MANAGING THE NHS

I was listening this morning to an interview with Amanda Pritchard who is the Chief Executive of NHS England and has been since 1^st August 2021. She was asked for comment on a joint statement made by the three main health think tanks in the UK, the King’s Fund, the Nuffield Trust and The Health Foundation, which said that the health service suffered from “insufficient resources to do its job, fewer hospital beds than almost all similar countries, outdated equipment, dilapidated buildings and failing IT”.

Amanda Pritchard

She did not make any comment on the matter. She did not even address the question and began with an upbeat message about the 75^th anniversary of the NHS and what a great thing it is. She also started her comments with the word “look”, as if to give the appearance or semblance of an answer to the question, being all chummy and down to earth, but is in fact a classic bit of condescension moving away from the question as if to suggest ‘that doesn’t matter, this is what matters’. She behaved like a politician, all the while suggesting “I’m not a politician, wages and funding is down to the politicians, I’m only the Chief Executive”. When it was suggested that she could put pressure on the politicians to resolve some of the issues causing the current difficult and possibly damaging industrial action, she again shied away from an answer. 

 

In the event she came across as ms pollyanna, speaking joyfully of planning for more trained staff in the future and generally looking forward. It sounded all very positive but was, in my view, merely a classic ministerial projection of neverland. She made no mention of the outdated equipment and dilapidated buildings and other basics which make it impossible for the staff to do their job. I do wonder just what the new trainees do, if they don’t have the facilities to actually perform the tasks they have been trained to do?

 

Look, she was, I’m sorry to say, all management speak. What can you expect from someone with a degree in modern history who served as a librarian of the Oxford Union, and, I’m guessing, after graduation, joined the NHS Management Training Scheme in 1997? Indeed, she has worked for the NHS her entire career. She has been in the system for over 25 years. So, you would have thought she would have developed some solidarity with the medical staff; however, that is clearly not the case. She is management and they are the workers. Her career path has been in support of management and hence in support of government (be it Tony Blair, Boris Johnson, Sajid Javid etc..) as opposed to the staff. Consequently, she will not be critical of government and mildly extolling the staff towards compromise.

 

What she should be doing is taking up the report from the King’s Fund, Nuffield Trust and Health Foundation and battering the Minister and government to deal with the failing infrastructure. Hospitals need urgent repair and maintenance. Hospitals need functioning and up-to-date equipment. Hospitals need the latest technology. Hospitals need the best and most efficient IT. Hospitals need staff trained to deal with the latest and best kit available. To train staff in, and with, crap facilities and equipment is counterproductive as they will have to be trained all over again. What reduces waiting and mistakes is effective efficiency. What makes efficiency effective is knowledge and training with the right tools. With effective efficiency you get savings and with savings you get more productivity. To get productivity you need the best staff, and to get the best staff you need to pay them accordingly. Corporations have been going on about this for years (The BBC is an instance in point – they claim they must pay high wages to keep the best talent).

It is not a difficult formula. Ms Pritchard, with her management skills developed over the last 25 years, should be able to push for that goal. There may be difficulties along the way, but the promised objective is in sight, surely, it’s just a matter of going there. Once again there is a lesson from Lawrence of Arabia. Think of Acaba as the ultimate NHS: