In my experience there is a distinct lack of any proper management all the way through the NHS.
Yes there may be people employed as "managers" but for the NHS this represents management of the endless chain of paper trails and computer systems in support of the internal "health market" dreamed up by Management Consultants like Arthur Anderson etc who have long gone out of business.
Examples are:
Clinical Service Managers on £40-50k who are never seen by the people who run the clinics.
Nurse Consultants, again on £40-50k (appointments made by the last profligate Govt) who are never seen by doctors or other staff in the clinics they are supposed to support. Does anyone know what a Nurse Consultant is for?
Hospitals who are cutting back on Clinical Coodinators (an essential but low paid position) whose role is to ensure the notes of the patients who will be seen by doctors are present at the time of the consultation. Managements proposed alternative is to have the doctor conduct the consultation without any prior treatments/drugs/other doctors comments being available and to record their notes on a blank piece of paper which will then in theory be placed with the patients notes (the notes they don't have time to get prior to the clinic). Only problem is there is no resoure employed to do this.
Hospitals who have had a recruitment freeze on medical secretaries for well over two years so letters dictated by doctors and which are essential for follow up care and communication with the patients GP are not being typed up until months after or not at all.
The sad thing about all of the example given above is that these cut backs are putting more and more strain on the very small number of truely dedicated and competent doctors and very very small percent of nurses who actually do anything (IMO).
The NHS has been at breaking point for many many years so I don't see how it can carry on as it is.
As far as the implication that GP's are going to be better off after the proposed changes I wouldn't be so sure. Wasn't it Gordon Brown who gave them a wapping increase and at the same time as reducing their committments!
Personally I think GP's pay levels should not be increased but I would have no problem if the good Hospital doctors who do the really serious sorting out of patients earned as much as the Bankers who have wrecked our economy. Any increase in their pay should be paid for by getting rid of the incompetent foreign doctors and lazy nurses.
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