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April 10, 2005
Political sleight of hand - Whitehall targets!
Our Illustrious Leader is always telling us that the NHS is the "envy of the world" and "getting better all the time under Labour". His other great claim is that his government have increased medical staff, increased funding. Yeah, right.
The truth is somewhat different, as ever when you have politicians and civil servants involved. Neither would know reality if it hit them in the face.
Yes, there are more Doctors and nurses in the NHS; the overall total of these "front line" staff has increased by 29% - mainly by employing doctors and nurses from developing nations to work in our hospitals. But, at the same time, extra "managers" have been employed to manage the targets set by Downing Street and to respond to the daily demands for performance reports and "achievement" reviews by the Department of Health and Downing Street's target-setting supremo! Gues what? The managers employed to do this are, at 41% increase in staff, well outstripping the increase in medical staff! The sheer cost of compiling the endless reports and devoting staff to monitoring these arbitrary and often draconian targets is actually putting patients' lives and treatment at risk.
There is a difference of opinion between the medical staff and the administrative staff on this, as well; the medical staff are appalled at the ploys they are forced to accept to meet targets, while the non-medical administrators claim that this is good management and that no one is at risk! Well, in several hospitals there are grave concerns among the medical staff at the use of surgical clinics to accomodate people from Accident and Emergency Departments - by moving them out of A&E you can claim to have met the target for patient "treatment" even if they haven't been treated - especially when they are used to accomodate people with infectious diseases! No wonder the numbers of people catching life-threatening illnesses after surgery is rising - but next this is also hidden by another management ploy - you simply do not record the infection as being linked to the stay in the ward or clinic! It becomes a "pre-existing" or, better, a "post treatment" condition.
One of Blair's key promises was that no one would be on a waiting list for referral to see a specialist for longer than nine months. That's right NINE MONTHS! Anyone out there still envy us the NHS? I thought not. Well, there is a simple way to meet this target; as you get to the eight-month point, you get a letter stating that your case has been re-assessed, and is deemed no longer urgent. You are then advised that you have been removed from the waiting list and that you should now see you GP for re-assessment. Surprise, surprise! You are no longer on the waiting list, the target has been met, and you are re-entered on the new list as a "new" referral. A "cunning plan" worthy of Blackadder's Baldrick himself!
We are constantly assured that this does not include anyone with "life-threatening" conditions - such as heart problems or cancer, but there are even more cunning ploys to ensure that they don't foul up the targets as well. You put them into a round of "assessment" and "re-evaluation" processes until nature has taken its course. Job done! Target met!
Since this shower of complete cretins took control of this country in 1997, the emphasis has been on target setting in all public services. The cost of this in real terms, that is in terms of time and money absorbed in an endless paper chase to show that you are meeting your "performance indictaors", is enormous - but it is concealed by Whitehall's dishonest manipulation of information. It is a hidden cost which is taking a huge amount of money away from the actual delivery of services of all kinds.
The obssession with targets means that management is focussing on disabled recruitment, ethnic recruitment, child care provision in the workplace, gay and lesbian rights, and fairness and diversity. Entire units are set up simply to monitor the target-meeting progress, and staff and managers find that more and more they are filing endless reports on the racial, gender, or disabled mix in their workplaces and not on actually managing or delivering whatever the service is. If Whitehall would allow access to the figures, I know that you will find that many of the "new" jobs being created in the NHS are filled by people from the "under-represented groups", very often at the expense of hiring people who are better qualified or more experienced, but who fall within an "over represented group".
I am a great believer in fairness and diversity, I could hardly be otherwise, but I most emphatically believe that everyone - and I mean everyone, irrespective of race, creed, gender persuasion, or whatever - deserves to be treated equally, but this also means that there can be no "target", and selection must be based on fitness for, and best skill set for, the job. This is no longer the case, and even though there are cases where the best person is the person appointed, under this slewed and biased regime of selecting to meet targets, those appointed are always going to be regarded with suspicion that they may not have been selected for their ability.
The truth of the matter is that Whitehall's targets, Downing Street's intervention in professional delivery, and the entire process of politically driven interference in all our professional services will, sooner rather than later, result in a serious collapse of confidence. No one believes a word the civil service says anymore; especially no one believes anything issued by Downing Street. Whitehall has become a Propaganda Ministry all on its own, and in particular, it has become the Minstry of Labour Misinformation. Well, we have a chance to correct at least some of this, hopefully the electorate will kick Blair and his cronies out of office, and even more hopefully, whoever gets into power will kick out all Blair's placemen in the various Whitehall Ministries and replace them with people who actually understand the jobs they are doing and the services they are supposed to deliver.
Faint chance, but we live in hope!
In the meantime, we need to get to work on calling the bluff of all these worthless "Health Service Managers" and expose their failures. Hopefully then we can rebuild the health service into something that actually delivers health care! Nine months wait for a referral to a consultant? That's pretty good, just getting to see your GP can be a three to four week wait! Let's see Blair sort that one out!
An Ice Age in Hell you say? Now that might just about do it!
Posted by The Gray Monk at April 10, 2005 09:38 AM
Comments
MB is so very glad she is not on the NHS, for the odds are very good, indeed, she would be dying right now - quite literally !!
Posted by: MommaBear at April 10, 2005 10:03 AM
You have highlighted the problem facing all our public services, not just the NHS. Whilst the New Labour lie machine goes into overdrive for the forthcoming election, I wonder if they can answer this question: Why can't I find an NHS dentist? The opponents of this odious regime must highlight the points you have raised and expose the terrible waste that goes on. I support the NHS as it has looked after me since I was born - and I want it to be there as I grow old.
Posted by: Slim Jim at April 11, 2005 09:15 AM