The NHS is the largest employer in Great Britain and the Conservatives’ number one political priority.
Since the inception of the NHS, over sixty years ago, there have been significant social, demographic and technological changes. Because of this, it’s important for health planning to keep pace with our rapidly changing society. Labour have reacted to changing health needs with a lamentable lack of urgency. They have lost all vision and relied on bloating the NHS with bureaucrats, like rain deluging a river forcing it to burst its banks.
Labour’s health legacy will be a litany of failures: billions of pounds of taxpayers’ money squandered on the white elephant NHS IT system; management by targets and tick-boxes that have distracted from patients; policies that tried to dumb-down both training and treatment; cancer survival rates amongst the worst in the developed world and an increase in health inequalities between rich and poor.
Added to that, the latest National Audit Office report highlights that only one hospital in England and Wales can offer full consultant cover in Accident & Emergency. The Royal College of Obstetrics and Gynaecology reported that over sixty per cent of maternity units lack full consultant obstetric cover. Sadly Labour’s love of administration has been at the cost of patient care. We can’t go on like this.
David Cameron has said “we will spend more on the NHS, but we will also improve it so that it is more efficient and responsive to patients. People working in the frontline will actually be able to get on with the job they signed up for, without getting tied up in a web of targets. And we will put more power in the hands of patients by giving them better information about the care they can expect to receive.”
That’s exactly right, and that’s why the Conservative Party’s draft manifesto on health has pledged to cut bureaucrats by a third and put patients at the heart of the NHS. It’s clear that only the Conservatives can remedy the centralised control that has come to constrict our NHS. Only the Conservatives have the vision, leadership and strength of character to bring the change we need.
( 15 comments ) Tags: bureaucrats, National Audit Office, nhs
Comment by NW Durham Voter on February 18, 2010 at 2:08 pm
Dr Tempest, a compelling and cogent summary of why we need change. You’re right to cut bureaucrats and put patients at the heart of the NHS (without losing sight of the fact that we still need a pool of capable managers).
Comment by Jeremy Thomass on February 18, 2010 at 3:01 pm
It’s significant that this is someone who has worked in the frontline of the NHS who is saying this. It shows why it’s so important to push the power to make decisions down to the professionals on the ground, who can make a real difference to people’s health and who really want to.
Comment by Steve Bell on February 18, 2010 at 4:05 pm
Well, what an insight in a few words which clearly demonstrates the failure of Labour and sadly the NHS.
We need more frontline Doctors working at the pitface to stand up and speak out.
Well done Dr Tempest
Comment by Jim Strutton on February 18, 2010 at 6:04 pm
I am commenting on the post by Dr Tempest as somebody who is scared to get ill and have to go into hospital.
In September 2008 I was taken poorly and called the NHS Direct Line for advice. I was quickly called back and advised to see a Doctor at my local hospital. I was asked if I needed transport but my wife was able to drive me there. I saw the first of many Drs that day very quickly, but from there on in things started to go down hill badly. Once I was admitted to A&E at the behest of the first Dr, things got out of control. First off there was no efficient way of transferring the data from the first Dr to the A&E department, so the whole case history was taken and written down again, key observations of the first Dr being missed out. I had a blinding head ache, and asked for something to ease the pain, I was told by one Dr that I would be given something, but it took three hours of asking before I got two paracetamol. I was told by one Dr that the scan showed I had not had a stroke, which was comforting as I had a chest infection, only to be later told that I was being admitted because they suspected I could have had a stroke. I was then given medication and transferred onto a ward where they then started to rewrite all the documentation yet again, but the icing on the cake was that in the process of this manual data transfer they noted that I was due to have medication and they tried to repeat the drugs I had been given some 45 minutes earlier. I refused to take them and had to get very insistent, so much so that they had to get a nurse from A&E up to the ward to deal with a recalcitrant patient, but the nurse then confirmed my version of events and said that I had had the drugs according to their records.
I would like to report a happy ending, but things continued to get worse. The ward was in a disgusting state, filthy floors and waste material on the ground. An elderly man in the adjacent bed was wandering around in a distressed state and covered in dried blood. All in all not a good position.
In my professional life I am used to going in and fixing broken businesses or helping businesses to grow. So I am very well used to questioning people, without them realising they are being quizzed. When the senior nurse came to see me to get me to undress and get into bed, I took the opportunity to ask a few questions. OK so it was very unfair of me to pin her down, but in the end she admitted to me that situation was bad, so bad in fact that the ward was Not Safe for patients. Which sort of made my mind up and I asked to be discharged, as on balance I felt I would be safer at home.
I had a discharge interview with a consultant, who really could not allay my fears. In the end when I presented my observations to him and asked if he would stay under those circumstances, he mumbled something and left quite sharply. The nurse who got me to sign the discharge papers said she could understand why I was leaving, as she was due to have left about 50 mins before herself, but had been there trying to make a difference.
The post script to this tale is that a few weeks later I ended up back in the A&E in a very poorly state again. Not through my own stupidity, but due to an adverse reaction to the drugs I was being asked to take for a ‘Stroke’. Fortunately this time I saw a very clued up A&E Consultant who immediately got very suspicious about my symptoms. He got me seen by his colleague a Stroke Specialist, who reviewed all the blood test and scan data and promptly told me that she did not want to see me any more. No offence she said but she only dealt with stroke patients and I had not had a stroke!
My relief at this point was tempered by the fact that I found out soon after, that I could not just come straight off the drugs, but they had to be tailed off over several weeks. In the end I had six months of hell, which maybe goes to explain why I stated first off that I am truly scared about getting ill and needing hospital treatment.
I wish that I could say that this was an isolated incident and that I was unlucky, but I have recent personal experience with both my sister and mother in law, getting less than satisfactory treatment and service from other NHS Hospitals. Going back a bit further I can relate the story of my own mother who got gangrene after an operation that was missed but the staff in hospital for over a week, despite her having a temperature and passing out frequently.
So this is not a new phenomenon, and it needs fixing urgently, not only because of the gross waste of money, but also because patients lives are at risk.
Comment by Tom I Balmain on February 18, 2010 at 7:17 pm
I do trust the conservatives will return the NHS to the patients rather than all the pen pushers and box tickers the NHS has at present. It is stupid that if you wish a doctors appointment in 6 weeks time they advise you to come back in two weeks because if they make appointment six weeks in advance it would upset the socialist government targets. Why not abolish all these trusts and give the money direct to the doctors and hospitals. With all the middlemen wiped out we could save money and even keep the same level of care but more would be spent on the patients. Its simple but those unelected civil servants will not allow it.
Comment by Steve Willis on February 18, 2010 at 7:48 pm
I’ve experienced listening to NHS managers sitting in 1st Class on the Bristol to London train discussing ward closures due to a lack of budget.
If there’s no money, why were they travelling 1st Class?
I don’t suppose the irony of the situation occurred to them.
Comment by Tim Kevan on February 20, 2010 at 7:21 pm
A great article Michelle and I echo other comments when I say that it is so valuable to have someone on the front line articulating the solution so clearly.
Comment by Sheila Roberts on February 21, 2010 at 8:24 pm
Dr Tempest might consider doing the job she has been trained for (paid by the taxpayer) instead of trying to become an MP. We do need experienced doctors, we do not need anymore MPs – we have far too many of them already.
Comment by Phillip Lee on February 24, 2010 at 11:45 am
A very interesting article Michelle. The real strength of your thesis is that it is based upon first-hand experience of working as a hospital doctor in the NHS. So, in response to the ill-judged comment by Sheila Roberts, I would draw her attention to the great need for healthcare policy to be shaped by those who have that professional experience, so that future decisions on healthcare provision are based upon a firm evidence base.
Comment by Jonathan Osborne on February 24, 2010 at 8:08 pm
My dad is stuck in new cross in Wolverhampton for 6-7 week but has a little stroke demenson. He had this now for 15 years. I have looked after him for 4 years. The hospital will not discarge him. The tell me that the social care is holding him in. Im sure the hospital need the bed. I like him to come back home as he has to home. His name is Harold H Osborne
Comment by Paul Matthews on February 25, 2010 at 2:26 pm
The NHS is highly inefficient with huge amounts of money wasted but I recall the conservatives saying they were not going to cut the NHS Budget (yet somehow they are going to reduce the national debt).
Well as a frontline NHS worker, let me outline some areas of improvement and areas for money saving.
1) Scrap the middle management!!! Why can’t my department managers report directly to the hospital boards rather than going through a middle man who is not even a health care professional and therefore has absolutely no real insight or understanding into healthcare provision.
2) Scrap the consultants privalidges, whether it is there prefered brand of tea and biscuits or there prefered brand of catheter, both paid for through NHS. Instead bring them down from their self created God status and use the most cost effective equipment (that means sainsbury’s basics tea and biscuits and standard equipment throughout departments rather than select equipment for select doctors).
3) Stop paying out so much compensation. In 2008 the NHS paid twice the amount of money in compensation than it did for drugs! What do people need compensation for? It is a free service, mistakes might be made but they were free to you to make and they will be free to you to fix.
4) Make doctors decisions more effective. If a patient is admitted to the Emergency Department with a query fracture of the ankle, do they really need an x-ray of the tibia and fibula and foot as well as ankle? No is the answer, apart from all these extra x-rays being a radiation protection issue, with each exposure giving the risk of cancer and other illnesses, they each cost money. One could have these young doctors more closely supervised by senior doctors. (In fact medicine should become a post graduate degree anyway!)
5) Stop dumming down the professions. We are wasting money on assistant health care practitioners or assistant radiographers. These people not only take away money from the fully trained nurses and radiographers but they need senior staff to supervise, approve or sign off work; this extends waiting times and affects quality of service. If nurses were to nurse it would improve the service.
Just a few tips to improve our broken health system.
Comment by John smith on February 28, 2010 at 1:13 pm
I totaly agree with Dr Tempest, but the whole tiers of Health Servicestructure and quangos needs to be cut and streamlined. It is like an inverted pyramid with the patient in the bed at the bottom. Excessive beaurocracy only leads to cushy jobs and inefficiency. I am surre that loads of duplication exists in the system which couls be eradicated by scrutiny.
Comment by jd on March 11, 2010 at 5:36 pm
I agree with Mr Lee entirely but as for not letting Drs choose their catheters (Mr Matthews). Thats where its all gone wrong, If I had worked at a speciality for 7 years plus, I would want to work with what in my “professional opinion” was the right one for my patients, and thats where its all gone wrong. Professional opinion counts and no I dont want a sainsburys basic catheter, etc I want whatever in The Consultants “Professional opinion is the right one for me and he/she has experience in using. Some people earn the right to priviledge and I have no problem in my tax being part of that provided with that priviledge comes responsibility and ethical behaviour. Consultants arent gods, but I want my life in their hands not the chief executive, not the PCT not even the Government. I want to be treated by the people who sat up night after night studying and when the chips are down have to own the responsibility regardless of the middle managers, Chief Execs, etc. Dr Tempest will hopefully be in the next cabinet then we can really see change!
Comment by Margaret Fairlie on April 4, 2010 at 12:21 am
Dr. Tempest.
You are a psychiatrist and therefore value and understand the need for effective communication. In view of this, why do you not respond to commments posted?
As a nurse I am very concerned re the downward spiral of the NHS. I want to enter in to dialogue with the Conservative Party about this. But there is nowhere to go! I am a voice unheard! I feel that my vote counts, but that I do not!
I find The Blue Blog very much a one way street and am frustrated by this! I would suggest you visit Medblogs and get in touch with real feelings out there. Or are you above this?
Nevertheless, kind regards.
Mags
Comment by rebecca millard on June 9, 2010 at 12:23 am
this is all well and good but the fact of the matter is tht if you are an english person in most city areas now unless you have driving license or passport cannot even access these services. i am dissappointed to be saying this but its true. my boyfriend has been looking for a doctor to register him for some 7 months now to no avail he is contantly told that he can not register because he can not prove who he is. this is pathetic if he can fall through the cracks of this service then how many are the same simply because they are english who dont drive and dont travel. i feel that something needs to be done we understand that some sort of system should be in place but when it is stopping people for recieving any service at all is it working.