Tory Health Policy
‘Health secretary Andrew Lansley has just spoken to more NHS managers than he will ever do again’. So observed the Health Service Journal after he told the NHS Confederation conference that management costs (i.e. jobs) would be ‘shaved’ by a minimum of £220 million this year. Redundancy packages and Brazillians all round.
According to Lansley, we’ll need fewer managers because targets will be abolished, GPs will be in charge of the money and an independent NHS board will ensure fair play. If only it was that simple. Targets per se are not a bad thing. If you can prove they improve outcomes for patients and the staff are given a degree of flexibility in implementing them intelligently, they work. If you enforce them with a rod of iron, irrespective of the clinical context – as Labour did too often – then they lead to bullying and disillusionment, and harm as many patients as they help.
Too many targets are inevitably counter-productive, like squeezing a tube of toothpaste in ten places at once. Labour’s failing was to believe that the NHS was a linear system, easily controlled by central levers. Doctors have never have been easy to control
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