Monday, 5 July 2010

The National Health Service



We all know the Westminster government has promised to ring-fence NHS expenditure without affecting front line services.

However one hospital in England has decided it's time for doctors and nurses to be put back in charge of running it and dozens of non-medical bosses are expected to lose their jobs in the far-reaching changes at Wythenshawe Hospital in Manchester. They hope to save in the region of £17m.

The radical plan will see 26 departments replaced with nine new ones - each run by a senior medical consultant instead of a professional manager. The doctors will spend 20% of their time running their departments and 80% on medical duties. Interviews for the nine heads of department roles are already underway. Each will be supported by a nurse and a manager.

The move is likely to be a major test of the new government's health policy to replace managers with clinicians. The University Hospital of South Manchester Trust, which runs Wythenshawe, has already agreed a contract with Manchester Business School to provide management training for medics.

The NHS across Greater Manchester has been told to find nearly £1bn in efficiency savings and hospitals all over the UK will be watching this with interest.

This fellow blogger has some unexpected positive news about Scotland's NHS. Of course it's coincidence that Health Boards have reacted in this manner and nothing to do with preserving their own positions.


14 comments:

Macheath said...

Thanks for the link.

I think you may be right; these turkeys are voting for Christmas in the hope that everyone will be eating goose.

It'll be interesting to see how the Wythenshawe system works out - I suspect that success will depend on weeding out anyone who has a vested interest in seeing it fail.

John said...

O now have my medical details on a USB stick which hangs from my neck chain. It also has my advanced directive and not of the GMC re doctors actions at end of life. The stick has READ THIS on the case,
My luck - the hospital will be running mac and cannot read rtf!

wisnaeme said...

Aye I can see the logic of this but as to the substance of application competency, only time will tell.
Years ago we had a line manager of our maintenance dept who was good at what he did, considering he was an office wallah and expert pen pusher. But when I patiently and with forebearance took the time to explain the technicalities of a particular problem and the difficulties associated with remedial solution ... his eyes would glaze over with incomprehension and frankly, I wouldn't let him change the batteries in my torch. Nice man though he was. Now we have a line manger who has work himself up from the ranks of us teckies and it's bliss. He knows our teckie problems, been there and done it, so he has. ...and us lesser spotted teckies are nae bothered and left to get on with it as we see fit without the continuous harassment and interfearance from management jobs worth , beezy bodies.
It gets results when you get respect and job satisfaction, you know.
Aye and the heid sheds are pleased for they too are not immune when it comes to self interst and self preservation from upset money people and shareholders (stakeholders) that really do detest inefficiency and dents in their money management (profits).

Clarinda said...

After 40 years of experience in the NHS and not wishing to be accused of looking back through rose tinted spectacles, I searched for current hospital management systems that produced clinical and financial success.

The worst performing were those where clinical staff had been removed or marginalised from previous mangerial responsibilty and replaced by managers held to political account with very little uptake from clinical staff consultation.

The best were hospitals that elected their own clincal staff to the top managerial positions (often on a 2/3 year rotational basis)supported by a competent but streamlined management cohort. This model of hospital management used the direct clinical insight and authority of the professional staff to drive decision-making within budget with the necessity of having managers to support, advise and implement the day to day organisation and achievement of clinically-led managerial decisions. Politicians were important as external complimentary patrons but were not a direct driving influence.

The particular poisoned chalice of our own NHS will need years of antedote administered by competent medics and nurses - if allowed, as Macheath suspects potential subterfuge.

Dark Lochnagar said...

Rosie, we've got a muslim surgeon at our local hospital. He's a lovely guy but he is not going to operate in August because it's Ramadan and he doesn't want to operate if he's hungry as he might not be able to concentrate properly. He won't be too hungry to pick up his pay cheque of course!

subrosa said...

A pleasure Macheath. As we know the private sector has quite an investment in the English NHS, so they have a vested interest...

subrosa said...

John, great idea. By the way, Macs can read anything. :)

I've never heard of Macs within the NHS though.

subrosa said...

In my early career we had the same wisnaeme. Men (it was always men), straight out of college with no hands on experience, joining management and doing their best to disrupt the smooth running of the business with their ideas which only worked on paper.

Then women became involved and the system changed. Common sense was introduced. :)

subrosa said...

Wythenshawe will be of particular interest to you Clarinda and no doubt you'll watch the process carefully. As you say it will take some years before success can be measured but it's a step in the right direction.

subrosa said...

At least he's been honest DL. I wonder how many can't do their job properly during that time yet never say a word.

Gedguy said...

Maybe they should bring back the likes of Hattie Jacques as Matron. Democratic committees are fine for political parties but benign dictatorships, in the running of hospital wards, get things done.

subrosa said...

Nicola Sturgeon said she would reintroduce matrons into Scottish hospitals but we've heard nothing more. That would be a start though Gedguy.

Chalcedon said...

Ah, getting back to the early 60s and beyond when hospitals were run by medics and matrons and a handful of departmental secretaries.

subrosa said...

We won't get back to that standard of management Chalcedon, too many vested interests, especially in the English HS.

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