Dr Alf is right, too many patients within the NHS are time-wasters. These are people who abuse the service because they think it is free at the point of need, are hypochondriacs, lonely and incapable of taking any personal responsibility for their own health. During their lifetimes, they may, and in many cases do, drink far too much, smoke far too much and imagine that the excesses of their youth, binge drinking and drug abuse are things without later effects or consequences. They cannot see that poor diet, missing meals and drinking on an empty stomach, will make them depressed and unwell, yet 40 % of the UK population suffer from depression for which the NHS has to provide them with Prozac and Seroxat at huge cost.
The case of the Welsh healthcare administrator gives rise to the bigger question of de-centralisation. We are told that decision-making must be devolved to “local people” and to the regions. The truth is this leads to fragmentation, cronyism and lack of scale economy when it comes to procurement. That leads to higher costs and the need for more NHS Trusts, more Trust Chief Executives and more apparatchiks, like this cancer-ridden former administrator, who clearly sees herself as a latter-day Marie Antoinette with subjects who not only don’t get to eat cake but are denied lifesaving treatment as well.
Dr Alf is also right when he says that the NHS needs to be scrapped and replaced with a healthcare system modeled on global best practice However, this presupposes that there are people within the NHS capable of effecting such reform.
WHO SHOULD IT BE?
We are told that we should “listen to the healthcare professionals”, yet despite the rhetoric the NHS is now light years behind Germany, France, Italy and Singapore, and produces the worst cancer treatment outcomes in terms of mortality of any country in Western Europe outside of Greece.
In China fewer people get cancer (it is 1 in 2 in the UK up from 1 in 80 in 1934) but the NHS refuses to use Rife frequency generators which are present in every German cancer ward.
The NHS uses Big 4 management consultants and ex-NHS managers to advise on improvements yet despite these interventions the NHS gets progressively worse. This is evidenced by the Gordon Brown/Wanless review, which injected £7 billion gbp all of which was wasted on higher pay, higher NI contributions and a reversal of productivity for no gain whatsoever.
McKinsey, the global strategy consultancy, were brought in by Tony Blair, and one of their early recommendations was to sack 10% of doctors at a time when the UK population was 10% higher than the ONS figures. The NHS insists that anyone who comes in to effect improvements must have”essential NHS experience”. This is insanity and ‘Catch 22’ nonsense because it means that only those who brought it to its present disgraceful state can be employed to put things right which they have proved time and again they cannot do.
We are told that this situation is down to “savage cuts” and “creeping privatisation”, yet 20% of the entire NHS budget goes towards gagging orders, payoffs for bullied/sacked staff and legal fees.
The number of Trusts and the failure to integrate local authority care within the NHS is not looked at, the 225% increase in NHS managers since 1992 is not talked about, and the size of NHS Trust boards is not talked about.
My own Trust in NE Hertfordshire has a CEO and a 15 person board.
So the excuses do not wash and the solution is not more decentralization and more managers.
A healthcare system, modeled along best practice, as described by Dr Alf, functioning to maximum efficiency, and using a Target Operating Model derived from the best practice of Germany, Singapore, Italy and France.
At a grassroots level Chinese self-healing, which does not use drugs should be incorporated into the Western mainstream, so that people are prescribed Tai Chi and acupressure, rather than wholesale resort to drugs.
WHO CAN APPLY THIS SOLUTION?
We can rule out all those currently involved in the NHS or those who have worked within it(excluding doctors, nurses and clinicians) because their record has been one of complete and utter failure.
We can also rule out the middle tier management consultancies who have come out of the Big 4 and the major strategy houses because they too have failed, based on the hard evidence of the past 65 plus years.
By a process of winnowing and the test of practicality, what we are left with are experienced ‘interim managers’, who have operated in the public and private sectors, understand transformation, understand change and understand human nature.
When I say interim manager I do not mean a contractor brought in to undertake specific tasks on a management consultant with an MBA plus laptop computer who has never run anything in his/her life. It means a person who can think, think the unthinkable, strategize and yet at the same time see the whole picture and most importantly bring it back to life.
A DYING BREED
Thanks to the actions of Governments, lobbying by the Big 4 management consultancies, and inertia on the part of many interim management providers, people like the interims I have described are either retired in sunnier climes, on the bench, dead or working at a fraction of their capability. That dying breed of less than 1200 people needs to be brought out, unleashed to design a new health service and left to create something that we can all be proud of and which is fit for the 21st century.