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No steady hand at the health service
wheel
• FIRST reaction, among many people, to the savage
job losses announced this week by the Royal Free Hospital
is to cast the blame on hospital’s board and its chief
executive Andrew Way .
Incompetence and maladministration – these are probably
the accusations many will level at the Free’s management.
How can a hospital find itself with a deficit, first announced
last August as £10 million, and now admitted to be well
over £30 million, unless there is something wrong with
the people running it?
The Royal Free’s management, of course, cannot be held
blameless.
Bearing in mind, that salaries are always the largest element
in the expenditure column of a balance sheet, a top heavy
tier of managers – many drawing excessive salaries –
obviously doesn’t help matters.
We warned about this last year.
But the root causes lie elsewhere – actually in the way
the National Health Service has been run since Labour came
into power eight years ago.
Instead of there being a steady hand at the wheel, the NHS
has had to endure one infantile shake-up after another.
So far, four ministers have had a go at it! Frank Dobson,
Alan Milburn, John Reid and now Patricia Hewitt – the
last three seen as incompetent meddlers by many doctors and
nurses.
There is little doubt the NHS was cruelly underfunded for
decades and that Gordon Brown tried to make amends by pouring
in extra billions. But, tragically, much of this has been
swallowed up in one hare-brained scheme after another.
Salary increases to consultants and GPs – making them
the highest paid doctors in Europe – may well have been
overdue, but was it necessary to pay GPs more than £100,000
a year and allow them to work fewer hours?
Targets for waiting lists may sound a good idea to a health
minister, who uncritically swallows everything Tony Blair’s
policy wonks come up with, but why didn’t someone ask
the first question a good business manager would want to know
the answer to – how much will it cost?
If they had, they would have seen the massive costs –
and run a mile.
Some waiting lists – but not all – did need to come
down.
But there were better, and cheaper ways of reducing them,
than simply imposing a blanket system for every hospital,
whatever its size and whatever its resources.
Instead of hospital trusts turning in on themselves and cutting
staff jobs and other forms of expenditure, they should have
the courage to publicly expose the real villains in this drama
– the government itself.
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