Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
NHS:the Blair years
- Rod Storring (21 May 2007)
-
Substance and spin in the NHS
- D B Double (25 May 2007)
-
NHS: the Blair years
- Neville W Goodman (25 May 2007)
-
Blair or Blofeld ?
- Alexander SD Spiers (25 May 2007)
-
Winston Churchill's N.H.S.
- GEORGE Y CALDWELL, Singapore 259858 (28 May 2007)
|
|
|||
|
Rod Storring, Consultant Physician 42 Felstead Rd London E112QJ
Send response to journal:
|
Polly Toynbee asks,as does the government repeatedly,why are NHS staff and voters convinced that everything is worse.The answer is obvious,and to do with the ever deepening frutration of NHS workers trying to do a good job,together with the endless experiences of patients who in a supposedly patient-centered and seemless service do not feel that their problems are even recognised,never mind sorted. I would like to suggest a remedy,a target no less,but only one. Each NHS Trust has an annual staff satisfaction survey.Many of these are poor,some are appalling. A commonsense thought would suggest that if staff felt that they were doing a good job,they would return a good staff satisfaction score. The single target for each Trust therefore that I would suggest,is an adequate staff satisfaction score.Not only would this improve patient care,but it would convert a top-down dysfunctional organistion which is today's NHS,into a bottom-up arrangement which will be more efficient,and therefore less costly.A further thought is that this arrangement could result in the Secretary of Health post no longer being seen as the short straw. Competing interests: None declared |
|||
|
|
|||
|
D B Double, Consultant Psychiatrist Norfolk & Waveney Mental Health Partnership NHS Trust, Norwich NR6 5BE
Send response to journal:
|
Polly Toynbee asks why NHS staff and voters think the NHS is worse despite the Blair record apparently being good.1 A problem is the way in which progress is reported to government, so that an overly positive gloss is presented rather than a balanced realistic perspective. For example, the National Director for Mental Health's report on the ten year progress on mental health care reform, although recognising that problems remain, did not describe any of these problems, except to suggest they often reflect previous neglect of the service before the last ten years.2 Instead an emphasis was placed on an increase in staffing, the increased use of the newer atypical antipsychotic drugs, specialisation of community services, the improved physical environment of acute wards and the reduction in national suicide rate. No mention was made of the fragmentation of services because of increased specialisation, the blame culture in mental health services, the need for training to make services more therapeutic and supportive, and the scandal of exporting difficult to manage psychiatric patients out of the NHS to expensive private care. Gordon Brown has signalled a shift from spin to substance in government with a priority on the NHS. How well health tsars deal with issues must be measured by more than presentation.
Competing interests: None declared |
|||
|
|
|||
|
Neville W Goodman, Consultant Anaesthetist Southmead Hospital, Bristol, BS10 5NB
Send response to journal:
|
I’m not sure what Rod Storring means when he says it is “obvious” why NHS staff and voters are convinced that everything is worse. Polly Toynbee describes the two big paradoxes: that overall satisfaction with the personal NHS is high, yet “the NHS” is condemned as failing; and that by many measures we are doing much better, but nobody remembers how much worse it was. So how is it “obvious”? One could say that the reason it is failing is that it is doomed to fail forever, because medical treatments advance and there will never be the resources. Anyone who thinks that the frustrations of the NHS, both the doctors’ and the politicians’, are anything new, should read Rudolf Klein’s “The new politics of the NHS”, now in its fifth edition. All Blair did really was to speed up the reorganisation cycle time. It is interesting that Toynbee concludes “Tony Blair leaves with the NHS as his Iraq on the home front.” Another angle on that is to ask to what extent Blair is held to have failed with the NHS because of Iraq, because one’s view of the man is forever tainted. Competing interests: None declared |
|||
|
|
|||
|
Alexander SD Spiers, Professor of Medicine (Retired). N/A.
Send response to journal:
|
I am no admirer of Tony Blair. Indeed, I believe that he is the worst Prime Minister that Britain has ever had and it is truly remarkable that he has held office for such a disastrously long time. If his ineptitude index (circa 80%) is multiplied by his ten years in office, yielding a disaster score of 800, his title as our worst PM is guaranteed beyond doubt. Polly Toynbee's article is a useful if brief review of the tribulations of the NHS between 1997 and 2007. She rightly states that things are not as uniformly bad as the press and Unison like to point out, and that some genuine improvements have been made. Her observation that "voters don't do gratitude" is very true indeed. Despite the slightly optimistic nature of her article, it is a fact that the NHS has been bedevilled by multiple reorganisations, a succession of incompetent Ministers, ghastly and costly blunders - for example in information technology, and the egregious habit of calling any change a "reform". Although the article is on the whole fair, the same cannot be said about the accompanying illustration. The PM is depicted against the background of an apocalyptic explosion. He appears to have triggered this with his mobile phone, and is overjoyed by the result. The depiction is reminiscent of Blofeld or other FIHS's (Fiends in Human Shape)of the James Bond films. One suspects that the picture is the contrivance of digital photography and does not represent a real event. This might be admissible for Private Eye, but certainly not for a distinguished scientific journal such as the BMJ. Competing interests: None declared |
|||
|
|
|||
|
GEORGE Y CALDWELL, General Practitioner 31 Balmoral Park, #18-33, Singapore 259858
Send response to journal:
|
Polly Toynbee gives much praise to Nye Bevan yet none to Winston Churchill. It was he who introduced the NHS Bill in 1943 with Sir Wiliam Beveridge's "Social Security Scheme". It was what he had always wanted. Sir Kingsley Wood at the time warned of the "open-ended" nature of the scheme and that it could be costly. Social Security and Industrial Injury and Sickness Benefit had always been uppermost in Sir Winston's mind since before the First World War though his Old Age Pension scheme of that time got hi-jacked by Lloyd George. Likewise did Aneurin "Nye" Bevan, who was Winston's lone opposition during his Government in the last war, get all the acclaim when the scheme eventually came into force in 1948. Indeed he encouraged patients to "go to their doctor and ask, demand" what they wanted. Cheaper by far if the Government then and now had just agreed to pay each doctor's bill for services rendered. Competing interests: None declared |
|||