Before the 1970s the staffing structure of the NHS worked well. Then it was changed – dramatically. Many layers of administration were introduced. A bureaucratic hierarchy where administrators demanded more control. This, aided and abetted by increasingly powerful professional trade unions, effectively destroyed the NHS.
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Before the 1970s, hospitals had been simply run. Each ward had a ward sister (who was in charge of the nursing) and a ward clerk (who was in charge of looking after the medical records). Each hospital had a matron (who was in charge of all nursing matters), a secretary (who was in charge of administration) and an almoner (who looked after patients’ social problems). Porters were hired to wheel patients around and to look after the heavy work. Nursing auxiliaries dealt with simpler, routine nursing work.
All this worked well, to the quiet satisfaction of patients and staff, but it was changed dramatically by the introduction of many layers of administration.
The new administrators demanded more control and closed smaller hospitals because they did not fit comfortably into a new bureaucratic hierarchy which had been designed more for the satisfaction of the administrators than the welfare of patients or the comfort of the staff. Nurses and doctors abandoned working practices which had been carefully devised and perfected over generations and replaced them with selfish demands for greed and power.
In both general practice and hospitals, the bureaucrats had taken control. Aided and abetted by increasingly powerful professional trade unions which abandoned any sense of responsibility for patient care in favour of merely improving their members’ earnings, the conspirators had successfully destroyed the National Health Service, removing all sense of morality from a system which had also become increasingly beholden to the powerful and corrupt international pharmaceutical industry.
What none of the unions realised, however, was that they had helped set up a system which was perfectly designed to ensure that individual professionals will, in just a few years, be completely replaced by robots and computers.
It has been proven time and time again that computers make better diagnosticians than doctors, that robots are better at surgery than human surgeons and that robots make better, more caring and more reliable nurses than human nurses. The robot nurses can be programmed with enough caring to revive the valuable placebo response that used to augment medical treatment in such a powerful way.
The healthcare trade unions haven’t realised it yet but there is no future for human doctors or for human nurses. They will all be replaced by robots and computers. The new system, which eradicated home visits and destroyed the traditional relationship between doctors and patients, has made this possible.
The NHS could be rescued, if there was sufficient political will and if the medical and nursing professions could be persuaded or coerced into putting the interests of patients a little higher on their list of priorities.
But at the moment it is very easy to argue that the NHS today provides a far inferior service to the NHS of 1970. And it is not difficult to argue that the NHS today provides a far inferior service to the NHS of 1950.
Taken from Vernon Coleman’s book The NHS: What’s wrong and how to put it right. To purchase a copy please click HERE.
Featured image: The changing face of Britain’s doctors and nurses, Daily Mail, 2 May 2018
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Categories: Breaking News
This world is going to hell in a hand basket!
Yup. When Cameron was the PM a friend who is the best of financials at a large teaching hospital was asked to look at ways of saving 20% of the staff budget. After polling part time staff he found most would be prepared to go full time again which would massively reduce handover errors and costs and would also mean a reduction in bank nurses and doctors. When he presented a plan to do this to the trust one of the women on the board asked what sex these part timers were and my friend said over 90% are women so she said that is sexism and demanded the idea be scrapped despite these people saying they would happily go back full time. The NHS needs to be closed down and a voucher system for private hospitals, including homeopathic and holistic hospitals put in its place.
Head of financials that should have said.
Well, Dr Coleman, I’d rather have a computer diagnose me than unqualified doctor from Nigeria.
Thanx. That’s funny and makes perfect sense.
The failure of the NHS is usually/typically (by TPTB) blamed on ‘the users’, increasing and widening demand and not paying enough, etc. but I, from inside, see it somewhat differently.
Even when I trained (late 80’s) in a major London teaching hospital (with close to 2000 beds) I had, as a newly qualified registered nurse, three ‘layers’ of ‘management’ above me (senior staff nurses, Sister, Matron – all, including Matron, worked clinically).
When I recently ‘left’, from a small rural city hospital (circa 500 beds), I had eight(!?!), not managers, ‘layers’ of management above me (including, literally, 8 Matrons – who usually spent the day in the hospital coffee shop emailing each other to make it appear as if they were busy. None had worked clinically in years).
I well remember a report by the Economist which calculated the relative numbers involved with (something like) one registered nurse for every 4 patients, one doctor for 20 patients, etc. The kicker? There was a manager and administrator ‘per’ patient, i.e. more administrators and managers than ‘all’ clinical staff … combined (and that was decades ago, the situation is worse, much worse, now).
Each of those administrator/manager has their own petty fiefdom, staff, budget, company car and parking space, etc. It has reached a point where the NHS spends most of its budget on ‘make-do work’ and has become a poster-child for Pournelle’s “Iron Law of bureaucracy”:
“First, there will be those who are devoted to the goals of the organization…Secondly, there will be those dedicated to the organization itself.
The Iron Law states that in every case the second group will gain and keep control of the organization. It will write the rules, and control promotions within the organization.”
and Conquest’s third law of politics:
“The simplest way to explain the behavior of any bureaucratic organization is to assume that it is controlled by a cabal of its enemies.”
In addition (a widely unpopular notion) is the changes throughout society. Where demands for ‘equality’ morphed and resulted in a situation where it went from “women ‘can’ work” to “women ‘must’ work” (just so a family could afford what it had previously on one wage).
To maintain this ‘they’ needed to create millions of jobs for these women to be employed in (witness the massive expansion of the public sectors, government, the NHS and social care.
It’s not just the NHS, to make ends meet I worked agency on refuse collection [Yes, I know, multiple degreed professional collecting rubbish on his ‘days off’, but needs must] and in one year it went from one driver and four loaders in each wagon [all men of course], being managed by two grumpy old guys in the office with one lady ‘doing the admin’, to one driver and two loaders [still all men], but eighteen female admin staff and three layers of, mostly female, management).
The failure of the NHS can, justifiably, be blamed on many things, but chief amongst them is that it has become a ‘jobs for the girls’ scam (most women in Britain are employed within the combined health-social care sector or the government departments dealing with them. That many of those posts are necessary, even essential, hides the fact that most, the overwhelming majority, are neither).
Look to how the 24/7/365 NHS functions on bank holidays. All but the ‘vital’ staff get the day off, yet it still works … better than any other time in fact. Consider that.
It’s not just women. The world has been taken over by a managerial class as your quoted laws point out so well. Someone said that “education, like religion, cannot do you much harm as long as you don’t inhale”. The education system has been steadily infiltrated by [guilt-ridden?], woke, middle class, socialists for decades and encouraged by Tony Blair’s initiative these evil dreamers now get their hands on most of the population. The result is a young to middle-aged population of both sexes heavy on largely meaningless “qualifications” and light on common sense and competence. Unfortunately far too many have inhaled and the result is what Mamie in Gone With The Wind called “mules in horse harness”.
Liberalism has brought about a situation where the multi-generational descendants of milkmaids and swineherds now feel that only immigrant labour should have to do “ordinary” jobs. I’m not sure how that mindset can, logically, sit comfortably alongside the current woke outrage at an Imperial past.
“It’s not just women”
True, but it is ‘mostly’ women. There have always been a minority of (leftist, corrupt, or both) men who act and believe in such a manner too, but it is ‘only’ when women, of whom the majority believe/act thus, support them that these policies and behaviours are forced on the rest of us.
That such wokery ‘only’ occurs when women become significant, or the majority, in such areas ‘could’ be merely coincidence or correlation, but what are the odds (when it occurs every time, everywhere they do so)? [You can trace the expansion of tax/welfare, size/intrusiveness of government, etc. with the rise in female influence. More recently you could predict how draconian and tyrannical the jab mandates would be in a country based on … how many women were in that countries legislatures. Fact, doubt me, check for yourself].
Men and women are (the horror) different. They have different, often diametrically opposed, perspectives, priorities and even approaches. Women’s (at least when tempered) is demonstrably superior ‘within the family’. Yet it is also demonstrably utterly disastrous when applied across society as a whole.
Systems and approaches that ‘work’ within a family, fail spectacularly when used in wider society (e.g. You wouldn’t treat a child who “stole” a cake from your kitchen as you would an adult who stole one from the supermarket, yet those adults are now treated like the ‘naughty’ child, with predictably destructive results).
When you examine ‘woke’ you see it is, at its root, closet marxism. Marxism, at its root, is the deluded wish to force the politics and economics of ‘the family’ on all of society (Where are you fed, clothed and supplied “ … each according to their needs”? Where does your status/category/class, instead of ability, determine your rights, worth and power? Where is there ‘communal’ property and ‘shared’ wealth? Where, in fact, does communism as a concept actually work? Answer, within the family, and nowhere else).
Leftism (marxism) is at its root the desperate wish to remain (in the roles of) women and children forever (protected, provided for and given power based on status, and both based on what, not who, they are). [Is it really any wonder the ‘trans phenomenon’ is on the rise as they demand, not just the rights, privileges and protections of being a woman, but that they ‘are’ women now?]
Yes, as you say, the rise of the “administrative state” is to blame, but when (uncomfortably) the vast majority of those administrators are women, they don’t get a free pass. Consider which institutions and organisations are the wokest and most totalitarian (education, health-care, media, nanny-state) and which are becoming so (police, judiciary, etc.) and anyone with eyes to see, how these all occurred with the increasing numbers of women within them, must at least consider that that correlation is in fact causation.
Women (and many men) have been sold a ‘bill of goods’. They are acting entirely rationally and reasonably, for their own benefits. Yet, they have been manipulated and steered (and bribed) into making choices that are as destructive for them as the for men. They are being used, but that does not excuse the destruction they have caused and are causing.
Any profession which women enter immediately becomes ‘safer’. Hours worked (and working lifetime) are reduced, time off (for sickness, family needs or a career break) drastically increase, benefits and (unrelated to the role) costly support increase (to make it more ‘family friendly). As a direct consequence any of the (still remaining) heavy, dirty, dangerous, low-status or just inconvenient (nights, weekends and holiday) work (i.e. most of the real work) is disproportionately forced onto the (many fewer) men or single, childless women (who often must have multiple jobs to ‘support’’ the part-time family-friendly hours demanded by, mostly, single mothers). The service (predictably) declines, but women (well, except for those irrelevant younger single ones or … the customers) are happy.
I agree, unreservedly, with every point you make, except the ‘outsized’ role women, and feminism have played in the collapse we see across society we see now,
I suppose my view is coloured by a background in which girls have done the same job as males since the 1960s and got the same money. That job probably met your dirty and dangerous description and I’m pretty sure none of those that I had dealings with [retired 1998!] subscribed to any feminist *******t. Those girls just got on with life and dealt with [usually minor] misogyny as and when it occurred. racinghorsesbook.com
Nurses then likely shared the same mindset and felt fulfilled in doing a job that enjoyed public respect and paid better than shopwork: at that stage they didn’t need a “degree” they just needed to pay attention.
Now degree courses for nursing and the British Racing School are turning out entitled alumni that Matrons and Head lads would not have tolerated for a moment. But just think how many well paid jobs there are in turning out these snowflakes.
I see that the head psychiatrist at Johns Hopkins has just defined transgenderism as a mental illness! Good job too.
I spent some time as a child living near Stephenson’s stables (knew Arthur, I was going to be a vet until I joined-up, and even dated some of the ‘girls’ there later), yes I’m that old, so I agree in part.
What most wont recognise, I suspect, is that those women who not only survived but thrived in such jobs and environments (like the academics, doctors and MP’s in pre-feminism days, who never existed as far as feminist history) were … ‘unusual’, outliers. The assumption that ‘all’ women were, and even ‘wanted to be’, like them is one of the greatest lies ever. That they also carefully picked and chose specific roles/areas ‘within’ those jobs is also …. conveniently forgotten.
There are many roles where women are not just ‘as good as’ but often superior. The problem arises (e.g. in the forces, ambulance, police, etc.) when you consider only a small part of what a job entails as defining it. There are women who (embarrassingly) easily out-shoot me, but not one of them could yomp to get to where the job requires them to do that (the best competition distance shooter I know, struggles to even lift her own rifle). The best combat medic I know is a woman, yet I thank God, when I was shot, it was a male medic there to ‘haul my 6’ 5” 18st carcass to safety’. So many, jobs are only achievable by women using tech, to support them, but still unable to do the bulk, or a crucial part, of it. Pretending otherwise results in … what we see now.
As a male nurse I was employed in a clinical area, but then spent a great deal of ‘every’ shift being ‘loaned’ to other areas to lift, move, deal with aggressive or confused patients, etc. (and nursing is an area almost ‘designed’, and supported, for a female work-force). This was not always so (although “bringing in the porters” ‘was’), and again (as you suggest) I suspect it is based partly on the assumption that those who now choose to work in the profession are the same as those drawn to the vocation in days past, when they patently aren’t.
The drive to ‘credentialism’ (certificates for their own sake and mainly to signal status and ‘exclude undesirables’) has definitely excluded and removed those with talent and ability (but not necessarily academic interest), but it has also attracted a group (now the absolute majority) who see themselves as ‘above’ such mere basic roles as hands-on care (which considering it is the entire raison d’etre of the profession ‘should’ make them think, but doesn’t).
The destruction of meritocracy, and replacement with ‘equality’ (though in reality the demand for, patently unfair, unjust and unrelated to reality in any way, ‘equity’) across the board ‘will’ eventually result in collapse (and perhaps, it may be the only way to reverse the idiocy. The “Gods of the Copy-book Headings” will come again. I can’t wait).
But I still can’t accept the sex divide problem – there are plenty of male medics who couldn’t have shifted 18 st. and there may well be some females that could! When the world was run on common sense people were allocated tasks based upon suitability and everyone accepted that. We had girls that might not have been able to ride the rougher horses but who got on well with the more delicate ones, but everyone understood that and no-one made it an issue.
The fact is that feminists generally would not have held their end up in a genuinely mixed environment and that their ****ing and moaning about glass ceilings and positive discrimination has poisoned the atmosphere for those that could.
Good to remember “W.A.” Stephenson who was good to me when I was starting.
Those men unable to do so, simply wouldn’t be allowed the position (whereas the women ‘are’). Men who are as capable are regularly overlooked and excluded, for those limited posts, in favour of women who … can’t do all the job … because of ‘equality’.
In a purely meritocratic system almost all jobs would be taken by men (as history and every non-western country ‘now’ proves) and ‘that’ is now seen as unacceptable. (Yes, many women, as in the past, would still succeed, just none of the reluctant or incapable would be forced on us. And … given the choice, most women would still choose to be wives and mothers, if it hadn’t been demonised and dimished as a role … by feminists).
There shouldn’t be the ‘manufactured and engineered’ divide, but there ‘are’ differences (and Vive la!). In a sane world we would complement each other (as used to be done). Men may have conceived/built and maintained civilisation, but they did it ‘for’ women, but, like chivalry, it wasn’t men who reneged and threw it away. The divide exists, and it is only now that men have noticed, and started pushing back, that women have ‘suddenly’ decided it is a bad thing.
But as you say “Common sense, the rarest of super-powers”. The simple truth is that the very last thing any feminist wants is ‘real’ equality (as all their special preferences, quotas, funding and privileges would go away – and where else can a women’s studies major going to find a job?)
Have to admit that we never had to choose a quota. Although [anecdotally!] some [ leading] trainers did select for sex [as it were!] – always amazed that there weren’t any “me too” claims.
When you have millions of invited parasite invaders, who have never paid in to the system, what did they think would happen. When you run out of other peoples money…..