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NHS problems from the horses mouth

(111 Posts)
Racingsparrow Wed 16-Nov-22 12:50:11

Why is nobody listening to the experts.
This is a letter published in the Telegraph today

SIR – I’m a retired consultant, and I know that so-called managers have multiplied dramatically over the past quarter of a century.

Hospitals used to be run by the consultants, who are the only people with the knowledge to appreciate what is necessary in healthcare. The medical executive committee consisted of one consultant from each specialty, and it discussed what was necessary for the proper functioning of the hospital. Its decisions were communicated to the hospital secretary, who implemented them.

Now, the hospital secretary has been replaced with a CEO, who is in charge of countless other managers. This grotesque experiment in managerialism has resulted in huge increases in expenditure without any improvement in patient care, as these managers are not medically qualified. They are appointed in order to prevent doctors spending too much money.

Unless this is reversed, with consultants put in charge of all medical decisions, the NHS will collapse. The health service exists to diagnose and treat. Doctors do this with the help of nurses, physiotherapists and others. They do not need managers, whatever politicians might imagine.

Katie59 Sat 19-Nov-22 07:23:38

“I also trained 50 years ago and progressed to ward sister level. The demands and expectations of our nurses today is a far cry from the good old days you have alluded to and in many cases nurses are as skilled and expected to perform as junior doctors.”

In my case I trained 40 yrs ago, the job has changed for sure but it has changed so much that nobody wants to do it any more. As for junior doctors, give me an experienced nurse any day.

tattygran14 Sat 19-Nov-22 23:07:50

I worked in local government, many years ago. Drastic cutbacks were necessary, and several strata of managers were removed. We were at the coal face, and could see that it made no difference to the service we gave to the public. Saved lots of money though.

Grantanow Sat 19-Nov-22 23:24:59

The problem at Westminster is that politicians know the NHS problems can't be solved in the 5 year gap between general elections so Health Secretaries look busy by tinkering at the edges and engaging in re-organisations in the hope we don't notice they have achieved nothing of substance.

M0nica Tue 22-Nov-22 08:17:32

katie59 A doctor can only become older and more knowledgeable and experienced by first being junior doctors., learning on the job, and becoming more experienced.

If colleagues consider them a nuisance and cannot be bothered to help them get the experience and knowledge they need, the first people to suffer are their patients who end up be treated by inadequately experienced consultants.

Katie59 Tue 22-Nov-22 08:31:05

The issue is junior doctors thinking they know it all (particularly males) and havn’t developed the patient handling or diagnostic skills, more experienced staff have to help them do the job better.
It happens in all industries.

argymargy Tue 22-Nov-22 08:38:31

Strange thread title - that particular horse has been out to grass for at least 25 years.

I hate these threads where everyone piles on, in mostly total ignorance about how the NHS works. Over 90% of healthcare is delivered outside hospital so the idea that if you “fix” hospitals that’s job done is pure nonsense. And the “overmanaged” myth has been busted so many times. Yes it’s complex and antiquated and inefficient and under-resourced and we certainly wouldn’t have built it like this in 1948 if we knew how people would (over)use it now. But it is still free at the point of use and none of us ever has to worry whether we can afford to use it.

kittylester Tue 22-Nov-22 11:39:55

Except that it is often not available because there are too many people trying to access it.

Spanisheyes Tue 22-Nov-22 13:23:37

Yes, that was a brilliant programme. So sad that his ideas were never adopted.

tickingbird Tue 22-Nov-22 13:51:08

I once accompanied my mother to see her GP and took some unopened pills and syringes filled with anti clotting medication provided by the hospital. The district nurse was to call round daily to inject with said syringes. After a further ultrasound they deduced she didn’t have a DVT so didn’t need the visits or the medication. DN said it all had to be destroyed. I was horrified and showed the GP it was still in the sealed containers and hadn’t been touched. She said it was NHS policy and when I voiced my surprise her reaction was “don’t get me started on waste in the NHS, it sends me insane”. That was a GP aged approximately mid 40’s. They pay over the odds for almost everything and definitely have too many managers. It could be sorted out but nobody has the guts.

Grantanow Mon 28-Nov-22 18:28:24

It's quite clear that NHS doctors including GPs are either retiring early or emigrating in significant numbers to obtain better pay and better working conditions in Australia, NZ and the USA. They are not being replaced at even the same rate because the Tories failed to provide enough medical school training places over the past 12 years and because the idiot Brexit decision removes the freedom of movement that enabled European doctors - including specialists - to come easily to the UK to work. Now visas and paperwork are required and most won't bother.