Patrick Barbour was chairman of two public companies, is a trustee of Civitas, and was one of the three
founders of Reform. The author of the position
paper for the TaxPayers’ Alliance Better Government Campaign, he argues that the NHS won’t improve whilst it’s managed by politicians.
The smoke is now clearing, just over a week after the Healthcare
Commission released the results of its investigation on the scandal at
the Maidstone & Tunbridge Wells NHS Trust where C. difficile
infections have killed dozens of people and contributed to the deaths
of hundreds. The chairman and chief executive of the Trust have both
resigned, Alan Johnson has set up inquiries to look into everything
except how government policy contributed to the crisis and the Nurse of
the Year has quit “in disgust at the pen pushers running the NHS”.
However, there is already a new crisis on the horizon. Just a week
after Johnson told the Today programme that the scandal at Maidstone
and Tunbridge Wells was an isolated incident a new scandal has emerged
in Lancashire. Before we go on to consider fresh scandals though, it
is worth taking a little time to consider just why things have gone so
wrong in Maidstone & Tunbridge Wells NHS Trust and whether there is
a connection to broader problems in the health service.
The right place to start is the original Healthcare Commission report that said:
"The lack of organisational stability with numerous structural changes over the last three to four years, meant managers could not settle into roles and focus on the key issues. The high turnover of executive directors and senior managers caused instability and left gaps in leadership as the trust grappled with its very busy agenda. Many staff felt the degree of change had been damaging and had contributed to the lack of clarity on accountability."
Did Rose Gibb, earning around £150,000 pa as Chief Executive of the Maidstone and Tunbridge Wells Trust, really have the management skills to run an organisation with a budget of £243 million and 4,527 staff?
Apparently not. Personal hygiene and cleanliness are management problems which could be righted in days not months. The Healthcare Commission described an autocratic senior management that failed to build managerial and leadership capacity throughout the organisation, with little delegation. In addition, Mrs Gibb is described as difficult to challenge. All it would have taken was one effective challenge to her repeated assurances that the infection problem was under control. If the Directors had ever walked round the hospital they would have seen for themselves that this was not so.
To add insult to injury the Board had apparently agreed to pay this failed manager £250,000, and gave her a glowing reference.
If the Maidstone and Tunbridge Wells tragedy (and there are twenty even worse hospitals in the Country) had happened outside of a government-run service politicians would be demanding major change. Imagine if a care home in the private sector had over 90 deaths due to negligence. But will anything happen here, where the NHS is run by ever-changing politicians, who lack management experience and knowledge of healthcare?
The Secretary of State, the three Ministers and two Parliamentary Undersecretaries have made up the top three levels of the NHS over the last 10 years. Yet they have virtually no management experience, no in-depth knowledge of the NHS and they frequently change their jobs.
Alan Johnson, the current Secretary of State for Health, is typical. Before becoming an MP he worked in the Communication Workers Union, a position for which no healthcare expertise was needed. Since he was first appointed to a ministerial position eight years ago he has been a minister at the DTI and at the DfES and a Secretary of State for Work and Pensions, the DTI and the DfES before moving to the Department of Health. That’s more than six jobs in eight years, in four very different departments. How does any of this equip him to run one of the largest and most complex organisations in the Western world? It doesn’t.
We will continue to have a Health Service which is ranked as 18th out of 19 developed countries by the British Medical Journal as long as politicians continue to manage the Health Service.