Not just bad management, but institutional resistance to improving that management. Including from doctors and nurses.
Very little the Conservatives have proposed constitutes “improving that management”.
Apart from attempting to bring in proven, successful private sector management you mean?
They haven’t got enough staff - hundreds of managerial vacancies because they just don’t pay enough. Problem is, at that level, they are competing against the private sector.
It’s like you’re quoting a local Tory MP. You speak like someone who doesn’t have any direct experience of anything to do with the NHS, except as a user.
The NHS hasn’t stopped evoloing since it started. How on earth do you think we got to a point where a service providing this quality of service consumes 9.1% of GDP - you’re saying that’s the result of “just bad management, but institutional resistance to improving that management. Including from doctors and nurses.”
You literally don’t know anything about the subject, except what bubbles up in your head.
That’s so cute. Like trickle-down, the whole “the private sector will inherently be better at running the public sector than the government” thing is one of those mantras conservatives continue to repeat despite evidence to the contrary.
Hey, remember when Thatcher privatised the NHS cleaning staff and standards fell so far they started having MRSA outbreaks? Good times…
Perhaps they should advertise to some of the 1.9M unemployed?
Most graduates of usable qualifications expect more as a starting salary or for career advancement as is shown by the current massive difficulty with recruitment.
The atmosphere surrounding health service management is based on a culture of bullying. No one trusts senior managers to reward skills with appropriate salaries and so we have a massive retention problem. The government agreed a complex skills related progression for staff and then reneged on it in England. Staff are paid reduced salaries with the expectation that they will increase with years of service towards the full salary; any attempt to change this will require recalculation of initial points unless we are to lose even more nurses.
Who have just failed in their first total responsibility contract and returned it to NHS management
If I were a British nurse, I’d need at least another three or four exclamation points to be really motivated.
There are plenty of older folk who’ve been left on the scrapheap who’d jump at the chance.
He has a point. If doctors and nurses were not in large part railing against changes to the NHS they would be one of the very few vested interests in society that do not try to protect their own interests.
It’s interesting to see how general the manifestoes for the 1945 general election were (not one single costing, not one mention of specific tax rates):
Yesterday, pace the housing bit, the tory rags headlines were swooning over Cameron announcing: We are the Party of the Working Man !
Today they are banging on about a bright new future, rolling uplands and all that sort of crap, stating all will benefit, provided they are willing to work hard.
This is what I mean by present universal political bolshevism: lotsa shiny promises, lotsa hard work, and lotsa lotsa excruciating moralizing.
Which is why I’ve said the management needs to change to one that will reward excellent work. Like successful businesses do. A system is needed that retains and rewards the best workers, not the mediocre time-servers.
Universal Credit is a massive clusterfuck. It can barely cope with single, no kids, JSA-only claimants. It’s miles over budget, miles behind in scope, miles behind geographical rollout targets. It’s shaping up to be a huge failure.
Except of course when you let private management run a public service what it inevitably rewards is itself, often to the detriment of the public.
Successful businesses in the private sector work because they are ultimately seeking to benefit themselves. They fail in the public sector for exactly the same reason.
But doctors and nurses seeking to benefit themselves, not the public, is fine? That’s a foolish double standard.
Of course they’re seeking to benefit themselves. The point is to reward the people who do best, hit the targets, save the lives or whatever specific metric is being used, so that desire to improve ones position works towards the aim of the organisation. The management skills are the same.
And bringing in private sector expertise is not the same as privatisation. I don’t expect any government would give up control of the NHS.
How do you propose to benchmark, down to the individual, something as complex as healthcare? I mean, a warehouse has some obvious metrics - deliveries stored in the right place, dispatches made on time, dispatches delivered to the correct customer, number of breakages etc. It’s obviously more complicated than that, but there’s at least individuals who have direct control over some of these things. Is it possible for a geriatric ward, or an intensive care unit to be judged so?
There are many things you can measure, from the floor being cleaned every day to the success rates of surgeons. Just because you can’t measure or benchmark everything doesn’t mean you shouldn’t do what you can.