Saturday, November 28, 2009

Who's bullying whom in the NHS?

More on better direction for NHS (see earlier post). Mike O'Brien, health minister, has described the kind of NHS manager that will be named and shamed (see HSJ article):

“It’s those who duck the difficult decisions, who hide in the quiet safety of their offices, or employ consultants to make decisions for them - who won’t put their heads above the parapet, not daring to engage staff and patients, putting off the inevitable for another day and not learning from others.

“These are the ones who should worry. But we will continue to support leaders and managers who show how we can deliver better care for patients”.

Managers are not used to this. They've even accused O'Brien of bullying them when he says he doesn't want them to slash and burn budgets. Managers have become more used to "top-down", centrally driven management, which could in itself become bullying when clinicians were not involved (see another previous post - Why do staff report high levels of bullying in the NHS?).

I guess the political stance must be gearing up for the election next year. It's about time Labour got it right on the NHS. O'Brien's speech even talks about looking at how a bigger proportion of budgets could be devolved to primary care trusts. This may not be that different from the Tory policy of giving GPs real budgets.

And anyway, clinicians have always said there needs to be better integration between primary and secondary care. I'm not saying that there wasn't a need to shift care from being too doctor-centred to more patient-centred, but the underming of professional values and opinions in doing this has been very damaging for the NHS.

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