No change there, then

A few months ago I started subscribing to Roy Lilley's NHS Manager's newsletters. Insightful and critical I have enjoyed being stimulated by the debates he raises.
In response to his missive today I wrote to him and this is the gist of it....

20 years ago (yes 20!!!). I had a post as a Strategy Adviser for the local Health Authority – first of the new wave of commissioning jobs (funded by the pharmaceutical industry) set to redesign and build capacity in an over stretched and under performing service. Guess what – as a nurse I was marginalised, bullied and ignored. I wrote a strategy that the Public health team felt was “too innovative and radical” (it wasn’t but it did suggest that patients & families (we didn't call them service users then) might have a say in where and when they received their care) and the consultants felt threatened by a bright and innovative nurse. I am still angry about that job as it promised much but in the end I helped out in clinics and GP surgeries so I felt I was doing something to contribute to the service delivery. I still don’t think commissioners have any leverage on dyed in the wool technocrats who deliver services they way they always have cos that is comfortable and cosy. Sitting in clinic rooms behind a closed door helps protect you from the grim realities of living with  long term conditions, the employment issues, the housing conundrums and just the getting on with life issues that people face on a daily basis when they have less than £20. 000 to live on. Not enough bright and innovative practitioners are heard as it is threatening to hear service improvement/redesign ideas from “lesser mortals”....

I also wrote an essay about the challenges facing the NHS back in 1985 when a DN student in London reflecting  the issues around GP contracts, NHS Consultants and private work. There are so many anomalies in employment, procurement etc in the NHS it is truly baffling BUT not theoretical physics, or biochemistry – it is not difficult to get your head round, what could and should happen, it is just that the powerful professions won’t and can’t let go.

Politicians tinker at the edges and we have had a series of Health Secretaries that are worse than useless and one that has been ideologically unsound.

God help the NHS - if you want to read some challenging stuff then subscribe to Roy's newsletter. http://nhsmanagers.net/