The ritual State opening of Parliament obliges Her Majesty to announce the Government’s programme through the traditional Queen’s Speech.  The speculation this year has been that it will focus on such issues as Prisons Reform, Adoption, unmanned drones and driverless cars! The reality is that the processes of public administration continue much the same, whilst MPs and Lords busy themselves making new laws.

What should sound an alert is whenever the word ‘Reform’ appears in a Queen’s Speech.  In recent decades administrations of every hue have endlessly tinkered or reorganised public services.  Sometimes the changes go unnoticed, except to those closest to the action.  But there are other times when ‘reform’ takes centre stage.  The reorganisation of the NHS in 2013 is a case in point.  Its complete re-structuring of key delivery and support functions in health and wellbeing caused an immense upheaval and the true implications are only now feeding through, three years later.  Much of this is because although structures and processes are of interest to politicians, civil servants and certain specialists, the wider public could not care less!