#NHS To get rid of trust hospital culture, get rid of the internal market whose only function is to prepare for privatisation

the Sunday express headlines said “NHS starved 1165 to death”.
This is untrue.
It was the Trust Hospital System that killed them.
I can’t remember why the politicians claimed that Matron run hospitals failed and why we had to reform them.
There seemed little wrong with the model displayed in the “Carry on films” and there was little to indicate any public dissatisfaction with their “caring” aspects.

Private hopitals seem to be happy with this matron run model (http://www.nuffieldhealth.com/hospitals/our-experts/matron-led-care)

The deterioration in hospital performance and the creation of the blame culture has grown out of the attempt to prepare the NHS for privatisation and it was Maggie’s creation of the “internal market” ((http://en.wikipedia.org/wiki/History_of_the_National_Health_Service_%28England%29), which created the failing Trust hospital structure and which led to the present officially condemned culture and its lethal consequences.
Remember it’s not just the deaths inside the hospitals, it’s the deaths of those sent home from hospital, to free up beds.

By creating an “internal market” an extra non-medical administration was created.

Instead of a medico saying this, or that, needs to be done and getting the relevant department to do it, we have a medico filling in a form, overly mindful of the cost, asking that someone else schedule that that work be done and possibly being refused, because of budget constraints, by someone who has no concern for medical aspects.

Budgets and paper trails take precedence over the Hippocratic Oath.

Get rid of the internal market and budget led decision making.

The medico in charge of each department should be able to issue decree’s which affect patient care and the job of Admin/management should be to see that the decree is complied with. Budgetting is management’s problem and is secondary to welfare of the patient’s.

The main bane of all British organisations is the creed that management must be superior to “the help”.

The belief that some little twerp (too often public school with an Oxon degree in Classics) must be paid more than the Chief Engineer, Scientist or Surgeon.
Furthermore the twerp must have an intervening layer of management, also on better pay and with greater authority.
This needs to be remedied, especially in the NHS Hospitals.

Appoint a Medico in charge of each hospital with a prime directive of ensuring patient welfare comes first, unfettered by budgetary constraints. All medico’s should be directly under his/her control, not some intermediate non-medical person.

In all other organisations, the chief accountant is the second most important policy maker but subordinate to the main policy maker and he/she should give direction to non-medical personnel.

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