Let doctors fix the NHS

November 16, 2006

Clinician led management can fix the NHS, argues a senior doctor in this week's BMJ. He calls on the government to let clinicians and managers plan and run their services free from political control.

Senior medical professionals are often branded as opponents of reform, writes David Flook, Consultant General Surgeon at the Royal Oldham Hospital. But most medical personnel support changes, they just oppose "the cynical, superficial reforms through which politicians have exploited the NHS."

For instance, he condemns the "fraudulent claims" by health ministers that initiatives such as the "two week wait rule" have contributed to the recent modest fall in cancer deaths, and argues that fast track referral prioritises the worried well at the expense of the target population.

And he questions how patients can make a meaningful "choice" of who treats them from the vast NHS array. Was not personal referral to consultants by a GP preferable to the current lottery?

Other examples of subtle misinformation abound, he writes. The reduction in accident and emergency waiting times achieved by one recent initiative is hailed as evidence of improved performance. But this overlooks the sometimes dangerous means by which this goal was achieved, such as the premature transfer of acutely ill patients to almost anywhere outside A&E.

For strategic planners, the evidence suggests that they recognise the problem but choose to cut corners in service provision and avoid any political upsets, he says. And the problem for NHS managers is that politicians have replaced doctors in priority setting. "Managers are now no more than foot soldiers implementing the latest vote-winning initiative and I have seen no evidence that management consultants do better at even greater costs," he writes.

Even good managers can only make the NHS safe and fair, if freed from political control and willing to prioritise in accordance with guidance from the staff who treat the patients, he concludes.
-end-


BMJ

Related Argues Articles from Brightsurf:

Politicians and governments are suppressing science, argues The BMJ
Politicians and governments are suppressing science, and when good science is suppressed, people die, argues a senior editor at The BMJ today.

Human intelligence just got less mysterious says Leicester neuroscientist
NEUROSCIENCE EXPERTS from the University of Leicester have released research that breaks with the past fifty years of neuroscientific opinion, arguing that the way we store memories is key to making human intelligence superior to that of animals.

Editorial: US healthcare must take a more proactive approach to prepare for future disasters
The COVID-19 pandemic has revealed major deficiencies and inequities in the US healthcare system, shining a spotlight on improvements that must be made to steel the country for future disasters, argues Maia.

Government should address climate change, health and taxes as one issue
Protecting our climate will protect health, and implementing evidence-based policies that consider action to meet targets on global warming, the economy, taxes and health together should be a priority for Canada's government, argues an editorial in CMAJ (Canadian Medical Association Journal).

Healthy brain development is a human right, argues Yale researcher
We know that the environment in which children and young adults are raised influences healthy brain development.

Access to medical cannabis must be improved, argue top doctor and mother of Alfie Dingley
Despite a change in the law last year, access to medical cannabis in the UK has been much slower than patients and parents had hoped, warns an expert in The BMJ today.

Retain UK healthcare as a primarily publicly funded service, argues leading doctor
In The BMJ today, she argues that a mixed public-private healthcare system 'ultimately reduces the effectiveness of healthcare for everyone' and says 'it makes sense on grounds of equity, effectiveness and cost-efficiency to retain UK healthcare as a primarily publicly funded, delivered and accountable service.'

Should doctors work longer shifts?
This week, The BMJ looks at the issue of working hours and burnout among doctors.

WHO decision to downgrade Tamiflu 'comes far too late' argues expert
The World Health Organization's decision to downgrade the influenza drug Tamiflu on its essential medicines list is better late than never, but still comes far too late, argues an expert in The BMJ today.

Children's Hospital Colorado research argues for use of medical homes in pediatrics
New research from Children's Hospital Colorado (Children's Colorado) argues strongly in favor of the redirection of public funding to invest in improving the use of patient centered medical homes for children with public or no insurance.

Read More: Argues News and Argues Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.