Half of 10 000 NHS jobs that may be cut are clinical, survey shows

I find it hard to believe that the significant clinical cut comes as
a surprise. Despite the politicians silver tongued assurances that
frontline services will not be reduced, they remain significantly detached
from actual NHS work-force planning. Although the well intentioned
command has been delivered from on high, the powers that be have made the
instrument of their actions the very same managerial network they seek to
curtail. Surely it is unsurprising therefore that the cuts are, in
reality, hitting both the managerial and clinical areas equally.

In fairness one cannot truly blame the managerial staffs, who have
the unenviable task of taking responsibility for an impossible business
model. Providing the standard of care, our country has come to expect,
for an ageing and increasing population, with reduced resources is quite
frankly, impossible. And so it falls to the managerial staff to tackle
the impossible feat of making the NHS prosperous. As they have been
appointed to steer the clinical domain into a more cost effective machine
their first port of call is inevitably the clinical resources. Their
managerial instincts are to cut outgoings, not managers and so their
proposed cuts come from the front line services they feel, in their
limited clinical experience, to be less important to the general
population. In contrast the powerless clinicians feel that the managers
over inflated salaries are the problem and protest at such aggressive
clinical cuts. However, I fear both these opinions detract from the most
fundamental issue which is that the NHS as we know it is becoming
unworkable.

We must start to accept that the political and international
environment is making it increasingly difficult to offer a truly free
healthcare service. Patient's expectations of care are increasing. Modern
patients expect international levels of care, more expensive therapeutic
agents offered in other countries. They do not want to wait and are not
prepared to compromise on services they feel they are entitled to due to
their faithful yearly tax payments. In stark contrast hospitals are
struggling and are being forced to be motivated by financial and not
clinical incentives which do not lend themselves to optimal patient care.
This results in widespread dissatisfaction of clinicians, managers and
more importantly patients.

The cuts we see are just the beginning of what will be a catastrophe
for the NHS as we know it. Patient care will undoubtedly suffer from poor
staffing and increasing hospital errors, the start of which we have
already begun to see in the media. In addition services previously offered
will be withdrawn from business as usual leaving patients to suffer as a
direct result. Unsurprisingly patient expectations of the NHS are unlikely
to change and it therefore seems inevitable that there will be a
significant push from the public body to radically modify the way
healthcare is delivered.

Perhaps as clinicians we should not worry so much about the cuts to
clinical staff or the overbearing managers and start preparing ourselves
for the biggest shake up the NHS has seen since its creation. After all to
be foretold is to be forewarned.