It Really Is Time For Nhs Reform

[youngmafbog]

If we dont do it soon we wont have one. Top down reform and weed out the dead wood. Also NHS facilities should not be used for private, there should be no 'down time' the facilities should be utilised 24/7 as much as can safely be done.

https://www.dailymail.co.uk/news/article-10712809/What-sick-joke-Private-breast-enlargements-nose-jobs-carried-NHS-pandemic.html

[davebro]

hm - reform just seems to add more to the administrative overload so a properly thought out approach is needed.
It's also the case that some private facilities are used for NHS treatments.

[ToraToraTora]

yes, definitely it needs a cull of the layers of management for a start. It needs to be run like a proper business.

[Old_Geezer]

It's way way way past time they should've returned to the days of proper matrons, nurses, etc. and times when things were done in house not subcontracted out to the cheapest profit making bidder, and culled management back to allow budgets for more actual health staff from the UK. But that would mean someone losing profit, and a better health service for the public, so that's unlikely to happen.

[calmck]

I agree with oldgeezer. Matrons should be brought back. There are too many managers walking around with clipboards and phones.Nobody seems to accept responsibility and get the job done

[New Judge]

The problem is that no political party will countenance the root and branch reform that is desperately needed. All they've done over the past few decades is to tinker with the administration, usually by adding ever more layers of bureaucracy. You only need to look at the number of "trusts", "agencies", "commissions". In England there are:

- 207 clinical commissioning groups
- 135 acute non-specialist trusts (including 84 foundation trusts)
- 17 acute specialist trusts (including 16 foundation trusts)
- 54 mental health trusts (including 42 foundation trusts)
-35 community providers (11 NHS trusts, 6 foundation trusts, 17 social enterprises and 1 limited company)
- 10 ambulance trusts (including 5 foundation trusts)
- 7,454 GP practices
- 853 for-profit and not-for-profit independent sector organisations, providing care to NHS patients from 7,331 locations

All of these require boards, directors, committees and financial oversight. Even when one is abolished, it simply rises, phoenix like from the ashes of its predecessor, employing the same people doing the same unnecessary work. Only the name is changed to give the impression of "progress".

No party will tackle this because large numbers of voters have the impression that the NHS is sacrosanct and "the envy of the world." It isn't. It's a shambles, a monster devouring ever larger amounts of taxpayers' money with the added problem that many people see political "success" with its oversight in terms of how much money is spent and ignoring the outcomes that are provided for that money.

The pandemic showed it up for what it is - a monster of an organisation whose highly paid bosses were totally unprepared for a pandemic and incapable of addressing the problems thrown up by it. But people stood on their doorsteps on Thursday nights banging saucepans in support of it.

Before anyone shoots me down, I'm not criticising the front-line workers in the NHS. They work hard, often for poor pay and do the best they can despite the deficiencies of the organisation they work for. It is that organisation - the hundreds of directors and managers as well as the politicians tasked with overseeing it - where my wrath is directed.

[Gromit]

Blair and Brown were the instigators of much of the privatisation of the NHS.
That resulted in short term gain (waiting lists were vastly reduced) but long term expense and management complication.
Successive Conservative Governments have embraced and expanded that misguided policy.
So today we have an organisation with an identity crisis.

I agree it does need reorganising, but I have misgivings about that being done by politicians, who are to blame for the mess we have today.

[New Judge]

//Blair and Brown were the instigators of much of the privatisation of the NHS.//

The NHS needs private initiatives to deliver decent healthcare. It is obvious that care provided solely by a state run behemoth doesn't work (few things the State provides work properly). The reason politicians are shy of ordering more private involvement is because, to many people, such a thought is heresy. Their adherence to the religion that the NHS has become to them is the reason progress with improving it is so difficult.

[campbellking]

Not sure why cataract surgery has been identified as something preventing NHS beds being used appropriately when these are day cases with no beds involved….

[Peter Pedant]

called in the trade
re-disorganisation

here is the ed of the BMJ on the one on 2001
https://www.bmj.com/content/323/7324/1262

[jourdain2]

NJ has said so much of what I wanted to say. The NHS is an actual health risk. If you trust and believe in it then you can end up unnecessarily dead or crippled. It was the one and only BIG IN CAPITAL LETTERS entry on the 'against' side when we were trying to decide whether or not to return to the UK (family reasons won).

I have actually written to my M.P. about its shortcomings. The point is that it is so unnecessary - with a bit of tweaking it could be brilliant. Mainly incompetent management and dissociation from actual patients is the problem.
I've thought of several solutions, but that's not the question.

[jourdain2]

^^^^^ Re. Cataract surgery. When I had both mine done last year (people cancelled due to Covid fears)I sat in a cubicle by a bed. I did not need a bed, nor did any of the others present. I accept that occasionally one may be necessary - but 1 per 'ward' is more than sufficient to cover every eventuality. I was in and out in 3 hours. A cup of tea was welcome (and needed).

[William51]

You are right. The NHS has become a top heavy bureaucratic monster. It should be scrapped and restarted on a similar free to use ethos based on affordable health insurance for all.

[sandra4444]

OP. If we don't do it soon we won't have one. The 6 million plus who are waiting for treatment already believe that.

[Deskdiary]

Get rid of the non-jobs would be a start.

A couple of weeks ago when female only spaces was confirmed, the head of LBGTQWERTY+ at a trust went nuts.

I suspect I’m conservative in suggesting this person was trousering £100k a year in a total non-job.

Does any trust really need a chief of LBGT?