Wanless is Clueless?

Walk in Centres
A&E 4 hour targets
SHAs
Treatment Centres
Extra bureaucrats and Quangos

Out of Hours Privatisation
Financed via PFI schemes

Modernising Medical Careers and MTAS
Other hairbrained schemes like PBC/C&B
NPfIT/NICE/NHSDirect
Endless reorganisation of the PCTs and health authorities
You get the picture, where has our money really gone?

One could quite easily be forgiven for asking the questions 'What does Sir Dellboy Wanless know about healthcare?' and ' is this another example of the arrogance of those who believe that management and business somehow transcend experience and expertise?'. After all he is a banker (literally - not rhyming slang this time - Ed), and therefore has questionable insight into the danger of extrapolating his experience of bean counting into the measurement of health care 'productivity'. It isn't like the NHS has ever really experienced consensus based or expert lead reorganisation is it? So why is this precursor to yet more pointless organisational jiggery-pokery any different?

Obsessing with health care productivity becomes very similar to a cat chasing its own tail, in that one would be better off ignoring the tail and concentrating on other more pertinent challenges. Interestingly Sir Dellboy managed to ignore all of the above when reporting on billions wasted, very strange that. The pay issue is a convenient scapegoat for this political stooge, no one ever argued that paying staff fairly would increase productivity, it was simply about some kind of justice.

The woeful record on productivity comes about from the endless top down tinkering in the form of the internal market, PFIs, Choose and Book, Reconfiguration of services and management structures et al. This is nothing to do with staff, staff do their best under increasingly difficult and Stalinist circumstances. The top down control freakery in the form of endless targets is no way to improve productivity, it is a way to make political priorities more important than clinical ones, this is not progress.

The way to improve the NHS involves investing in the front line services, treating staff better by trusting them to make sensible clinical decisions, stopping this never ending drive to monitor and measure everything; after all when something becomes measured, you then change the meaning of what you are measuring, a principle this thick regime has never cared to grasp. Again no one has really thought what health productivity means, I strangely get the feeling that our controllers have no real interest in understanding these issues; they have only their selfish interests at heart.