THIS week ah’m owersettin intil Scots an important piece that haes bin publisht oan the “Big up the NHS” Blog (http://bit.ly/BigUPnhs). The person wha wrote this haes chosen tae bide anonymous. That itsel is a worryin thing. They’re sayin whit thoosans o us aareadies ken aboot wir NHS, tho this is mibbes frae the Englis perspective, but lat me mak it clear – things is warse in Scotland! Ah hae seen it first haund!
l Aa major NHS institutions frae NHS England doun are managed bi a board consistin o Executive Directors (EDs) wha dae the actual wark, an Non-Executive Directors (NEDs) wha are there tae haud thaim tae account.
l The EDs are appyntit bi the NEDs, wha alsae hae the power tae remuive thaim gin they arenae up tae the joab.
l EDs are required at intervals tae provide the board wi assurance that things are aa gaun weel an that gin this isnae the case that thair are plans in place tae correct the situation.
l It is essential that the board accepts this assurance. Gin they arenae assured they must report up tae their regulator – usually NHS Improvement (tho likesay in Scotland it’s much waur – we hae nae regulator o oor NHS tae report tae!).
l Gif they arenae assured the easiest action they can tak is tae get a new ED wha wull assure thaim better.
The kinch is that the EDs ken fu weel that risin demand, puir fundin, a manpower plan that’s a complete bourach, an health inflation wull mak it impossible tae provide honest assurance tae the board, but tae say they cannae deliver a sauf solution is professional suicide.
Oan the tither haund, NEDs cannae affuird tae hear that there is nae sauf solution. It means that they hae failed an in aa likliehood NHS Improvement wull replace thaim – likesay, this disnae heppen in Scotland due tae oor haein nae regulation ava.
This is whaur the rot sets in!
Aa board memmers ken the rael state o affairs – but they arenae alloued tae admit it. Yet they cannae lee, or at least be claucht leein, or they’ll be doun the road! In board meetins EDs chuse thair wirds gey eidently, glossin ower the negatives an biggin up the positives. They are aye-an-oan ower-optimistic anent the likely success o recuivery plans.
The NEDs dinnae believe a wird but it’s no in their best interest tae challenge ower haurd, especially whan there’s nae solution that wull be acceptable tae the government. Certes, they wull aften pile rael pressure oan EDs tae get thaim tae say whit they need tae hear. This is whaur NHS bullying culture oreeginates. NEDs accept the assurance in the knowledge that whan it aa gangs pear-shaped they can say they wir misled an wull hae an obvious scapegoat tae blame.
Sae boards are made up o intelligent fowk wha ken the score but cannae see a solution, wha dance roond their haundbags misleadin ane anither, desperately howpin that they wull mak it tae retirement or the next joab afore it aa gangs agee!
This climate o deceit an bullyin filters doun tae middle management an ultimately pussions the hale o wir NHS.
They tend no tae lee oan paper acause that can be mair easily challenged. They hae tae pit the facts in the board papers, but they hide thaim in a sea o “boardspeik” platitudes. Thair plenty evidence o this oot there gin ye’d like tae hae a luik.
Ye’se can aa hae a swatch o an ackwal board meetin whaur this kindae thing is discussed; http://bit.ly/ackwalMeetin Maist fowk wullnae hae seen this. Indeed at the time o publishin the blog anely 53 fowk hae boathert tae watch it. It’s 24 meenits lang, but ye’se wull get the gist eftir twa meenits. Gin ye really want tae get yer bluid bilin stey wi it fir 10 meenits whan they stairt gabbin aboot the emergency department crisis.
We seem tae hae the dreidfu situation whaur aabody at the tap o the NHS kens that it is faa’n apairt but in order tae keep their joabs they hae tae reassure yin anither an their political maisters that aathing is fine an dandy. Atween haunds the NHS is gaun tae the dugs, clinicians are burnin oot an patients are sufferin.
We desperately need senior fowk in the NHS tae admit whit is heppenin. It’s howped this wull stairt wi clinical board memmers – medical an nursin directors in parteecular. They hae a legal duty tae protect patients unner their respective professional codes o practice.
It is heich time they grew a backbane, an spake oot – afore it’s ower late fir oor NHS.
Likesay, this pents a gey dowie pictur o the current state o wir NHS in Englandshire – but believe me, wi nae regulation o the NHS ava north o Hadrian’s wa, it’s faur ower warse in Scotlandshire.
The ae savin grace here is that in Scotlandshire an can pit ma nem tae a piece o writin lik this – in that great “democracy” doun south ye cannae.
Why are you making commenting on The National only available to subscribers?
We know there are thousands of National readers who want to debate, argue and go back and forth in the comments section of our stories. We’ve got the most informed readers in Scotland, asking each other the big questions about the future of our country.
Unfortunately, though, these important debates are being spoiled by a vocal minority of trolls who aren’t really interested in the issues, try to derail the conversations, register under fake names, and post vile abuse.
So that’s why we’ve decided to make the ability to comment only available to our paying subscribers. That way, all the trolls who post abuse on our website will have to pay if they want to join the debate – and risk a permanent ban from the account that they subscribe with.
The conversation will go back to what it should be about – people who care passionately about the issues, but disagree constructively on what we should do about them. Let’s get that debate started!
Callum Baird, Editor of The National
Comments: Our rules
We want our comments to be a lively and valuable part of our community - a place where readers can debate and engage with the most important local issues. The ability to comment on our stories is a privilege, not a right, however, and that privilege may be withdrawn if it is abused or misused.
Please report any comments that break our rules.
Read the rules here