Your Humble Servant: Leadership – the art of getting away with it

To: All NHS chief executives and chairs

From: The health secretary

Subject: Leadership – the art of getting away with it

First things first, if this memo leaks, I didn’t write it, my special adviser did and I had no idea they would do such a thing. There you go – your first lesson in getting away with it.

I feel compelled to write to you at this time of grave stress and scrutiny I am putting you under, to pass on some coping tips and strategies that I have found useful. The general premise is rules are for losers.

• Read this week’s End Game: No clash of loyalties here

La-la Lansley loved rules so much that he created more than any other health secretary in history, and the joke is that they were all to stop people like me from breaking them. Ha.

‘You don’t like targets and I don’t like targets. My answer is simply ignore them’

Remember, just because the rules intend you to do something doesn’t mean you have to do it.

There are options: ignore the rules, find the loopholes or change the rules.

We all want the same things really – and here are my tips on getting them:

• You don’t like targets and I don’t like targets. My answer is simply ignore them.
• Your sums don’t add up and my sums don’t add up. My answer is creative accounting.
• You don’t like Monitor and the NHS Trust Development Authority and neither do I. Let’s all but abolish them.
• You don’t like to make promises you can’t keep and I don’t like to be kept to promises I make. My answer is to cancel them – cap on social care costs gone.
• You don’t want to be held to account for me and I don’t want to be held to account for you – so I hired Simon Stevens.
• You don’t want to cut the NHS budget and I don’t want to be seen to cut it. My answer is pass the public health budget to local government and then cut theirs.
• You don’t want the focus on your failings and the prime minister does not want a spotlight on the NHS. An easy one to solve: when all else fails, just dump on Wales.