Did you see that very illuminating short TV series where some captain of industry - Geoffrey Robertson? - investigated what was wrong with the NHS?
I remember these things:
No culture of innovation - if somebody has a bright idea, there's no forum to evaluate and implement it.
Too much unionised demarcation - they showed a bit where the guys painting the walls had to paint round radiators because they weren't in the right union to take them off the walls to paint behind them.
The role of doctors - as I recall they are not employed directly by the NHS but are self-employed contractors. Because of their "clinical judgement" they would not recognise the authority of hospital trust managers and would bloody well do what they liked - at consultant level they seemd to have no bosses. Thus the hospitals were run for their benefit and not for the patients. This attitude is very prevalent in the British medical establishment and is a direct result of the way they are trained to be arrogant.
After 60 years, those problems are entrenched in the mindset and cause no end of inefficiencies, but there's no reason why an American system should reproduce them, they could have a universal medical system and avoid all of those issues. I hope they do.
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branchandroot
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Date: 2009-08-14 11:08 am (UTC)I remember these things:
No culture of innovation - if somebody has a bright idea, there's no forum to evaluate and implement it.
Too much unionised demarcation - they showed a bit where the guys painting the walls had to paint round radiators because they weren't in the right union to take them off the walls to paint behind them.
The role of doctors - as I recall they are not employed directly by the NHS but are self-employed contractors. Because of their "clinical judgement" they would not recognise the authority of hospital trust managers and would bloody well do what they liked - at consultant level they seemd to have no bosses. Thus the hospitals were run for their benefit and not for the patients. This attitude is very prevalent in the British medical establishment and is a direct result of the way they are trained to be arrogant.
After 60 years, those problems are entrenched in the mindset and cause no end of inefficiencies, but there's no reason why an American system should reproduce them, they could have a universal medical system and avoid all of those issues. I hope they do.