BBC Newsreader holds the history of the NHS in his hands…it’s blank just for now….but he’ll soon think of something to fill all those pages. Behind him, he tells us, is a picture of Mrs Thatcher as she wept for what she has done to the country.
I have frequently commented on the BBC’s reluctance to mention Labour by name when talking about the deaths at the Mid Staffs Hospital in many of its articles and discussions about this scandal.
I have now learnt why….Labour was not to blame. Who was responsible for all those deaths?
Mrs Thatcher.
I kid you not.
The BBC, in the shape of their Business reporter, Lesley Curwen, concludes that the enormous number of deaths at Mid Staffs happened because Thatcher imposed ‘management’ upon the NHS and that management failed to speak up and stand up to government when Blair and Labour imposed its reign of ‘targets and terror’ upon them or taking self serving decisions designed to protect their career, therefore…Thatcher is to blame for the deaths at Mid Staffs.
Curwen seems determined to find ways to excuse Labour and plants the blame firmly in management’s lap…and therefore the person who introduced ‘management’.
The programme missed out important, relevant information and seemed intent on ‘proving’ something that it had already decided was ‘fact’.
Curwen repeatedly states her position:
‘For me it wasn’t questions about just what happened on the wards but in the boardrooms and executive offices of the trusts…I want to pick apart the part played by the managers and leaders of the NHS in these failing cultures.’
‘Wards’ and ‘Boardrooms’….what’s missing? No 10 Dowing Street 1997-2010.
She wanted to look at….
‘How the modern NHS manager came into being and how the flaws in that long evolution may have played a part in today’s cultural failings.’
Targets produced a culture of bullying and fear. It is clear that management were intimidated and cowed by targets but can this alone explain how they lost touch with the organisation they were supposed to be leading.
I’ve been looking for any clue that might explain senior management failures….a split developed , a fault line between management and the clinicians.
That sowed the seeds in what happened at Mid Staffs where staff expressing concerns were ignored.
So there you go…Thatcher sowed the seeds for what happened at Mid Staffs.
Curwen brings it all bang up to date with a warning about current reforms:
‘Right now the NHS is undergoing its most far reaching change for decades and at the same time is facing an unprecedented financial squeeze.’
An ‘unprecedented financial squeeze’?
What? The government is putting in money not merely ring fencing the NHS.
What planet is the BBC on?
Let’s remember what the Labour politician, Aneurin Bevan, Labour Health Minister, said:
‘Administration will be the biggest headache for years to come.’
So not quite as simple as some like to portray.
The programme is a mixed bag of messages which confuse and contradict….for instance she tells us that managers are to blame…and yet ‘ultimately Ministers pull the strings….maybe that’s why managers hold staff’s feet to the fire to get the performance they want.’
But she rapidly disassociates Labour’s era of ‘Targets and terror’ from management decisions.
She tells us of the introduction of ‘Consensus management’ in 1973 by the then Tory government…this had boards of doctors, nurses and administrators all making the decisions for hospitals….and all having a veto on any decision.
There was in fact too much bureaucracy…to many tiers of administration.
What happened was that often no agreement could be met on what might be the best probable practise so they plumped for the ‘lowest denominator’…the system was ‘deeply flawed’ but the BMA liked it.
It of course involved the very clinicians, the frontline staff that Curwen is now saying should be involved in management….but paradoxically she tells us resulted in something that ‘truly was a monster’ in the 1970‘s.
Curwen then skips over Labour’s stewardship of the NHS during the 70’s…which is odd…as Thatcher based her policy upon that of Wilson and Callaghan…who …em…advocated a ‘value for money’ policy.
The irony of Thatcher’s introduction of management, based upon the ’Griffith’s Report’, was that it was implemented as a consequence of the failures of the ‘management consensus’ regime and 20 deaths at Stanley Royal Hospital due to food poisoning for which no one would take responsibility.
Curwen blames Mid Staffs on Thatcher but the introduction of ‘management’ was supposed to prevent such occurrences…..and might have if it hadn’t been for the ‘era of targets and terror’.
Curwen tells us a ‘them and us’ attitude developed when non-clinical management came in……what she didn’t say was that it was the managers who were ‘demonised’, indeed the RCN ran a massive advertising campaign against them being introduced.
Were nurses and doctors involved in management? Curwen gives the impression that there were very few at all.
However there were certainly many nurses taking on management roles…though that was slow to begin with:
“One old style consultant was heard to say, ‘She used to be our matron, now she’s come back as our boss’.”
Eventually organisations revised the initial management structures that had excluded nurses.
“So to a degree the RCN campaign was successful,” says Mr Rowden, who became a general manager in 1986 after hearing a speech by health minister Kenneth Clarke. “He said, ‘Stop whingeing – anyone can go into general management.’ In three years there were more than 100 nurses in unit and district general manager posts.”
And the doctors and consultants wielded huge power and authority still:
He was quick to grasp the importance of getting on with the “power broker medics” who could block change. “I was told it was impossible to deal with inefficient or lazy doctors directly. If I took on a doctor directly, that would be the end. We did get rid of several, but not by the direct method.”
Ultimately doctors and consultants didn’t want to manage….and even Christine Hancock, originally a nurse and someone who has served in various senior roles in the NHS, including head of the RCN said:
‘In my experience we are the only country where doctors don’t manage the health service….doctors don’t want to manage.’
Curwen, though interviewing Hancock, didn’t manage to winkle that out of her.
I don’t think Curwen can have read much of what is written about Griffith’s Report judging by her incomplete take on events and the ultimate overall effectiveness of the new management regime.
This is an indepth look at the report with those involved from politicians, civil servants and NHS staff: The Griffith’s NHS Management inquiry: Its origins, nature and impact
And from the Health Service Journal look at Griffiths after 25 years:
Yet no one suggests the NHS should abandon general management, nor even that any viable alternative exists. It has enabled the NHS to attract high calibre chief executives, rationalise management structures and sharpen accountability for how it uses taxpayers’ billions.
“Management is much more an advocate of the patient and public voice than clinicians, because managers play a neutral role in services. They are not a vested professional interest,” says King’s Fund director of leadership development Karen Lynas.
“The NHS is better now at responding to what the public want, and a lot of that is to do with general management.”
The blame for Mid Staffs lies squarely at Labour’s door…staff shortages, not mentioned by Curwen, and the imposition of the ‘Targets and terror’ regime that forced management to take certain actions.
It was not a failure of the concept of management but the distortion of its implementation by politicians out to win the PR war in the studios of the BBC or on the front pages of the news papers with headlines about ever shorter queues and more money going into the NHS…..all based on highly suspect statistics as management was forced to massage the figures to meet the targets…so in fact they didn’t meet those targets and treatment, as we see from Mid Staffs, in reality got worse.
And patients died as a result.
It seems that the BBC not only are intent on continuing to hide Labour’s part in that but seek to spread the blame, or shift the blame, to the ‘usual suspect’.
Not me, guv!
The selfsame disingenuous lies which ZaNuLab and its broadcasting arm use to deny their part in the financial crisis, which they brought about here in the UK.
And the public still believe them, in large part.
I’ve never seen that photograph of Margaret Thatcher before.
Nor had she…
If only the BBC would devote even 10% of its endless wind ,sails, kites and backdrops to this appalling scandal at mid-Staffs,; as they do the Hillsborough nonsense.
The sainted Julie Bailey who raised this issue at the time when her mum was so abused has now had to leave Stafford, has had her mums grave desecrated and lost her cafe that was her livelihood….and the BBC don`t give a flying f***!
Hillsborough was a scandal and justice will have to be done-but far more died at Mid-Staffs, and there was no cultural excuses for the evils perpetrated…unlike Hillsborough after Heysel, Bradford and the like.
Mid-Staffs gets the free pass because it WAS Labour wot did it-and the likes of Burnham, Johnson are still around and are not to be taken on.
Thank God Margaret Thatcher was able to die at the Ritz…she`d have died far earlier had the mid-Staffs Eintsatzgruppen of the Left got to her first.
Yet the BBC will continue to dig up the 96 or Stephen Lawrence-the white old trash at mid-Staffs would only have voted for Tristram Hunt anyway.
Lord HawHaw is alive and well at the BBC…but let`s hope he ends up in mid-Staffs sooner rather than later for a brain replacement…or are ALL BBC stiffies all covered by BUPA?
… the NHS is the nearest thing we have to a ‘national religion’ these days and the most socially acceptable face of government-knows-best thinking. Instead of constantly treating such problems as minor ailments on an otherwise health body, maybe it is time for a proper and hard-headed diagnosis of the NHS’s ailments with all treatment options on the table. It may well be that a tax-funded system is the best way forward, that for all its faults it still provides the widest care at the lowest price. But we’ll never know because, by and large, politicians refuse to discuss it.
http://www.spiked-online.com/newsite/article/nhs_time_to_disestablish_our_national_religion/14026#.UjrJQH-ymSo
This is not the first Inquiry into NHS failings. The dear lady of the BBC perhaps should read a bit of history. The !970’s were a period of scandals into the failings of NHS service for people with a Learning Disability. The Normansfield Hospital inquiry of 1976 – 1978 is instructive. This was before a Thatcher’s so called Managerising of the NHS. Here the difficulties were squarely laid at the door of the Consultant Psychiatist who’s tennure was describrd as a ‘reign of terror’.
http://hansard.millbanksystems.com/commons/1978/nov/21/normansfield-hospital
Visit for a brief outline of the events. I could not find the full report. By the by this was during a period of Labour dominance from 1964 to 1979 with a Con gov from 1970 – 1974 crippled by union unrest.
A typical piece of BBC journalism doing less than half a job the investigation merits either through sheer laziness or because there is an agenda to be pushed, or some combination of the two.
Curwen’s observations on management in the NHS completely ignore hospitals that are successful not only in patient treatment but also in culture and efficiency – and without any higher staffing levels often bleated as an excuse by moaning doctors and nurses who did very well indeed thank you from Labour’s tax/borrow/spend largesse. At last, according to this morning’s news, best practice is being recognised and an attempt to infuse the rest of the NHS with the success achieved by excellent management at other hospitals is being made. Common sense prevailing for once – as long as the union dinosaurs don’t get in the way.
A proper investigative journalist – i.e. not the bBBC – would also do a comparison with Hinchingbrooke NHS Hospital, an NHS Hospital Trust which since February 2012 has been operated by a private sector partner, Circle.
The only difference is its management.
And its high patient satisfaction ratings.
One in Bath too – outstanding.
I listened to this program and came to the conclusion that the Biased Bunch had landed a double whammy on their two most hated politicians – Thatcher & BLiar. Targets & Terror is not a compliment ! They did not mention Labour, it was an attack on BLiar not the party.
1300 dead – surely a red line has been crossed?
One of the great failings of the NHS was the placing of political apparatchiks at the head of NHS trusts. Incompetent, recycled, failed placed men and women with no experience or competence, with political agendas rather than the needs of patients.
And it continues with the news that disgraced for Home Secretary, serial public purse trougher, Jacqui Smith has been appointed Chair of Birmingham University Hospitals NHS.
God help them up there.
Jobs for the boys
http://www.birminghampost.co.uk/news/former-mp-jacqui-smith-gets-5912320
What I’d like to know is who were the 1300, who did they vote for and what class were they? In other words were they selected for the showers for any reason other than clinical?
I’m lost how have you come to the conclusion that she said/meant Thatcher?
You quote the following: ‘I’ve been looking for any clue that might explain senior management failures….a split developed , a fault line between management and the clinicians.’ but how have you came to the conclusion that she is talking about Thatcher???? I can’t see the link the between the two…
You seem to be expecting Alan to apply logic, common sense and, ooh, facts to his demented ramblings.
You must be new around here.
Or maybe if you’d both read these ‘demented ramblings’ properly you’d have seen that Alan clearly signposted Thatcher’s involvement in the increase in NHS management, which was the very thing being attacked. I disagree with a lot of Alan’s articles but there was no ambiguity in this one if you’d bothered to understand it.
Stick to Cracked if you can’t engage with this instead of hurling names around.
There have been managers in the NHS since time immemorial, called by different names, like District General Manager. There has always been a chain of accountability between the supplier of money – Treasury, Department of Health and managers of hospitals. Doctors have always been shroud-wavers to get more money for their specialty. Hattie Jaques was an actress, not a matron. Most managers are women, often nurses skilled in climbing the greasy pole of management. Few are comfortable with money and numbers, which are the business of managing £bn of resources. Given a target, they are usually adept at finding a way around it, or failing that, lying. They don’t believe in targets.
This dopey BBC bird Curwen arrives with an agenda and reconstructs the facts to fit her agenda. If doctors and nurses were as good at their jobs as Lesley Curwen is at journalism, most patients would quickly be dead.
What’s going in with that BBC blokes hair?
He has the dead squirrel on top look going on recently, getting darker by the day
Two Stalinist monoliths yet to be privatised………
Bevan would be turning in his grave.