What a question! Who knows enough about the NHS to be able to answer it?
I certainly didn’t, but I knew from the almost constant stream of newspaper articles that there were really serious problems with it. Furthermore, it was suffering from periodical ‘movement of goalposts’ as the result of political decisions that would make life difficult for any company.
300,000 more patients on NHS waiting list under coalition http://www.theguardian.com/society/2014/feb/13/patients-nhs-waiting-list-coalition
Hospitals must stop providing certain services or shut to sustain NHS – MPs http://www.theguardian.com/society/2014/feb/12/commons-health-committee-warning-hospitals-stop-services-merge-survive
NHS chief admits to dismay at Jeremy Hunt’s meddling http://www.theguardian.com/society/2013/dec/21/nhs-service-jeremy-hunt-malcolm-grant
NHS crisis talks over introduction of patients’ records database http://www.telegraph.co.uk/health/healthnews/10644864/NHS-crisis-talks-over-introduction-of-patients-records-database.html
NHS database put on ice http://www.telegraph.co.uk/health/healthnews/10647430/NHS-database-put-on-ice.html
NHS trusts in financial difficulty double in number http://www.theguardian.com/society/2014/feb/22/nhs-trusts-financial-difficulty-double-year
Shrink our hospitals to give better care, says NHS chief Sir David Nicholson http://www.telegraph.co.uk/health/nhs/10632226/Shrink-our-hospitals-to-give-better-care-says-NHS-chief-Sir-David-Nicholson.html
Stafford hospital to be sentenced over poor care of diabetic patient who died http://www.theguardian.com/society/2014/feb/21/poor-care-diabetic-patient-died-stafford-hospital-details
I knew the NHS only from the viewpoint of an occasional patient, and thought it was high time that I found out more. I started here:- Can Gerry Robinson Fix the NHS?
After watching that, I was, quite frankly, horrified! However, I now had a starting point.
One of Gerry’s tenets is that “Any business, no matter how large, can actually be made to work well.” I wholeheartedly agree with this, but there have to be some provisos.
a) To be able to manage anything properly, we have to understand it completely. There is not the ghost of a chance that a politican would be able to do this. The requirement then is to run the NHS purely as a business, and take politics completely out of it.
b) It is not possible for a single person to assimilate all the data necessary to do the job. It needs a dedicated, structured, management team, headed by a responsible executive of proven ability. (Not a politician in sight here either).
c) Medium and long-term healthcare goals must be set, and plans developed to achieve these goals. Both goals and plans must be agreed at all levels of the NHS, or they will come to naught. (Politicians need only get involved to agree goals, and nothing else.) Don’t underestimate the workload for this requirement – it is a mammoth task!
d) In the interest of overall cost reduction, the purchasing system must be completely reviewed:- “The NHS should be doing more to harness its vast purchasing power to bring down the cost of buying drugs and medical equipment, from swabs to replacement hip joints. Yet last week, a Telegraph investigation revealed that pharmaceutical firms appeared to be rigging the market in so-called “specials” – prescription drugs that are largely not covered by national NHS price regulations.” (Extract from ‘Sir Gerry Robinson: Tesco could really teach the NHS a thing or two’, http://www.telegraph.co.uk/health/healthnews/10141241/Sir-Gerry-Robinson-Tesco-could-really-teach-the-NHS-a-thing-or-two.html
e) Again, to reduce costs, the use of agency staff and locums should be kept to an absolute minimum by efficient planning. To understand why, see:- “Doctors paid up to £3,000 a shift, official figures show” http://www.telegraph.co.uk/health/healthnews/10641189/Doctors-paid-up-to-3000-a-shift-official-figures-show.html
f) Increase efforts and funding for prevention rather than cure. We already know that obesity, cancer and diabetes are increasing at alarming rates, and it is surely better to adjust lifestyles to effect a reduction than pay the increasing cost of continuing treatment.
“One year later, Gerry revisits Rotherham to see how they are coping. What he finds both surprises and delights him. The hospital is now run efficiently, waiting lists are down and staff relations are excellent.
But there are clouds on the horizon. With government policy encouraging more out of hospital care in the community, what is the future for the hospital?
Gerry takes a long, hard look at what is planned for the NHS and asks whether it really adds up and whether it will really deliver the change the service needs to face the challenges of the coming years.”
“So should we be recruiting our next leaders from Tesco? Absolutely. You should certainly look outside the NHS. You don’t have to have a medical background to manage it.”
And there you have it, albeit rather simplified. This could be a very well-paid job!
If you are interested in reading further, search for “Gerry Robinson on… fixing the NHS: lessons learned”