And still the Queen cried "Faster! Faster!"
What a muddle the Government finds itself in this
week. Alan Milburn has added to the general dismay over the state of the
rail industry by announcing further reform to the National Health Service.
Ironically, the plans for the NHS, which are loosely designed to release
central government's grip on the management of hospitals and primary care
organisations, are going in entirely the opposite direction to Stephen
Byers's recent announcement for the railways. Whether or not NHS management
is devolved and managers are home-grown or drafted in from elsewhere are
red herrings. Since the NHS is the largest employer in Europe, the unpalatable
truth is that there simply may not be enough good managers to go round.
The problem for the NHS, like the railways, is that
there is no quick fix, whatever governments hope. The political acceptance
last year that the NHS had been under-funded for decades, that new money
would flow in and more staff would be employed was broadly welcomed. It
almost seemed that the Government might be placing some value on the health
professions. But anyone working in the health service knows that extra
staff have to be trained and that even Tony Blair cannot conjure up extra
doctors, pharmacists and nurses overnight.
Morale is low across the health service because,
just as Alice was urged to run faster and faster to keep up with the Red
Queen, health services staff are running very hard indeed to keep up with
reform after reform. Like Alice, they are getting nowhere. They might
get somewhere if all the good ideas and initiatives in the NHS Plan were
to be properly funded and given a chance to bed down. It would be simple
for Hazel Blears and Alan Milburn to put money where their mouths are
and say, "Yes, we have confidence in the pharmacy profession to deliver
these new services now. Let's get going."
However, the Government does not seem to care about
the people working in the health service after all, and it is not supporting
them as they try to deliver its agenda. (Indeed, pharmacy is a prime example
of this Government's neglect.) It seems to care more about newspaper headlines
and patients as voters than it does about what is actually happening in
the NHS. The latest announcement suggests it is in a panic and unable
to stick to its plans. This is why health service professionals and staff
have lost confidence in the Government.
When Alice became exhausted and giddy from running
faster and faster, the Red Queen propped her up against a tree and said
kindly, "You may rest a little now." A rest from reform is what health
service staff need more than anything: they need a period of stability
and no threats of further change. Then they might be able to deliver what
the Government wants.
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