The NHS cares more about PR than patients
The Mafia-like NHS management style continues to endanger countless patients. Organisational and personal reputations are far too often placed far ahead of good practice and safe patient care by the use of skilled but expensive PR.
As has been reported this week, whistleblowers – those who highlight errors and problems – are treated like criminals. They are hounded and bullied out of jobs, with their financial and professional futures ruined by bureaucrats who rarely have any actual medical experience.
Defusing, and then covering up the story, becomes the priority instead of addressing the root cause. This stop-gap approach saves the day in most cases but eventually disasters leak out. Regulatory bodies such as the General Medical Council (GMC) for doctors and the Nursing and Midwifery Council (NMC) are weaponised to silence doctors and nurses, with so-called heretics flogged in front of the baying mob. This sets an extremely effective deterrent.
I’ve seen it myself as an expert witness at a GMC tribunal of a leading oncologist. I, and the only other defence expert, are both now under investigation. I’m too old to worry about it, but kangaroo courts for offending NHS staff are common, with patient safety far too often right at the bottom of the agenda.
Many medical professionals, no matter how senior, find the whole process of raising concerns extremely intimidating and incredibly stressful. NHS management have designed it to be that way, and want all involved to know it. It’s a toxic environment, with poison pumped in from the very centre at NHS England.
Swarms of overpaid and over-promoted PR managers seem to care little for patient outcomes, viewing them as secondary to the reputation of their hospitals. They thrive on “crisis management” as a way to justify their own positions. Having submitted a subject access request to NHS England late last year, I finally received the answer one week ago. Hundreds and hundreds of pages detailing lengthy correspondence between NHS “communication” specialists about some of my statements in this very paper. The amount of time and resource that has been poured into dealing with my concerns is astonishing and surely indicative of a much wider problem.
It’s not only patient wellbeing that is put at risk, but that of the staff making these complaints. It can drag on for months, or even years, with all manner of threats and abuse being felt by those who put their heads above the parapet. Is it a surprise that so many professionals are leaving?
When I worked in the NHS as clinical director of cancer medicine at Hammersmith Hospital, I was in charge. I took responsibility for what happened under my watch, and the buck stopped with me. That is exactly how it should be. Now?
There are layers and layers of bureaucracy and bureaucrats, many of whom contribute nothing productive to providing timely and efficient care for patients. It’s a mess, and eventually all bloated systems break down – as we’ve tragically seen with Mid Staffs, Morecambe Bay and so on.
Returning responsibility and power to health professionals is vital. Without it, the NHS bureaucratic machine will grow stronger and even more untouchable. And, as public attitudes towards the flawed system sour, with surveys revealing satisfaction is already at an all-time low, senior managers will go to ever greater extremes to silence dissent. Doctors and nurses within the system who raise legitimate and important concerns will not stand a chance.
Where is the accountability for those in charge? The Chair and CEO of NHS England wield far more power than the politicians. NHS leadership should be hauled in front of Parliament on a weekly basis and subjected to intense questioning on the poor quality of patient care – that is, or at least should be, the overarching objective of everything that the health service does.
Whistleblowers deserve to be protected and celebrated, not persecuted and harassed. The whole system is designed to safeguard and enhance the existing establishment. A radical overhaul of how we deliver care is required – does the political courage exist to deliver that even with a new government?
Professor Karol Sikora is a leading cancer specialist