A very concise summary of the appalling non-relationship between practising clinicians and government (thanks to Thomas Pascoe):
I gather that there is considerable anger among doctors at the policy reversal over the Liverpool Care Pathway, which has left them looking like murderers while senior management takes the credit. Those I have spoken to say that, rather than consult with or devolve decisions to doctors on the wards, NHS managers and senior politicians first imposed a policy on them and then hung them out to dry once The Daily Mail became involved. Decision makers surrounded by nodding SpAds who have only recently started shaving have been making policy in a vacuum, alienating those supposed to implement it.
Sounds about right. The above obviously refers to the bureaucratic and overrated “Liverpool Care Pathway” for dying patients – just what the medical profession needed, not. However it is probably even more applicable to the arbitrary, absurd and VERY expensive targets for waiting times for non-emergency, non-life threatening conditions, in which obsessing about a 9 week wait rather than, say, a 12 week wait has become the major raison d’etre of politicians approaching elections.
There are too many cretinous examples of this unsustainable policy to list here. Pascoe’s article also suggests the obvious solution, referencing The Knife’s favourite principle of subsidiarity, as an antidote to the Sovietisation of the NHS by desperate politicians and (some) managers:
When the Coalition came to power, they articulated a vision of subsidiarity which would have seen power devolved to the lowest possible level: not only between institutions of state, but within them. Policy formulation would always take account of the views of those closest to the action, as well as those taking a view of the strategic sweep. Once policy was made in such a way, it would give the lesser parts of the system the credibility to make suggestions to those higher up the chain. This excellent idea has fallen by the wayside.
The NHS is like the Eurozone, either we dismantle the inefficient, expensive and pointless bits proactively, in a planned way, or we sit around until disaster strikes. Which it will.