Clarinda is one of my readers who has a vast understanding of the NHS and its systems. I thought her comment on my earlier post showing the above graph may be of interest to those of you who haven't read it.
I suspect that despite our professional health care staff running ever harder to sustain what they can in terms of patient care (there are still remarkably good examples of the original principles of the NHS around) it must be so demoralising for them to see their best efforts in the face of incompetent managemnt and political decision-making resulting in the blame being laid at their door and not that of the real culprits. Perhaps this factor is a little similar to our armed forces being so professional in their duties with such poor equipment and dreadful political decisions overwhelming their potential?
I suspect that if you question a random group of doctors and nurses they will tell you in a blink where the money has gone - the transient, incompetent and oppressive deluge of management that has been politically imposed since the mid 70s which now accounts for the greatest spending explosion since the NHS began.
Management in our public services has become one of the largest growth employment rackets fueled by political interference and subjugation over the once respected and effective services once run by experienced health professionals. Patient care is also reliant on the 1000s of other health care Professionals Allied to Medicine (PAMs) who are also at the wrong end of managerialism.
Billions have been wasted on untried, experimental change, re-organisation, IT white elephants and 'modernisation' i.e. faffing about with non-clinically relevant or beneficial paper initiatives with the predictable consequence (inevitably foreseen by the doctors and nurses but brushed aside by management) of falling standards of patient care.
Training places for doctors have been cut and their training experience truncated - which are both predicted to become even worse in the next two years. Yes - salaries have improved - but if there are fewer trained/training doctors around - care and patient safety will suffer. The EU Working Hour Directive has further inhibited the potential of doctors to achieve requiste standards of experience and good practice. Many Consultant positions have been dumbed down to account for the lower quality and quantity of medical practice but this lower qualified position of Consultant grade allows the government to claim there are more Consultants! Yes, there may be but not as we once knew them!
The statistics, in their defence, are not comparing like with like when the origins of their data are considered. The USA may appear to have better cancer survival rates but this may be due to the omission of 1000s who die from cancer due to their lack of health insurance to access early diagnosis and treatment. What effect has our own 'health tourism' and immigration had on UK statistics and over-stretched services. Many arrive with advanced disease and disability not then ammenable to early diagnosis and effective treatment resulting in unavoidable death or chronic disease managemnet costs.
These graphs should propel us to demand a stop to politically motivated and managerial interference and return the NHS and many of our other public services to the respected and capable authority of the professionals whose expertise is currently marinalised by incompetent and costly managerialism. Of course the NHS needs managing - good managing!