The management bubble that won’t save the NHS
So, just one in every three staff working at Royal Cornwall Hospitals’ Trust would recommend their friends work there.
However, staff morale was worse but ignored at Mid Staffordshire Hospital as they strove for Foundation Trust status, but left a litany of poor care and avoidable death on their wards. The new Inquiry report produced by Robert Francis QC showed that wards were trying to cope with too few nurses.
My Health Select Committee cross-questioned the learned gentleman this week. I wanted to get to know whether he believes it was poor quality rather than an insufficient quantity of nurses that was the problem.
A raft of reports have carpeted nurses for being uncompassionate, ‘too posh to wash’ and other less favourable judgements. However, observed from close quarters most people quietly admire their capacity to take responsibility for an unfeasible workload of acutely ill patients, to tolerate the absurd micromanagement of tick-box targets, to calmly complete encyclopaedias of forms every time a patient moves to/from the ward or to fill a detailed incident log if a patient so much as burps, in case an ambulance chasing lawyer seeks to litigate.
The Mid Staffs report stops way short of understanding the lot of the registered nurse, but instead hangs them out to dry to be picked on by media and politicians seeking scapegoats and to apportion blame.
The Mid Staffs report retreats into a froth of management babble. We’re told hospitals need to “foster a common culture shared by all” with “a relentless focus on policing compliance”, “strong leadership” and “openness, transparency and candour”. A list of unarguable platitudes which justify the time and money spent on the report.
The NHS has become a victim of management consultants who arrive with eye-catching initiatives and a glossary of new phrases to create the smokescreen behind which poor standards can flourish. For every “new ways of working” or “pathways of care”, there’s another service cut or a battalion of lowly paid nurses re-graded onto lower bands of pay to do more work.
Rather than yet more mumbo jumbo, what the NHS needs is practical solutions, such as: a safe ratio of registered nurses to patients on hospital wards; training and registration for care support staff; and a post qualification period for junior nurses onwards, just as junior doctors are eased in before being left to fend for themselves.
I’ve discovered a new campaign slogan? “DOWN WITH PLATITUDES: UP WITH NURSES!”
Take Andrew George MP’s 2013 survey here, and let him know your views on the NHS, paying for care, regional pay and other matters. You could win a hamper from the House of Commons shop too.