By Steve Carne, Oct 17 2017 11:02AM
NHS managers are ecstatic at the thought.
After yet another three day inspirational training course (there are many) in "realigning the mindset", they can do it! Corporate thinking managers are now to be the saviours of the NHS.
Yes! More top level managers and business consultants that's what we need. Never mind the shortages of nurses, doctors, GPs, paramedics, all clinical staff! Who needs them moving forward in the new 5 Year Forward View preventative, digitally driven, "look after yourself cos it's your bloody fault" going forward NHS?
Never mind the Art of Caring, the vocation of nurturing and supporting another human being. Suck that! That's so 1948. According to the guys'n'gals in suits, facing the challenges of the 21st Century means participating in a lean healthcare system , cutting away the fat, the gristle, cutting to the bleeding bone, slicing away every ounce of "waste" - including, it seems, patients and frontline staff. Everything is better done at a bed near your home, preferably even in your home - assuming you actually have one.
Promoted by USA West Coast "experts", who can spout endless Toyota Car Factory bollocks at the drop of a million pound bank deposit, NHS Managers have now been enthused by the rescuing of the NHS by more efficient business ethics. Non-clinical amoral business ethics. The hippocratic oath has less and less to do with the modern chrome-edged shiny sparkling NHS of the future! Suck morality! That's so 1970s. What we need are Doctorpreneurs.
“Markets are systems without any innate sense of ethics or morals. It is the people within the systems on whom moral duty rests.” Erik Sherman (USA journalist)
No kidding Erik! Top NHS Managers are now shining false beacons, leading the way down digital dark paths to the future where none of us need a hospital, a GP, or a nurse. Forget having to go to hospital to be met by such wasteful things as a nurse or (god forbid) a doctor, we just need a smartphone app and personal confidence to know that everything will be fine with a glass of water and an algorithm.
There will of course be a new smiling less qualified less paid workforce (in lovely private company logos) to support you on your yellow-brick road health pathway. The USA job role Advanced Nurse Practitioners - a very good supportive role but not a replacement for consultants - are a much cheaper workforce. Nursing Associates the same. Leaner and cheaper. The NHS Future is bright. It's red white and blue with spangly stars and a glistening profit margin...
One bright spark, noble and cuddly Sir Bruce Keogh, actually said "people like going to A&E and obviously we've failed in that regard" (watch the video). Yes! damn those bloody nurses, doctors plumping cushions and making cups of tea for those who fancy a quick social visit! The 21st Century ageing population with complex needs and too much fat, are a nation of change-fearing, attention-seeking, moaning old gits who bounce, wobble and zimmerframe into A&E wards every winter to have a natter and be urgently treated causing yet another 'crisis'. So let's solve that. Cut the number of Accident & Emergency Depts by half! See where they go then! Yes that'll sort out the whinging old fat mad bastards! "And if they still insist on turning up at all hours we'll ban them!" says Jeremy Hunt, Secretary of State for Health. Well pub landlords do it.
It is this honoured 2013 morsel of no-evidence base wisdom that is now accepted and promoted by those waving the Lanterns of Transformation on the troubled waters of our nation's pride. But lo and behold up pops Sir Bruce de Fucquitter in 2017 saying he’s very worried about the dreaded “winter crisis” because of the demands on A&E - well he recommended getting rid of half of them what does he expect?
Anyway back to the near-the-top aspirational managers... You can’t underestimate the workings of the business empires as they eat their way into all our public services through the lobbies of parliament and the corridors of our NHS. They have to because corporations themselves don’t produce anything worthwhile. They’re not in the business of producing, they’re simply managers. Takers. Controllers. Consumers of our public money. That’s all they have to go for.
Like the shameful Wreckers of coastal Cornish past, smiling business consultants are waving their smartphone flashlights on the shore, shining false hope into NHS Managers eyes and leading them (and us) crashing onto the rocks. Far from saving the good ship NHS they are about to smash it, crack it wide open and collect the goods inside - because (like wreckers) they know the loopholes in the law and NHS Constitution. Leaving an empty shipwreck. Behold the new lean corporate led NHSDIY.
Is there any hope of resisting the lanterns' light? Steering clear of the rocks? There just might be if those near-the-top manager followers can reject the cult-like appeal of Transformation. It’s insidious in it’s happy-clappy 'think positive' approach and managerial compulsory happiness. It’s very difficult to criticise even with a simple honest question raised in a meeting can lead to the whole room thinking you are the most negative and therefore destructive individual who will let the team down “moving/going forward”.
Well recently the Wreckers overstepped their mark, they hauled the unsuspecting NHS Managers into a safe haven and, after berating them for failure,began demanding their participation in a West Coast USA style team building exercise - positively (bonkers) chanting "WE CAN DO IT" whilst waving their hands about like demented baboons.
This has proven too much too far for even the most enthusiastic private health promoting social media pundits, the top NHS Managers who seem to have suddenly seen a few jagged rocks ahead of them. This has shocked a few but not enough yet to fully appreciate the danger they, and we, are in. They haven't yet understood who is waving the Lanterns of Transformation. And why. Hopefully, once they realise that campaigners are not the enemy, that will come. Sometime very soon we hope
Time for some Proper Positive Thinking...