Change in approach neededin NHS as well as more money

Date: Friday 26th May 2017

Sir, It is always heartening to hear something positive about the NHS, as I did in our local post office recently.

Of course, most people are satisfied with the service they get. Imagine what it would be like if 50 per cent. of patients complained.

At the same time, it has to be acknowledged that the number of complaints is increasing and the problems are mounting. I suspect that the level of public tolerance is high enough to dampen the urgency with which politicians and managers approach this. There seems to be no end to the degree they are willing to play down the whistleblower. That has to change.

Dr. Wrigley (Herald, 20th May) states that GP services are at breaking point. He is quite right but the remedy he suggests — more investment and/or reallocation within a limited budget — is not a complete answer to the problem.

Over decades, there has been radical change in the way that nursing and medical services are organised and this has changed professional practice. Some of this is inevitable in the face of progress, but continuity of care has been sacrificed and clinical assessment of the patient has been partly replaced by the use of complex diagnostic techniques and scans, interpreted at a distant site weeks later without reference to the individual.

Clinical practice has been broken down into modules at the expense of the broad overview that was the foundation of good medicine. The whole is managed by a bureaucracy in which clinical need is subordinate to finance.

Even though we fail to train enough doctors to be self-sufficient, we limit entry into medical schools for economic reasons.

Low morale, heavy workloads and possibly poor selection of candidates culminate in huge numbers either emigrating or leaving the profession. Suitable foreign doctors and nurses are not easily available to make up the shortfall.

A perfect consequence of this is the staffing crisis affecting the whole service which has been caused by appalling national manpower planning over decades. We are now seeing an end game in all this with a failure to recruit staff to unfilled posts for which the finance is available and a dissipation of that finance to overpaid locums or, as in the case of Alston, no workforce is available from which to recruit competent nursing expertise.

It is axiomatic that if you de-skill a profession and get rid of facilities and jobs, you diminish the available workforce.

Without a change in approach, money thrown at this will simply be wasted, as it has been in the past. It will take a long time but what is needed is a long term plan to train the staff we need and provide them with permanent and secure employment. Until this is done, the NHS will continue to provide stop gap remedies and lurch from one crisis to another. Yours etc,


Knotts Farm, Watermillock.