From: Paul Rouse, York.
ONCE again the NHS is about to have money thrown at it. This worries me for two reasons. One way or another, the money will have to be borrowed, and, as usual, no one will keep an eye on how it is spent.
Much of our NHS is already a management ‘basket case’, a situation which will never be improved by increasing the money available to waste.
Last year, I spent three months in hospital, either because of my heart problems or the resulting medication seemed to have caused my legs to stop working.
The first month was in an NHS hospital, and I still have nightmares about it. Some of the nurses were kind and helpful, but others were not. Bearing in mind that I was immobile, the doctors simply tried various medications, and most of the nurses stood by watching me trying to do things for myself, telling me that they were no longer allowed to help for health and safety reasons.
The NHS is simply too big to centrally manage, other than for things such as purchasing property, consumables, equipment, and medicines.
However, I know improvements could even be made in these areas after witnessing common sense proposals for ways in which to slash expenditure on drugs, whilst simultaneously helping patients, are ignored.
To effectively manage a hospital trust we need to ensure that the people involved are up to the task, starting at director level. On a number of occasions, I have seen the lack of experience and sheer incompetence of non-executive directors. They are often appointed from the ‘great and the good’ rather than being chosen for their experience and expertise.
This could be solved by making it clear to senior businesspeople about to retire that honours will only be awarded after a year spent as chair of a trust. The executive directors would not be happy as it would put their performance under the microscope, but that is what is needed.
The other change that is desperately needed is to ensure that the God-like senior specialists, who run most of the functions within a hospital, know how to do so cost effectively. Skilled physicians they may be, but managers they are not.
On the other hand, the General Practices could do with more central management, instead of being left to their own devices. Again, there are many excellent GPs, but they are not managers. Addressing the above would be better than throwing more money at a bottomless pit.