Good About the NHS
posted: Thursday October 2, 2008
If you’ve been following my blog, it’s
possible you think I am hopelessly cynical about the NHS, can’t
see beyond it’s problems, and despise everything it has become.
Nothing could be further from the truth.
Like a lot of other people, I think the NHS offers
the vast majority healthcare that is sometimes world-class, normally
excellent but does on occasions fail to deliver what we can reasonably
expect. I also think that the failures often get more bad press
than they merit.
The reason I am so harsh about the management
and culture of the NHS is that despite every obstacle they put in
the way of those actually delivering the service, healthcare in
the UK gets delivered pretty well most of the time. There IS good
management but not a lot of it. Too many NHS managers are inept,
unimaginative, and downright vicious to anyone who questions them.
The way forward is to conduct a rigorous campaign of change aimed
at eradicating the negative and self-interested and building on
the positive. Angry? You bet! Having worked for the NHS for 5 years
I’ve seen the dedication of many of the staff and how demoralised
they are by the environment in which they are forced to operate.
Just imagine how good the NHS could be if everyone
involved was pulling in the same direction and the organisation
leveraged the goodwill of the ‘good guys’ who are in
the clear majority!
Almost invariably, when you talk to those who
have received treatment, they are very positive about the NHS experience
in general. Granted there may be reservations about waiting lists,
inefficient discharge procedures and sometimes the levels of cleanliness,
but the overall impression is one of dedicated and sympathetic treatment
from almost everyone they deal with.
It seems therefore, that although cogent arguments
are often made that The NHS is in terminal decline, these seem to
be justified from an analysis of its structure rather than from
the outcomes the NHS still manages to deliver on a fairly successful
There is no doubt that the NHS is indeed in serious
trouble – but I do not believe it is too late to sort things
out. Regrettably, yet again the solution lies in the management
structure and the stifling culture within which it thrives.
I don’t think it is too strong to
describe too much of the NHS management as parasitical; it’s
difficult to pinpoint the level at which this becomes the norm rather
than the exception, but as a generalisation, the more power a manager
wields, the more cynical and self-interested they seem to be.
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