Wednesday, 19 June 2013

NHS loses its Halo

Just two or three years ago even implied criticism of the NHS was unthinkable. It was the nation's sacred cow, free to wander unhindered and unquestioned; it defined 'Britishness' and even to hint that it was less than perfect was alike to declaring one's support for kiddy-fiddling. 

How things have changed. The accepted view is now that the NHS is an out-of-control behemoth, unmanageable, our hospitals death-factories, contaminated with deadly bacteria and viruses, uncleaned and unhealthy, staffed with uncaring incompetents, our GPs overpaid fat-cats who golf at weekends while patients die. Above all, we have accepted that NHS management is not only wholly disfunctional, but criminal in its negligence and grossly culpable for its cover-ups.

And now, to little surprise, the Care Quality Commission, the body that itself should have policed standards, has been caught in a massive cover up. This time it's new born babies that have been dying in Herodian proportions. And all the while the top guns, like senior bankers, escape jail. 

The reality is that there are many more good, professional, dedicated, caring and committed professionals in the NHS than there are incompetent fraudsters, shysters and other senior managers. A large part of the problem has been a culture of Managerialism that has robbed the professions and the Royal colleges of their authority to secure professional standards. 

But not until we have strangled the last NHS bureaucrat with the small intestines of the last NHS board member will we be able to reclaim a useful health service.

20 comments:

dusty said...

I will give you an example of one of the root problems.

I went for a blood test a few years ago. After a 40 minute wait I entered the room. The phlebotomist waiting to take my blood sample was sucking a lollipop. I refused to let this person take a blood sample. None of the other staff paid any attention. After repeatedly asking who was in charge, one lady eventually said I should have to go back to the waiting room and take another ticket.

I did not.

As I left the hospital, I telephoned and got through to HR. I said, "I am complaining that one of the phlebotomists is sucking a lollipop whilst taking blood samples." The instant reply was "We will not tolerate racism at this hospital."

But the trick was, I had said only that sentence above. I had not said anything else. So the complaint had obviosly been made at least once before that morning. It had gone up the line, hit the glass ceiling and the telephone operator advised accordingly.

This story illustrates what everyone in middle management in the NHS will tell you.

It is not possible to administer discipline to any degree whatsoever.

Anonymous said...

"sucking a lolipop"

"But the trick was, I had said only that sentence above"

It is not obvious how sucking a lolipop would interfere with taking a blood sample. - then I am not a medical professional.

For the 'hard of understanding' you're gonna have to be a bit more explicit.

G. Tingey said...

Has anyone here heard the phrase:
"Regulatory Capture" ??
You set up regulator(s) because a [Insert name of service/businees/function here] is unsatisfactory & needs watching ...
The regulators often comew from within, & an "Old-boy" network starts to take over, then the regulators get inside the cosy little system.
Calssic case in the USA was with petrol/diesel additives, such as Tetraethyl Lead ... took vast outsdie pressures to get change, followed, 20 years later, by massive drops in crime-rates (across the planet) as the effects wore off ....

This is what's happened here.
{ Again ]

Anonymous said...

G_Tingey: "The regulators often comew from within, & an "Old-boy" network starts to take over, then the regulators get inside the cosy little system"

Think FSA.

Elby the Beserk said...

One must add that one of the top bods at the CQC was one of those responsible for the South Staffs Morgue. Sent packing from there with a seven figure pay off, she popped up at the CQC to continue the work she had so successfully started at South Staffs.

Reward for Failure. The motto of the UK Public Services.

Peter Whale said...

The way to get standards up in the NHS without any cost whatsoever is to make all MPs, civil servants and local government employees and all services that are paid by government including their immediate family, banned from using the private health care system with immediate loss of job. Then you would see change.

Anonymous said...

Old boys network eh? I do understand the meaning here but there is also an "incompetent woman's network". The network that puts women in place because of their political views, rather than any qualifications or experience. It's just like the old boys network, but more pernicious and vicious. Read on.

http://www.channel4.com/news/mid-staffordshire-health-scandal-a-question-of-trust

Coney Island

Anonymous said...

Coney Island: "The network that puts women in place because of their political views .. "

Not to mention in the case of the NHS, wimen are so much more caring, it's only right they should be well represented in the 'caring professions'.

anon 2 said...

Yes. This 'wimmin' business is way out of proportion - but then, that's what Marxist approbation does for the feminist cause. So now, "Bossy Boots" postures and poses as being qualified to manage everybody and everything-- just because she's female and thinks she can understand all people.

And boy, is she making a mess of it.

We might remember, however: hospitals were much better run when Matron was in charge! And she, too, was a woman. She wasn't the touchy-feely Feminist, however; in her day, hordes of foreign cleaners didn't run round with besoms, swirling all the infected dust over everybody in a ward. I guess masculine management of other aspects was also better represented.

My point, then, is that gender (like race) is irrelevant when it comes to management. Knowledge, competence, integrity are what matters. Their application led to improvement of the health system in the first place. Their corruption is taking us backwards...

Anonymous said...

@ anon 2.

Just as a matter of interest, I looked up a woman I once knew who had seriously screwed up an NHS trust as treasurer for said trust and lost it millions (literally). Tax payers money up in smoke.

What was her punishment? She was promoted to Chief Executive of another trust not too far way.

Reward for failure - again!

Coney Island

James Higham said...

But not until we have strangled the last NHS bureaucrat with the small intestines of the last NHS board member will we be able to reclaim a useful health service.

The difficulty is in defining 'we'.

TrT said...

"The reality is that there are many more good, professional, dedicated, caring and committed professionals in the NHS than there are incompetent fraudsters, shysters and other senior managers."

No, there arent.
When a patent dies because they are given the incorrect medication, its easy to blame one staff member, who injected the wrong drug, or who ordered the wrong drug, or recorded the wrong drug previously.

When thousands of patients die of malnutrition, the reality is, every nurse, doctor, administrator and cleaner who worked on that floor walked past that patient every day and they starved to death, and not one of them looked at the patient, investigated and solved the issue.

They didnt intervene, they sat behind their desk, filling in their crosswords and tapping their union badges whenever anyone asked why they wouldnt help a dieing patient.

Any staff member with an ounce of integrity would have quit long ago.

Anonymous said...

"Any staff member with an ounce of integrity would have quit long ago."

"Integrity", that's not an NHS competency.
Unions, and the system frown upon "integrity", "integrity" is for mugs - patients dying - no worries because the correct boxes were ticked.
Until someone stamps on unison/unite, RCN, the BMA et al and the TFIF nine to five culture - nothing but nothing will change in the NHS.

Anonymous said...

Medication is prescribed by a doctor.
The nurses giving the medication then check with another that the meds are right, the drug dose is correct as prescribed, and the patients armband ID shows the right patient.
If you want private that's OK, as most private patients are now treated at hospitals that treat both NHS and private patients. Since April all NHS trust hospitals have been allowed to obtain 49% of their funding from private patient treatment. Since nearly the turn of the century GPs' have been able to use private health providers for services, and have been doing so.
In fact, since April the NATIONAL health service has ceased to exist as such...the health department no longer funds any hospitals. All GPs' are self employed, as are all consultants. They have been since the NHS started.
I'd be really interested in how you hope to fund your healthcare as a private patient with a chronic health problem.....

Anonymous said...

http://www.bbc.co.uk/news/health-22980803

Edward Spalton said...

My aunt who died recently, aged 92, was a deputy matron.
It must have been the late Sixties/early Seventies when she took a career break to nurse her ailing mother.

She kept up with developments in her profession. She was surrounded by expensively produced manuals and folders, concerning the latest reorganisation.

"I have looked and looked and I can't find a mention of the patients anywhere" she said. Almost every government since has launched its own reorganisation - with the effects we know.

I have always thought that the decision to create an administrative corps of "NHS Managers" was perverse -
Rather like placing a civil servant with no military experience in command of an army because he was good at logistics. A commander should have front line experience - in a hospital, medical experience

G. Tingey said...

Private companies also reward failure - my old employers kept on doing this.
It got them in the end, but now we are worrying about our pension schemes (Kodak)

ANother point, the NHS is a bureaucracy ...
ever hera of the "Iron law of bureaucracy" ??
Google for it - very interesting.

Anonymous said...

He has restated it as:

...in any bureaucratic organization there will be two kinds of people: those who work to further the actual goals of the organization, and those who work for the organization itself. Examples in education would be teachers who work and sacrifice to teach children, vs. union representatives who work to protect any teacher including the most incompetent. The Iron Law states that in all cases, the second type of person will always gain control of the organization, and will always write the rules under which the organization functions.


Jerry Pournelle has a very keen mind.

GT - nice one.

Anonymous said...

@ Greg T.

So you are an ex Kodak man like me then? Have you had your pension letter yet?

Coney Island

G. Tingey said...

Anon Coney Island ...
YES, been to the London meeting, will be voting for the new Plan - we can still collapse into Pension Protection if it all goes pear-shaped ....