Why the NHS cannot survive in itâ€™s current formâ€¦.
Over years the National Health Service in the UK has evolved into one of the best in the world â€“ and employs some fantastic â€˜front-lineâ€™ staff. However, it is in danger of losing that reputation. You only have to read the papers or listen to the news to be aware of the increasing criticism of hospitals and health authorities â€“ from both staff and patients. In the majority of areas, the NHS overspends each year â€“ or cuts various services in order to stay within budget â€“ and our nurses and doctors are becoming increasingly vocal about not being allowed to do as good a job as they would like to do.
Consequently, the NHS falls in to the trap of many businesses â€“ they over-promise and under-deliver. This is because the â€˜customer expectationâ€™ has never been managed, either by politicians currying favour or by senior NHS managers unwilling to stand up to the unrealistic demands of these political â€˜leadersâ€™. Instead, managers in the NHS just keep responding to demand after demand; demonstrating the same reactive performance traits of Zebras!
Unfortunately, these NHS â€˜leadersâ€™ are responding to two competing stakeholders â€“ politicians and public â€“ without them having defined one key component of any organisation, namely their Mission. When have you ever been told what you can expect from the NHS; what it will â€“ and will not â€“ provide?
Instead of leading their hospitals, they try to manage the increasing demands from politicians in order to appease them. These same political â€˜leadersâ€™ know they cannot afford the NHS but lack the courage to say so; as it’s never going to be a vote catcher. The NHS managers are also under pressure from the public, who view any new kind of medicine or treatment as their right.
To be really contentious, if we took all the emotion out of the debate and made it completely objective, then, based on finance alone, the NHS is not sustainable. Consider the facts:-
Less money going in with more and more money coming out â€“ what sense does that make? Imagine if this was your business – how well would you be sleeping at night?
The Local Government Chronicle Â quotes that “a number of NHS finance directors at trusts with overspends said the position was â€œpredictableâ€ due to NHS Englandâ€™s unrealistic assumptions about both efficiency savings and the volume of work they would carry out in 2013-14.”
Basically, the figures do not add up! Yet, we still have politicians espousing how they are going to put more money into the NHS – without ever saying where it is coming from. If it were down to accountants, I am sure they would put a stop to all medical research, as we cannot afford the outcomes.
Of course, when the subject is our health, itâ€™s difficult talking about what or what not to deliver, as emotion plays a significant factor. We all want the best health care for our loved ones and ourselves. But, is it not time we took some personal responsibility for that? If it was made explicit what was â€“ and was not â€“ available on the NHS then we would also know what we would need to get private medical insurance to cover.
Every new medicine or treatment found seems to be more and more expensive â€“ and is immediately perceived, by the public, as the â€˜right of everyoneâ€™, even though the NHS cannot afford it.Â For example, obesity is a pandemic of western society but, when the NHS was first introduced, did anyone imagine it paying for gastric bands?
To become sustainable, strong leaders need to define the mission statement of the NHS and then review the current â€˜offeringsâ€™, to see what should be delivered and to decide on what patients will now have to fund for themselves â€“ and it is no good waiting for any politician to do what they are, clearly, never going to have the courage to do! These leaders must show the strengths of the Rhinoceros in managing change. They must be focused, have determination and be resilient. They will also need integrity and not pander to the whims of vote-catching politicians.Â This contentious debate needs to happen as, financially, what the NHS delivers is not sustainable.
Whilst some may think it is too late for such radical reform, without it we do not have a sustainable NHS â€“ and we will regret it when it collapses.
Just a thoughtâ€¦.