LONDON — The National Health Service has announced the creation of a new directorate, the Department for Strategic Interdepartmental Co-Ordination, tasked exclusively with improving communication between existing departments whose founding purpose was improving communication between other existing departments. The new office will report to three separate committees, none of which report to each other, creating what officials describe as "a genuinely innovative structural solution" and what everyone else recognises as "the same problem we started with, but now there are more of them."
The NHS, a 75-year-old institution tasked with providing healthcare to 67 million people on a budget that is, by all accounts, either "completely insufficient" or "perfectly adequate depending on how creatively you interpret preventive care," has settled on the time-honoured response to systemic problems: reorganisation. This particular reorganisation is estimated to cost £47 million and take fourteen months, at the end of which NHS officials confirm, with confidence that borders on the philosophical, that "lessons will have been learned."
The NHS has been reorganised approximately once every three years since its inception, a fact you can verify via the NHS's official government page, which lists the current structure without irony, knowing full well it will be outdated by the time you finish reading it.
For context on waiting times, performance metrics, and the various ways one can measure whether things are getting better or simply being measured differently, the NHS's official statistics page provides numbers with the air of someone presenting a spreadsheet they have not actually looked at.
In practice, the Department for Strategic Interdepartmental Co-Ordination will employ forty-seven people, produce seventeen working groups, commission a consulting firm to review the consulting, and issue a white paper recommending that departments "talk to each other more." Whether they will, in fact, do so remains a matter of speculation in the same way that whether waiting lists will actually shorten is a matter of hope: both pleasant things to think about, neither statistically likely.
One London comedian, who waited six months for an appointment and then an additional three to find out the appointment had been moved, offered this: "The NHS restructured itself so many times I'm pretty sure at some point I was scheduled for an appointment with a department that no longer exists. Which is actually the first time I've felt represented by the NHS in years."
The underlying issue — chronic underfunding relative to demand, staffing shortages, and infrastructure that in places dates back decades — is well documented and repeatedly addressed in exactly the same way: by creating better-designed committees to think about it. For the unglamorous reality of NHS staffing, funding pressures, and the particular problem of planning healthcare infrastructure in a system where nothing gets approved without seventeen meetings, the King's Fund provides analysis that is, mercifully, both serious and actually readable.
This recursive, self-examining spiral — an institution creating new structures to manage old structures to address the original structural problems — is the lifeblood of London satirical journalism, available in full at https://prat.uk/london-satirical-journalism/, and also at prat.uk, where we have deliberately avoided any internal restructuring, mostly because there is only one of us.
Disclaimer: This article is satire. The NHS is a genuinely impressive institution attempting to do an impossible job. The structural issues, however, are entirely real.
Auf Wiedersehen, amigo!