Monday, May 3, 2010

NHS: Free Advice

The best advice is often free. Yet our government would prefer to spend millions (or was it billions) to buy them from people whose only motive is to get the easiest money they can lay their hands on: government money. Just look at Greece. Here in the UK, despite the fact that we have failures like Metronet, we still have other PPP/PFI projects.

We might get new hospitals that look like airport lounges but what about the doctors and nurses when we cannot afford them. Or are these places only there to house the ever increasing numbers of managers. What about the patients? Patients, did you say?

One Professor of Medicine was giving out his free advice in the Times: 
The internal market has been a costly disaster. Let the professionals manage medicine
This may sound familiar to those of us that were brought up the old fashion way in Medicine:

“……When I started in medicine, the hospital was run by about three people. Things were so much more simple when doctors and nurses treated patients, doing their best without the guidance of guidelines and targets, doing their best ... yes ... to make the patients better. How did we manage without forms to fill and waiting times compliance? Quite well actually. The medical director ran the medical side of things while matron and the accountant handled the rest.”

“It wasn’t much of a business then: it didn’t have to be, because there was no internal market to manage.”

“The internal market ……..has wreaked havoc. It has spawned a nation of administrators, here today and gone to another post tomorrow — while doing nothing to bring costs under control.”

“There are savings to be made. It is alleged that there are just 75,000 administrators at work in the NHS but this figure is laughably mythological. Doctors and nurses know that there are many more than this. They look around and see the numbers increasing.”

“One report by the Centre for Policy Studies published in 2003 indicated that there were 250,000 administrative staff employed in the NHS: at least one administrator for every nurse. In recent times the rate of increase of admin staff within the NHS has exceeded that of nursing staff.”

“……The principle of care for all from cradle to grave is worthy and wonderful. But the current reality is a cradle rocked by accountants who are incapable of even counting the number of times that they have rocked it……..” These are the very same people we pay market rate or they will go elsewhere!!!

“……Over the years politicians have made dramatic changes to the way that the NHS has been run. Recent changes have caused fragmentation and not led to any cost saving……”

“Moving patients from one place to another does not save the nation’s money, though it might save a local hospital some dosh.”

I have personally experienced a Trust buying a house for a family to move them to a neighbouring Trust.

It is still the same NHS paying for the care but the CEO of one trust will get more bonus.

“……So the internal market has failed because it does not consider the health of the nation as a whole, merely the finances of a single hospital department, a local hospital or GP practice…….”

Here is the advice:

“……Let us go back to the old discipline of the NHS. Let the professionals manage medicine, empower the professionals, the doctors and nurses and shove the internal market in the bin and screw down the lid…….”

Professor Jonathan Waxman is a consultant oncologist and he is unlikely to be joining Lord Mandelson.


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