www.telegraph.co.uk/news/2024/05/17/nhs-whistleblower-end-culture-of-closing-ranks-atkins/
NHS must end culture of secrecy, says Health Secretary
Yes, it's a public service. The public needs to know of all coverups, bullying, racism, nepotism, bias, poor performance, death rates, etc
I love the NHS. As an idea it’s probably the best thing about this country - I think that not having the “does my insurance cover this, and will it bankrupt me anyway?” question hanging over you provides real peace of mind, compared to what our American cousins have to put up with.
We must resist every attempt to push us towards that awful model.
But the secrecy problem is real. British civic society is inherently and reflexively secretive, and the NHS is no different, with its bullying and ineptitude and cover-ups, etc.
The problem with humans running a system as complex as the NHS is that human failings, which will happen no matter how hard you try to prevent them, often occur at the most difficult moment in the life of a victim - when they’re sick in hospital (or, when they’re unwell but aren’t being taken seriously).
NHS staff must be able to blow the whistle with confidence internally and externally when they encounter bad behaviour or other problems. I don’t want this to become some bad-faith wedge issue that moneyed interests deploy to worm their way even further into the service, which will inevitably be to our detriment. The profit motive is corrosive - just watch any of John Oliver’s videos about the US health and regulatory systems.
(Or think of the UK water company scandal, or Post Office scandal, or Grenfell Tower scandal… You get the idea.)
Lets stop comparing ourselves to the US and start comparing ourselves to other European countries on this.
Otherwise I agree.
For all services we should be comparing ourselves with places that have things better and try and improve ourselves.
Well said. The US is what we want to strive to not be.
Walmart smouldering rage intensifies
Well a lot of European countries have insurance models. If a British politician were to suggest we mimic the French or German system in this country, there'd be outrage x
The reason it's compared to the US is that that's where the government have their sights firmly set.
Yep absolutely
The companies salivating over the NHS are from the US and want it to go that way, which is why the comparison is usually made
America serves as a bogey-man to deflect criticism of the NHS. Every religion needs a devil.
Very well said. Staff should be supported to speak up and feel safe to express concerns, good managers will see this as positive. Mersey care seem to be doing well, let’s hope many more follow.
The United Kingdom and UK politics subs are pushing a lot of Telegraph articles recently, I assume as a last attempt to sway the public before the Tories get royally fucked in the next election, when they grow the balls to call it that is.
In my experience, they remove posts they dont like for arbitrary reasons thin enough they can convince themselves it's neutrality.
Managers don’t get sacked they get moved
Performance reviews are like 10% of the issue
I think if more people realised that probably a significant minority, if not a majority, of the movement of managers between trusts was because they'd fucked up at the previous job then they might start to ask more questions of those managers.
Look at the alder hey organ retention scandal, most of those managers who were involved or negligent in spotting it weren't sacked, they simply went off to some other cushy role doing policy reviews or maybe a spot of external consulting.
This.
I respectfully disagree, the NHS experiment has been a disaster for British health and a large part of this country is going to hell as it takes up an ever-growing part of the budget. I don't call it an economic black hole for no reason. It has also made us worse off in both health outcomes and the erosion of our rights.
We need to stop pretending that it's this wonderful system and see it for the half-dead, diseased, crippled sacred cow that is and that it should be put out of its misery. It was designed to fail and it is failing exactly the way it was designed to and was inevitable.
Then move to the Swiss system (where Private does all the services but you get government vouchers), before moving to a free system (not like the USA).
As for Comparisons, while it is not "Does my insurance cover this, and will it bankrupt me anyway?" but "Will I live long enough on the waiting list to be seen/treated"? and "Will I get enough time with the doctor for the issue to be corrected in time"?
Then move to the Swiss system (where Private does all the services but you get government vouchers), before moving to a free system (not like the USA
If the NHS is privatised this simply will not happen. Any government willing to privatise the NHS will only do so at the behest of private healthcare firms who will want full bore, USA style, credit checks for paracetamol type healthcare.
As for Comparisons, while it is not "Does my insurance cover this, and will it bankrupt me anyway?" but "Will I live long enough on the waiting list to be seen/treated"? and "Will I get enough time with the doctor for the issue to be corrected in time"?
That's the fault of austerity, not inherent to the NHS itself.
"If the NHS is privatised this simply will not happen. Any government willing to privatise the NHS will only do so at the behest of private healthcare firms who will want full bore, USA style, credit checks for paracetamol type healthcare."
No, they don't, that type of system hurts those companies as well, but they are in no real position to work otherwise.
"That's the fault of austerity, not inherent to the NHS itself."
No, it's core to the NHS model, austerity only acted as an accelerator. Whenever you make anything free at the point of use, you open it up to the tragedy of the commons, with overuse and abuse running rampant and rationing as necessary (i.e. wait lists). The NHS was doomed from the start.
The Tories have been in control of the NHS for 12 years. If they haven't in the past, they never will
14 years
Sorry yes 14.
Things such as the charging of Dr Bawa-Garba impress this upon the service. You tell people not to cover things up, but when they're honest they go to jail. When excess deaths at an NHS trust hit the headlines, it's not the people who're responsible whose careers get hurt, it's whoever's in charge of the trust during the press attention (often a few years later).
Our culture doesn't seem likely to change this: consider the arguments about which politician/s from which party to blame for the post office thing...none of them in reality, but bad press hurts careers, fair or otherwise.
We've got a system where the case is often: 'you've done nothing wrong, help coverup & lie or get fired.'
Bawa-Garba cooperated openly, got fucked...doctors learnt to say whatever the hospitals lawyers tell them to.
This is so true. Part of the problem is that we've depoliticised lots of things. This has advantages but speedy turn-around isn't one of them. The knee-jerk reaction of any politician to any scandal is to kick off a public inquiry. It's a good way of finding out the details of what went wrong but it's a terrible way of holding anyone to account and often not a great way to make sure it doesn't happen again. By the time an inquiry publishes its findings, the people responsible have moved on, the processes have already changed to the point that any recommendations aren't really applicable and the next scandal is already brewing.
Yes just as labor are about to take power now the tories worry about transparency!
we spend £1bn a year on making up for massive life changing cock ups in maternity care
The budget for maternity care is £3bn!
We spend 1/3 our maternity care budget on fixing the mistakes!
This won’t stop overnight and Labour will inherit this shit show and it will take years to fix
Maternity care is always very expensive in terms of indemnity because the payouts of medical malpractice take into account your projected lifespan.
You fuck up in oncology and disable an 80 yr old bloke, well you only have to pay for the next decade or so.
You work in obstetrics and disable a newborn, that's 70 odd years of costs you're on the hook for.
Now that's not to say obstetrics and maternity care can't or shouldn't be improved, austerity has fucked them just like the rest of the NHS, but we should always expect them to be a very expensive area of medicine.
Yeah that’s fair, but you know, stitch in time and all that!
Oh 100%, I think it goes without saying that we should do everything in our power to make sure mistakes aren't made for newborns or their mothers, not just for cost reasons but also because nobody should be forced to grow up disabled because someone else fucked up.
But unfortunately humans make mistakes and those mistakes are always inherently going to be costly (both monetarily and in quality of life terms) for babies and children.
Front what I gather the main issue in maternity is chronic staffing issues that are affecting quality of care (understandably) and also causing issues with retention, which then causes even worse staffing issues.
Alot of senior staff burnt out and left, this is also something the Tories drove at schools trying to cut budgets there by cutting out senior teachers.
This whole mess isn't some surprise, almost all of it stems from the 10 year period of chronic underinvestment during austerity. George Osborne has alot to answer for.
Labour are no different from the Conservatives. There is no plan to "fix the shit show", it is designed to be a shit show
No guarantee either way; but history has shown that a Labour government has always resolved the problems holding England back and allow for a better society; then everyone and their dog votes for the torrid because money is good and then suffer when the time still isn’t right
"Resolved" is very strong language for what new labour did. Soothed, perhaps, but to resolve the problems would imply they were fixed. Blair and brown papered the cracks over but, for instance, the use of PFI was a sticking plaster on the problem of NHS investment.
No chance. The NHS is like a cult; you either accept it as it is or you want the American system.
These are the only two choices Reddit tells me
I want to end the culture of incompetent health secretaries.
You can’t spell secretary without a secret…
I want to end the culture of incompetent medical secretaries.
"How can your husband's job not be a conflicting issue with being a Health Secretary"
"Its ok i recuse myself from influence"
Yea right
"You can't just say you're recused from influence!"
"I didn't say it, I declared it."
Why is the model for aircraft safety not built into the NHS I.e all near misses, errors, etc must be reported by statute, in order to continuously improve processes and procedures?
They are supposed to to report all near misses etc. The problem is the NHS is not a single monolith. There are 217 trust's all with different reporting systems, and different working practices. All competing against each other, and all trying to get funding from the government. One of the issues is reporting errors up so they can get to the top of the NHS/government to then go back down to all the trusts is incredibly difficult. Add to that people often don't want to come forward/report errors because they are likely to be thrown under the bus if they do.
I kind of missed my point that all such reporting would be protected as well as mandatory….
The thing is, it’s protected in theory, but the culture aggressively discourages it on a daily based. I worked in the NHS in a great trust (not one of those really awful trusts out there) and even there I felt that raising concerns was too counter-productive to patient-first care to be worth it. Everyone is so overworked and there’s so little spare time to go around, that if you open the can of worms of having a whole investigation done… hours of your own time, others’ time, microscope on every detail, just to have it come up inconclusive with a casual warning to the perpetrator at most. Doesn’t even fix the problem of them not following rules, they just stop doing that one specific thing and cut corners somewhere else instead. So you only consider reporting things which are actively imminently dangerous to patients because anything less than that makes you “that guy” who’s causing all sorts of new problems when half the people are already on the brink of leaving when operating at full throttle.
The NHS does indeed already have this process. Errors and near misses are reporting internally. The bad ones are reported as 'serious incidents' externally.
Because if they tried to run to that level of safety the system would fall apart even more than it already is.
Airlines have very strict restrictions of duty times, consecutive shifts, out of hours shifts (period of circadian low) that if they tried to use in health would simply be impossible due to a lack of staff.
These measures would make everyone (patients and staff) lives better but good luck getting there.
Probably because that would require reforming the NHS
Secrecy like how Tories hand out contracts to their mates etc?
So will the government have to follow suit or is this designed to discredit the NHS in the publics eyes?
It prob is in a state with the low wages and funding, no it’s not supposed to be profitable, it’s for the public, yes the public moan about it but the alternative is a lot worse.
Stop taking advantage of the good people in the NHS who above all this crap care about their patients.
Feels like a snuck premise. Whats the reasoning for suggesting the NHS has a culture of secrecy?
Oh, look, another Telegraph article all about how terrible the NHS is...
The secrecy and coverup method is wider than the NHS. No politician will support the ending of it. It is used by rich people or those who can access public funds, to coverup their offending, whether financial or personal / sexual. It’s a development of techniques from tax avoidance. The Law Society and Bar council support it. The SRA can’t do anything while it bows to the Law Society. Ending it would mean ending all that contractuel embezzlement and money laundering through London and nothing for the lawyers to get a cut of. Basically not gonna happen.
The NHS is used for money laundering?!
No, the method used for coverups of wrongdoing / crimes is used to carry out money laundering. If it hadn’t been extended to major public sector embezzlement it might not have come to light how it was done.
One day a journalist outfit will have the co jones to tel’ the story.
Yup the NHS has a horrific hatred of transparency. It’s usually using the excuse of patient privacy and data to prevent any sort of transparency but when you consider the fact that they applies even when patients are complaining or sueing them over they’re own treatment you quickly see how this is clearly just a smokescreen for limited accountability.
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