Thursday, 17 April 2008

No common sense in the market

Why do we sometimes reach a point where everything around us seems rather foolish, and it's almost as if the walls are caving in but one doesn't quite know how to go about stopping the impending collapse? That's how I feel about the NHS and medical training at the moment.

The government have cunningly attacked the medical profession and our professionalism on so many fronts that they have split us up into numerous ineffective little camps. We have not had the power or organisation to unite as one in order to prevent the government's plans for piecemeal privatisation.

My everyday experience of hospital work helps convince me that the ridiculous payment networks and bureaucracy that have been assembled over recent years are so awfully thought out that they cannot possibly be good for anyone involved. The staff on the ground really want to the best for their patients, but over time they get ground down by the stupid protocols and the highly complicated internal markets that have been forced upon them from above.

I wonder why can't a hospital just get some money from the government and be left to spend this money as it sees fit? Would this really be worse than the intricate network of payments that currently take place that mean money is shuffled back and forth while the needs of patients are forgotten, and most importantly doing proper work is frequently disincentivised by the artificial gradients. The whole internal market has simply not been thought through, and it appears to me that the damage can increase exponentially as more hair brained managers come up with new market based solutions to problems that have been caused by the market based approach.

I could waffle on about the catastrophic idiocy of Darzi and his polyclinics, Brown and his penchant for PFIs but the theme remains the same, this government believes only in improvement that is driven by the excessive use of power from the top. There is a massive irony here, as when Alan Johnson states that choice is a means to an end, how on earth can improvement come about when choice is nothing but a sham and an illusion? The only choices being made are being made by the government, they choose the path that we must choose, there simply is no other option. I am still standing in the same place and the walls are still collapsing, which way to turn?


Fx said...

Yeah, ironic isn't it that Labour used to represent the working people of this country ... and now they're dismantling the health system specifically set up to help them (the workers, that is). And raising their taxes to boot.

It's a funny old world.


Steve_Roberts said...

The "market-based solutions" bear as much resemblance to real markets as the cargo cults of the pacific bore to the airfreight business. Their worst consequence is that a generation of doctors will believe that markets are the enemy - actually they are simply a social phenomenon arising wherever people make choices under scarcity - whereas it is centralised bureaucratic micromanagement which is the source of the evil.

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