Following the Maidstone & Tunbridge Wells NHS Trust debacle last week, it seems there is a bad situation developing in Wales, according to THIS BBC report. People need to be careful not to tar all hospitals with the same brush, but one thing is becoming clear, and that's that NHS management is failing. If managers are not able to implement proper cleaning procedures it is only right to ask what else they are getting wrong. The NHS is one of the world's largest employers - second only to the Indian army, I read somewhere. Reforming it is like turning round an oil tanker. Successive governments have tried and failed, partly because few politicians have the courage to admit what we all know - that it's a 1940s national structure, trying and failing to meet the demands of twenty first century healthcare. It seems to me that there should be national centres for some treatments, but apart from that, the NHS needs to be broken down into much smaller units. You cannot run an organisation employing more than a million people centrally. At the moment you have the worst of all worlds, with national, regional and local administrations burdening people at the coalface with daily demands, targets and bureaucracy.
The other reason the NHS creaks is because no one will own up to the fact that it cannot meet every demand placed on it. When it was created it was meant to provide a comprehensive system of healthcare. No one envisioned to the medical advances that would be made. No one predicted that we would need a body like NICE to ration the provision of drugs. Certainly no one would ever have predicted that the NHS would take up around a sixth of government expenditure.
But it's this expenditure that has proved to be the essence of many of the NHS's problems. Since 1997 expenditure on the NHS has more than doubled, yet the outcomes are nowhere near what one might have predicted with such a rise in funding. Ok, much of it was spent in salary rises for nurses and doctors, but one might have expected at least a 25% increase in productivity. Instead, what we have seen is a target culture which has led to a huge increase in false prioritisation within the NHS. Everything is about patient throughput, rather than patient care. And, I am afraid this brings us back to where we started. Dirty hospitals are a direct result of these false priorities.