Improved waiting times
High paid staff, who are project managers, management assistants, service managers and the like.
Too few nurses, basic clerical workers, cleaners, junior Doctors, porters and the like.
Huge salary bills
The National Health Service in the UK is still a wonderful way to provide free health care to all. However, over the years it has had many difficulties and has become hard to fund. Previous Governments began many initiatives to try to improve and modernise the Health Service.
In recent years targets have become a priority in the NHS. Although these are sometimes nonsensical, overall, they have improved the waiting times for certain procedures and appointments.
One of the problems has been that, Mrs A, who may be quite happy to wait a few months to see a Consultant, may have to see the same Consultant before Mrs B who, actually, urgently needs such an appointment. This will be down to how long someone has waitied and meeting the government target on waiting times.
So what can happen is, a person whose need is not urgent, will be seen before someone who does need urgent attention. More recently Hospital Trusts have implemented a dedicated Suspected Cancer referral service and this has redressed the balance somewhat.
However these days most Hospital Trusts are fighting to achieve Foundation Trust status so that they can receive appropriate funding from The Government. The problem is though that, as the press reported last week, some Flagship Foundation Trust Hospitals have been found to, in reality, be failing.
My problem is that as much as I applaud the measures taken to improve and maintain the NHS, there are some obvious problems. One of the main ones is that currently there are, as the saying goes, Too Many Chiefs and Not Enough Indians.
Those that work on the frontline of NHS care tend to be lower or underpaid. As people leave these jobs many are not replaced. With all hospital trusts needing to be more efficient and reduce their expenses these jobs are often the first to go.
The NHS has seen a huge increase in highly paid managerial and executive positions. Many of these are needed to meet the targets, which were actually implemented in order to improve patient care. As the salaries, for such staff, are way over the odds, this means that there is little left for support and essential staff.
The NHS has recently brought back Matrons, which many people believed were much needed. However, years ago one Matron would be responsible for huge areas of work. These days each business unit has at least one Matron who spends much of his or her day ensuring that targets are met.
There have also been many new posts created which are simply there to try and ensure that a patient's discharge from hospital is as swift as it can be. This may be all well and good, and prevent bed blocking, but all too many patients are sent home before they are properly fit. Still at least they have freed the bed up. It does not matter that they will be re admitted, perhaps just hours or days later, as a new target is set and the hospital has done their job.
In reality of course they have not. Yes they have freed the bed and met the appropriate target but the patient was sent home before he was definitely medically fit.
Whichever Political Party is elected next year, they will find it hard to correct problems in the NHS. In the past the Tories under-funded this service, in fact for many years, and so the rot set in. Personally I still think The NHS is a world class service and worth protecting.
However, creating too many managerial highly paid jobs and sacrificing front line lower paid staff will lead to chaos. With modern changes in technology the NHS needs to be investing in improved Healthcare, not simply meeting targets. Eventually the NHS will simply be too expensive and unworkable to maintain and our free health service will be gone for ever. This should never happen but I fear that unless UK Governments get the balance right this is what will happen.