August 29: ‘Fiefdoms’ to blame for National Health Service inefficiency

From: R Martin Downs, Linton-On-Ouse. York.

I WRITE in response to the recent letter from retired surgeon Paul Muller giving the EU’s diktat that doctors and nurses may only work a maximum of 48 hours a week as the reason why expensive agency staff are employed.

A year or so ago, a TV company asked a successful businessman, a certain Geoffrey Robinson, to access a Yorkshire hospital that had a waiting list of three months for operations and advise on ways to improve this situation, whilst making a documentary about it.

1. He highlighted that there were “fiefdoms” from top to bottom, consultants to cleaners/porters.

2. These “fiefdoms” operated purely to suit and glorify their own positions and importance, totally ignoring that their main and only duty was to look after the sick taxpayer as it was the taxpayers that actually paid them, not the NHS.

3. There was a total non-comprehension that there were 24 hours in a day and seven days in a week and ill taxpayers couldn’t get ill to suit their “fiefdom’s” preferred hours to work.

Over the weeks, he slowly overcame the prejudice of the unwillingness of teams to 
work together, unless it suited their schedule and to be more flexible.

As a result, the operating theatre waiting list came down to one week so “job done” and successfully. He did state, upon leaving, that he would be surprised if the staff kept to the new efficient ways of working he had installed and not slip back 
to their “fiefdom” ways of working.

Around a year later on his planned return to access what the situation was then and yes, they had returned to their old ways of working and, yes, the waiting list as nearly back to what it was originally.

Mr Robinson is not the only one who “knows” that hospitals aren’t run efficiently.

You only have to be an “ in patient” for some time, laying in ones bed watching the inefficient way of working and the wastage of both time and money.

The problem is so serious that it is practically criminal.

There are some very good, caring, knowledgeable and hard working doctors and nurses in hospitals. From my experience, I am sorry to say that they are in the minority.

As a last comment may I say that the biggest mistake the 
NHS hospitals ever made was to drop the nursing qualification 
of SEN, and I’m sure the 
majority of SRNs and doctors would agree.