We Streeting has to decide. Does he want to control the NHS, or does he want it to have operational freedom? When he can make up his mind on that (which I am not expecting any time soon), then there is a chance that standards in the NHS might improve.
But I stress that there is only one answer that is politically viable, which is central control, and only one answer which is operationally viable, which is to trust local management to respond to local situations.
If – operationally – the best solution is without edntral control then why the insistence that it must be that nationally and centrally controlled monopoly?
Why not markets?
It’s the difference between strategy and tactics
It’s a well versed military principle
At the tactical level individual hospitals and GPs implement the strategy, but they should have autonomy on how they achieve it within constraints (budgets, medical practice, NICE drug approvals etc)
What seems to be missing is the bit in-between , what the military would call the operational level. Or if it exists it just isn’t effective
If it existed then trends would be identified and reserves could be deployed to assist tactical kits under stress, also lessons learned at the tactical level at each unit could be fed out to other units and also back to the strategic level which would feed the strategy
It seems to me that there is far too much meddling at the tactical level by the secretary of state and departmental civil servants, the BMA ,RCS etc and far too little attention spent looking at strategic issues
Like demographics, especially at regional levels, like new treatments and innovations, like reducing the bureaucratic load on the tactical level and shielding it from interference, like the potential for pandemics
We pay shedloads of money to train medical professionals who are then controlled by non professionals
Every waking hour anyone in the NHS who is not directly involved in the delivery of care should be focused on supporting the frontline units
It is quite evident that they are actually just feeding the bureaucracy, parliament, NGIs, think ranks and health lobbies to interfere
Ya know Starfish, I wouldn’t object to the military analogy if I thought the role of the enemy in it was not played by me and the rest of the victims.
We need local management to lose their jobs if they do a shit job (which they will). A bit like the Uni’s going bust, crap hospitals need to go the same way. The medical staff will find employment elsewhere and ideally the management would have to stack shelves in Tesco. Sadly, Cressida Dick, Lin Homer, Andy Hornby and Fred the Shred show the reality is somewhat different.
Most humans don’t “spontaneously improve”, except when it comes to their own conditions, which is why the NHS is excellent at self-preservation. For it to be good for its customers, it needs to compete for paying customers. If it can only survive from money given to it from paying customers the standards experienced by the customers will improve no end.
This is the main reason the BBC is now just a pile of shit that just loves employing very strange people who enliven parties with their fun antics and pays its favourite employees a fortune for fuck all. I’m unsure what function Lineker can now perform, because he’s only sun-lamp tanned and not melanin rich enough and now the Tories are history his attacks on social media are no longer required. Mere middle management can perform the necessary adulation of the Labour Party…