One of the leaders of the British Medical Association has described the NHS IT programme as “the worst case of planning blight across the NHS” and called for it to be ended.
Speaking at the BMA’s Consultants Conference, Dr Jonathan Fielden, chair of the BMA’s Consultants Committee also said it was time for the health service to wean itself off failed, expensive government policies, commercial contracts and management consultants.
“When MPs regain probity, regain trust, then perhaps they can join our crusade to further improve healthcare; until then don’t stand in our way,” said Dr Fielden.
Earlier this week, the BMA launched a campaign to “save” the NHS from “commercialisation”, saying it should remain “publicly funded, publicly provided, and publicly accountable.”
The campaign includes a website on which NHS staff can sign up to the campaign and contribute examples of market reforms that they feel have cost the NHS money or harmed patient care.
At the Consultant’s Conference, Dr Fielden said hugely wasteful Private Finance Initiative and Independent Sector Treatment Centre (ISTC) deals should be scrapped. He also that private management consultants should be “ditched” and that the health service would do much better to rely on the experience and expertise of its 1.2m staff.
“Ditch the management consultants – when we have to tell them how primary care works, when we see them flogging our ideas there is immense frustration that we are not utilising the great talents across the NHS. We have 40,000 hospital consultants, 1.3 million employees, 250 ‘top leaders’ - surely we can utilise the talent we have?”
Dr Fielden said the value of electronic patient records had been established, but that the National Programme for IT in the NHS was taking too long to deliver them. “At what stage do we cut loose from this spiraling disaster?” he asked.
“It is thwarting local chances to move forward; the worst case of planning blight across the NHS. Let’s free hospitals to move forward. Keep the ‘national electronic super-highway’ but free trusts to go their own way. It will be faster; it will deliver for patients, meet the needs of clinicians and produce another massive saving.”
Dr Fielden also argued that the BMA’s Look After our NHS campaign was vital given the growing public sector funding crisis that is set to trigger cuts and savings in the health service.
“For the first time in working memory, we may see real cuts in health spending,” he said. “This will provoke some stark choices: what is kept, what is cut, what can the NHS afford?
“Let’s ensure that it’s doctors making those difficult decisions in partnership with our patients and healthcare colleagues, not faceless bureaucrats, accountants, and those out to fleece the taxpayer.”
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doctors, management and the BMAunknown 310 weeks ago
With a few notable exceptions, in my years in the NHS i have found doctors respectful of the role and abilities of mangement, and vice versa. Where that respect has been absent, organisations have rapidly disolved into crisis
Sadly the same cannot be said of the doctor's trade union, the BMA, who appear to be constantly sniping and unhelpful, and denigrating the contribution not only of management, but of nurses, allied prefessionals, patients bodies and government.
mind you, if i had their negotiating skills, maybe i would be a richer man...
us and themunknown 310 weeks ago
As an IT professional within the NHS, (and I have studied other models), I do think that the Internal Market is very harmful to joined up and seamless care, and the continuous churn of NHS organisational structure also squanders significant money, clinical and management time far better spent improving patient care.
But, I also find particularly primary care one of the key conundrums and challenges here. Most GPs are dedicated to their patients, but quite a few are grasping opportunities to set up companies, to take over services run by NHS employees, and generally to actively promote the Internal Market so long as they personally gain. So I'd welcome the introduction of salaried NHS GPs, Dentists, Pharmacists and Optometrists.
And at the same time as PCTs go to extraordinary lengths to split commissioning and providing functions, GPs seem completely immune to such calls to probity.
Not sure how Marvin above can call for unity at the same time as apparently failing to recognise that General Managers often work very hard to reduce the impact of political and often illogical policy dictats, and to keep local organisations funded and going forwards.
I have deep respect for the clinical judgement of clinical colleagues. If we could ditch the management consultants and rely on primary care clinicians as full NHS colleagues, a 'market-free' NHS might be possible. Were the BMA calling for that ?
There's no need for 'us' and 'them'!MarvinLittlewood 310 weeks ago
As representatives of Doctors' views, the BMA has called for change. Why turn round and criticise the very people without whom, and without whose clinical colleagues the NHS would not function and arguably without whom, this country would not have a as good a service as it has now.
I don't think many would argue that the benefits of general management for the NHS are obvious. Fewer still would argue that it is blindingly clear that the internal market and the model of running the NHS like a business has been particularly effective either.
Clinical practitioners and management have differing skills. Both sides should respect that. What is needed is for both to work together to make best use of resources. The most effective way forward is to focus on using feedback from patients and staff to develop better ways of working, supported by decent IT. This is the model put forward by many QA practitioners.
Let's focus on working together - especially at the outset of a time of prolonged financial stringency.
Nationalise GPsunknown 310 weeks ago
In my opinion the NHS would get better value of money if GPs were required to be NHS employees rather than independent contractors. This would save the NHS significantly.
Do I say this to the press? No. Why not? It's not really my area of expertise.
Trust me, I'm a doctorunknown 311 weeks ago
Quote: “This will provoke some stark choices: what is kept, what is cut, what can the NHS afford? Let’s ensure that it’s doctors making those difficult decisions in partnership with our patients and healthcare colleagues, not faceless bureaucrats, accountants, and those out to fleece the taxpayer”.
Yes, absolutely. Because as we all know, doctors are completely independent observers here, are capable accountants themselves who can assess affordability and make difficult management decisions, are most definitely not out to fleece the taxpayer, and are clearly not faceless (is this a medical condition?).
Exactly how will doctors engage with their patients in making these difficult decisions about what the NHS can afford? Individually, as part of their 1:1 consultations? In group discussions perhaps? And how will the results of these discussions be fed into practice/hospital/trust/SHA and national decision-making? Think it through!
This is just shallow spin of the worst, self-interested, self-righteous kind. It does nothing to help address the very real problems and challenges we face every day, month and year but which are brought even more sharply into focus by pressing economic realities.