JUST A THOUGHT - ON BRITAIN'S NATIONAL HEALTH SERVICE'S 70TH BIRTHDAY. PART 4.

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I have grown old, and no longer function efficiently in all that is being asked of me. Is what the NHS might have said to anyone who cared to ask this benevolent institution.

It is not just a matter of me not having enough resources, enough staff to do what the government and people expect of me, the personified NHS would have said. 

No, it is more than that, much more. The are asking the impossible of me. They have allowed me to grown too big and I have become unmanageable. 


They have tried to tidy me up, streamline and standardise me. Make me fitter, healthier and more efficient, but they have failed dismally. 

 Because I am simply too big, too unwieldy to be contained under one management and as a unitary organisation. 

 So they have tried to break me down into separate trust or groups of hospitals, with their own budget limits, but that has also not worked. 

 Not least because they are not able to remain within their financial limits. 


And how can they, when they are still expected to provide the treatment for all their patients, apparently within their budgetary limits, which is not achievable? 

 So, they relegated more financial and budgetary resources and responsibilities to general practitioners. 

 But that also does not work.  Because their front-tier providers of health care are now compelled to spend more time commissioning healthcare services and managing their budgets, and less on providing direct services to their patients.

 To be continued!




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