in for George and he starts challenging the junior doctor team to an arm wrestle.
Next up its Healthwatch. It's a spare! The other teams start clapping and Healthwatch note down their score on the computer. They are asked to note down the others teams’ scores but seem reluctant to note the impact of the other teams on the overall game. George starts heckling Lansley just as he has got to section 12,543 of his lane/pin splitting idea.
The junior doctors have been patiently waiting for their go. They play ten pin bowling all the time and are real experts in it so they stopped listening to Lansley a while back. Problem is that every time they try to take their turn, Jeremy Hunt starts distracting them. He's heard they are pretty good at this so he's worried that they are the team to beat.
It’s a strike! All pins down. There are grumblings from the government team that they don't think it's appropriate for Junior doctors to do strikes and how they couldn't have done it if it was a weekend match but nobody is really listening since the UnitedHealth team are stepping up.
There’s another kerfuffle as the UnitedHealth team look over expectantly at their former star bowler, Simon Stevens, now seated with the NHS England team, hoping he might come and bowl for them too. Stevens looks bashful and stays seated. But the consultancy all-stars have no such compunction and are happy to play for more than one team. Up they jump, with one of the Monitor team doing the same.
The junior doctors explain that this isn't really how ten pin bowling works; that you have to have separate teams for the integrity of the game. Lansley refers them to the rest of the Monitor team, but they've fallen asleep at the bar.
The CQC get themselves ready but by this point Lansley has started to separate the pins into separate lanes. CQC take their turn but they only have one pin to aim at and so they file a report complaining that ten pin bowling doesn’t work and that the pins should be put in ‘special measures’. They don’t mention Lansley’s new arrangement in their complaint, though. It’s obviously the fault of the individual pins.
All evening the 'consultancy all-stars' have been watching the unfolding chaos and chuckling to themselves. They always enjoy the Department’s Christmas do, and this one is no different. They are used to working with different bowling arrangements so they simply separate their team, one for each of Lansley's new lanes and proceed to step up and smash the pins into the back of the lane. 'Strike' they shout! Jeremy looks around nervously in case it's the junior doctors, then relaxes.
The Consultancy All-stars have won the game under the government’s new rules and they all slope off into the night.
'Are you being served, Sir?'
And there I was back at my works do in a nice little pub in Brighton.
Here's hoping that the NHS gets the bowlers it deserves in 2016.
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