Thursday, April 13, 2006

NHS Crisis: Factory Managers Show Trial

Downing Street NHS Summit

As his massive NHS spending spree ends in crisis, the Beloved Leader is feverishly running through the Joe Stalin playbook. The field commanders have already been executed, and now he's personally running the show trials for failing factory managers. The terrified group hauled before him yesterday were left in no doubt production of the T34 must be stepped up by all necessary means:

"We have to hold our nerve and be confident that the changes will deliver a better service. We have a huge ambition. There is no way we are going to do it by the old way of working. It will be a challenging year, there’s no doubt about that at all. But turnaround can be done and has to be done.”

The cameras rolled, and the confessions were blurted out for the newsreels:

"Tom Taylor said he was the fourth chief executive at Shrewsbury and Telford NHS trust in 10 months. He was slashing the deficit by increasing the number of patients treated as day cases and freeing beds by discharging people in the morning. Duncan Newton, the medical director at Bradford foundation trust, said he was saving on costs by making able-bodied patients walk to the operating theatre."

That's it Dunc- at Stalingrad they were herded to the front by armed NKVD officers. Have you considered how that might speed things along?

"Antony Sumara, the chief executive of University Hospital of North Staffordshire, who announced 1,000 job losses at the trust in Stoke-on-Trent last month . He said his staff were "angry and bereaved" because they felt let down by former managers."

"Angry and bereaved". I like that.

It almost captures how we taxpayers feel about this whole disaster.

PS We're told that the government “narrative” remains that the bulk of the NHS is in balance and relatively few trusts are responsible for most of the deficits". Well, the overall final deficit for 2005/06 may have been somehow constrained to the £600-800m they're talking about, and that may be "only 1%" of total NHS spending. But that entirely overlooks the damage caused to services by the need to slam on the financial brakes, sack staff and delay ops.

PPS I've just listened to the excellent Doc Crippen on the R5 Live NHS phone-in. As always he made some telling points. And it was interesting how the "narrative" is shaping up out there in phoneland. There's a widespread understanding that more money has not solved the NHS problems, and a feeling that much of it has been wasted on more administrators, higher salaries, management consultants, agency staff etc etc- all the things we're so familiar with. This is a definite step forward from where we were in the 90s. But there's much less understanding that the longterm solution is more consumer choice. Most people seem to think some kind of "rationing by clinical need" is the way to go. There's still so much to do.

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