Saturday, 27 March 2010

The manager will see you now?

Here in the UK you can tell we are in the run up to a general election as all three parties have suddenly become interested in the National Health Service. This is not because they want to improve patient care, for this they endlessly hamper by reforms. It is because they want to score points off each other in order to either, preserve their current position of power and privilege or, because they wish to acquire power and privilege.

Those of us grunts on the front line know whoever wins will not help us but will either, continue with their mismanagement of the health service or, will seek to change course and introduce more mismanagement via new “reforms” for the “better” using similar ideas to their predecessors but with different names and emphasis.

Medicine has changed by the introduction of new drugs and treatments but as GPs our job as doctors is still the same. We talk to patients, examine them, try to come up with an idea of want is wrong with them and either, treat them ourselves or, send them on to an appropriate service or consultant for their condition.

This process is largely unchanged and most patients will recognize this process. What has changed is the bureaucracy of NHS data collection and box ticking that doctors, nurses and any other health care professionals involved in treating patients have to record and submit from their consultations.

The data a healthcare professional needs to do their job is normally in the patient’s medical notes. However, managers are not bright enough to read or write and understand medicine so they employ healthcare professionals to extract the data and submit it to them in simple forms they can just about understand.

As the information these managers needs changes with each new "reform" for the "better", each healthcare professional is obliged to frequently learn new "skills", not to treat patients, but to submit information to managers so they can justify their largely futile existence in terms of healthcare to patients delivery.

We here at ND Central know that our patients want to see doctors and nurses, by enlarge, when they are ill and usually that is NOW, this minute. We suspect that if you surveyed people this is what they would want, and expect, the NHS to provide.

We were listening to a 12 o’clock news bulletin as we set off to do home visits one day this week having been in surgery working since 07.30hours and heard the following statistics on it which we repeat from memory.

Increase in NHS managers last year 12%.

Increase in NHS managers in last decade 80%.

Increase in consultants in last year 7%.

Increase in GPs in last year 5%.

Increase in nurses in last year 2%.

Compare that with our practice in the last 10 years:

Increase in managers = 0%.
Increase in nurses = 0%
Increase in GP = 1 GP but due to increasing list size we are still under doctored despite living in the hugely affluent parts of Northenshire.

We are still delivering healthcare with almost the same resources as 10 years ago. Despite huge sums of money having been chucked at the health service in the last 12 years by the Party we ask, where has it all gone and what has it actually delivered to the customers of the NHS, our patients?

Praise be to the Party who as ever are all wise. We are sure there is a survey saying that of a 1000 patients who were asked, “if ill would you rather see a doctor or a manager?”, 80% said they would rather see a manager.

How else can one justify these figures?

(Could not find link to news bulletin but a couple of links re similar figures are here and here).

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