Friday, 19 June 2009

Shambolic and unclear: Kafka's NHS

It's not hard to find diagrams like the ones above, the Internet is littered with examples of just how overly complicated the NHS' management structure and bureaucracy has become. It shouldn't take several textbooks and a few years of intense study to understand the way in which a health care system works (or does not as the case may be), the fact that the NHS is so hard to understand implies that it is a disorganised shambles with no clear chain of command. It should be so much easier to comprehend, but the government keep reforming, making things more complicated and shambolic.
The market argument is a complicated one, even a bottom up market would probably be more inefficient and bureaucratic than a well run state run system. However one can guarantee that a top down state run market system will be ridiculously inefficient and cumbersome. The diagrams above the the government 'newspeak' sum up the stupidity of the current process. Even people at the top are starting to see the light, and about bloody time too, it's just a shame that our moronic leaders like Tony Blair cared more for their own wallets than the nation's health. The lack of a clear chain of command means that the system is also incredibly dangerous as no one ever takes any responsibility when things go wrong.
The sad thing is that there appears little that we can do as cogs in our great 'democracy' to affect change in this regard. Labour copied all the flawed ideas of the Conservatives and then put them into practice from 1997 to this day, the Conservative would carry a lot of them on if reelected, while the Lib Dems never seem to oppose anything much with any vigour. The current economic situation and the future NHS spending cuts mean that we can expect to see front line services hit hard, while I am sure that the spending on bureaucracy, managers, PCT numpties, new incomprehensible reform strategies, management consultants, quangos et aliter would not be affected much.
It makes my blood boil. So much corrupt and cynical politics dressed up in nothing more than glossy bullshit. In the current financial climate it is a disgrace that money should be wasted in such a wanton manner. If I want to buy a load of bread the most efficient way to buy it is not to pass the money to the shopkeeper via four organisations and decide upon which loaf to buy by employing a cohort of idiots who then hire a group of management consultants to make the expensive decision for them, I haven't even started talking about how this NHS-style system would go about getting my loaf home; if I need a loaf of bread I'd go to the shop and buy it myself.


Jobbing Doctor said...

Top quality Rant, my friend.

And 100% correct.

Garth Marenghi said...

Cheers. Night shifts make me ranty.

ajuniordoctor said...

I was about to congratulate you on these great parodies when I realised that they are actually real...

A disgusting waste of money. A well-deserved rant.

Anonymous said...

Interesting rant but not with out its flaws.

The discussion of "new speak" is justified and there are example listed above however some are used and identified terms. Before you hit me with a plain English demands I will ask first that you start to refer to hypertension as high blood pressure ?fall as fall of unknown cause (dont even start with rhinorrhea or acopia). Of course you wont want to as these are terms used. Technical terms have their place and it is not our job to educate you in there use as tyou do not educate the public in medical jargon.

As for the loaf of bread analogy if 300 000 people want to buy a loaf of bread for use in same location and purpose it is an incredible misuse of resources for them all to buy it at separate locations at different prices with all holding the individual associated costs.

Pharmacist turned accountant
(the dark side of the dark side)

Henry North London said...

And should you complain and say I want to take the bread straight to the patient they say Oh but you cant do that


andy@healthvox said...

Now that is what i call a classic rant. Im not a health professional but i can sympathise with the amount of sheer mangagement nonsense out there - those graphs look like something out Brasseye!

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