The big change

GGI’s latest monthly webinar explored structural upheaval, governance, and reform across public services

The latest event in GGI’s monthly webinar series, The big change, was chaired by GGI principal consultant Simon Hall. It offered an occasionally provocative exploration of structural upheaval, governance, and reform across public services. Our main speakers were Michael Burton, editorial director of The MJ and Healthcare Management, and GGI chief executive Andrew Corbett-Nolan.

Michael opened with a historical overview of reform efforts across UK governments, illustrating how successive administrations—Labour and Conservative alike—have struggled to implement transformational change.

Drawing on decades of journalism experience, Michael charted a familiar cycle: grand manifestos curtailed by risk-averse institutions, political short-termism, and the illusion that structural reorganisation alone can drive improvement.

His cautionary tale highlighted the rise and fall of previous reforms, including the Lansley NHS restructuring and Universal Credit, while critiquing the abolition of NHS England as another bold yet potentially directionless move. He noted that reform rhetoric often masks deeper inaction on "wicked issues" such as health inequalities, social care funding, and economic stagnation.

Andrew Corbett-Nolan broadened the discussion, putting UK public service reform within a global context. He characterised today’s world as “highly geared and tightly coupled”—an interconnected, debt-laden environment where public-purpose organisations must navigate extreme complexity and increasing mistrust. Drawing from Professor Mervyn King's latest work on governance, Andrew argued that boards must become not only the “controlling mind” but the “controlling conscience” of organisations.

He called for a shift from competition to collaboration, and from compliance to outcomes. He said boards must exhibit greater moral clarity, assume responsibility for long-term stakeholder value, and develop a high-risk appetite coupled with strong assurance systems. Andrew also critiqued the overreach of regulation, arguing it often disempowers boards rather than enabling leadership.

The discussion revealed a sector weary of constant restructuring and concerned about the risks of rapid change. One guest warned of “mid-Staffs-style” governance failures arising from memory loss and capacity depletion during chaotic reorganisation. Another echoed these fears, urging slower, more reflective decision-making. Others expressed frustration over the missed opportunities of integrated care systems, although there was also agreement that ICSs haven’t really had a chance to establish themselves properly.

There was also optimism, with one guest seeing the abolition of NHS England as a chance for boards to reclaim autonomy and make local, talent-focused decisions.

The session closed with a shared sense that the big change must be more than rhetoric. Effective reform will require empowered, ethically grounded governance and closer collaboration between health and local government leaders.