Posts Tagged ‘Leadership’

skeletal-debate

Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community.

Aneurin Bevin

The ability to provide safe, cost effective health and social care, across the National Health Service (NHS) England, and other recognised agencies, is continually being driven further into an abyss.  Contribution to this situation is seen through numerous factors: the change in societal expectations of what treatments should be available on the NHS; the historic failing of successive governments to create mechanisms within general taxation, and additional charging to facilitate the continuing demands on these services; poor leadership by the Department of Health-a direct result of short-termism and political ideology-cascading down to hospital management teams.  The private funding initiative (PFI) projects that have been demonstrated have a phenomenally catastrophic impact on patient care.  Outsourcing of services to the private sector which are integral to patient care, for example portering, and domestic services.  And more recently a drive, initiated through a shared myopia of government, and hospital managers, to blindly follow a culture of “more for less”, to name but a few.

Making savings ad infinitum with the objective of maintaining the same standards, is detrimental to an organisations ability to be efficient and sustainable.  Savings are a tool used by accountants to achieve short-term gains.  Whilst “Lean” working is a viable proposition in health care “lean” is not anorexic.  The long term effects of short term savings are to drive down standards, to force errors through the cutting of corners, and to cost the organisation dearly in the future.  “Speculate, you can’t accumulate, if you don’t”: true leaders in the NHS will see the value in this proverbial saying.

Hospitals are finding themselves in such financial dire straits, that with no apparent means of raising capital for investment, in the very basic infrastructure to make them viable propositions, under any  other circumstance they would be bankrupt.  It is possible to put a plug in the bath, even if it is a round(ish) plug in a square hole; and to at least turn the flow of the, money, taps down so they are running at a steady flow and not gushing.  But this requires long term policies, more freedom from government control, and leadership: not crisis managers.

It is time for hospitals to look at becoming shrewd financial investors; to speculate wisely.  If £25million in the red, to continue saving will only drive debt.  Speculate and invest to drive productivity over the long term, bringing the debt down.  If it is a system allegedly good enough for the government to implement, then why not Hospitals?

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Managers do not inspire doctors or clinical staff but good leaders do. NHS needs good clinical leaders.

Dr Umesh Prabhu

It is true, managers do not inspire doctors or clinical staff; it is also true that the NHS needs good leaders. 

However, even good leaders will fail to inspire the diversity of professional groups within healthcare, even though they share common objectives. Professionals, who with their own opinion toward hierarchical importance within the organisation, are but a barrier to progress.

Recognition needs to be given to the real and present danger within health care. One [danger] so great that the power it wealds will lead to the conclusion of the self fulfilling prophecy, based on the negative implications, of a failing NHS. This danger to healthcare, and leadership within healthcare, is the short-termism afforded to financial savings imposed by accountants, on the behest of others.

What is required, is for NHS Trust boards to be represented by members of all parties with intrinsic and extrinsic vested interested in the provision of healthcare, each with parity of voice. 

NHS Trusts must be empowered to raise funds: but not held captive by the shackles seen imposed through Private Funding Initiatives (PFI); to facilitate long-term investment. There is real truth in the addage, “speculate to accumulate”.

NHS Foundation Trust Hospitals are in a position whereby they no longer have the facility, ability, to progress.