Thursday 7 February 2013

Scotland's NHS - its 'No' future

The English NHS is in a mess and it has little to do with over worked and under staffed front line operations and a lot to do with political ignorance, vested interests (medical and Westminster) and ineffective management from the Department of Health downwards. 

There is no understanding by politicians or NHS management on how best to meet patients needs and expectations - their focus is always on their own wants of all sorts. I may want specialist treatment in my local hospital but what I need as a patient is care from a properly trained care team who have not just had to work 72 hours on the trot becuase of a shortage of 'Agency' staff. My expectation as a patient is I will be appropriately cared for within the context of my condition or illness which will be palliative or resolved. 

How do I know this?

Because I worked from 1996 to 2005, mainly within the English NHS, dealing with shit storms caused by the simple fact that patients needs and expectations were not being met. So much money paid out by the NHS on the back of complaints and litigation could have stayed within the system if NHS management and politicians would understand patient's actual needs and expectations of the NHS are clear and achievable rather than creating self justifiable political  wants as patient needs. 

NHS PFI is the biggest most costly failure for the NHS in meeting patients needs simply because its has no cohesion with so many responsibility splits between Trusts and the PFI contractors. Folk complain of dirty wards and suggest that nurses should clean them up, change beds, wash patients. Under a PFI contract the auxiliaries who change beds and clean patients may well be employed by the PFI contractor and if nurses undertake these operations they will face a disciplinary hearing. Likewise ward cleaning in PFI hospitals, this will be a sub contractor, on tight margins, training the minimum of his staff to deal with hazardous spills (blood, urine etc). This is why wards look 'dirty' because if one member of the cleaning staff throws a 'sicky' wards will not be cleaned that day. If it is one of the Hazardous spill cleaners blood could lie upwards of two hours before being dealt with. 

A nurse may well see a cleaner is not cleaning the ward as they think it should be but to lodge a complaint means a whole load of extra paperwork, a visit to a line manager which will take them away from an already over stretched ward team and end up with nothing changing because it is a different cleaner the following week. This is NHS England and the politically lead lunacy that is wrecking it. Is it any surprise that third year student nurses left on their own because of staff shortages or money saving rotas make mistakes in a system that is designed to kill their enthusiasm stone dead? Is it any suprise they end up cynical and bitter by their mid twenties? The nurses and junior doctors are trapped in a managed system that does not give a 'shit' about them or their patients - it is enough to demoralise any one. The problems with NHS England start in 10 Downing Street and all the privatisation in the world is not going to change that.

This is the future for NHS Scotland if the 'No' vote wins in 2014. A public health care system worse than the USA with equally as big inequality in care.

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