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What's 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 basis.

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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