NHS in dire need of radical reform

When meeting targets puts too much pressure on staff and impacts on patient safety, it’s time for a rethink

When it comes to the National Health Service, politicians often seem to put the popularity of policies over their efficacy.

All mainstream political parties have been guilty in recent years, when discussing their plans for the NHS, of spinning easy headlines rather than introducing proposals of substance. Thus, we see medics put under sometimes intolerable pressure to meet targets while, at the same time, staff shortages point to flaws in the health service that require urgent attention.

We are not opposed to the use of targets in the NHS; how else could we measure the standard of service and note any improvements if targets did not exist? But when the pressures placed on medical staff by politicians start to have a negative impact on patient safety, it’s time to think again.

This would certainly appear to be the case in Accident and Emergency units across Scotland, where budgetary pressures have led to vital risk management systems being “diminished or abandoned”.

According to the Royal College of Emergency Medicine (RCEM) in Scotland some casualty units have axed clinical governance systems – which help ensure patient safety and the management of risk because the cost is prohibitive.

The RCEM warns that, for medical staff in A&E departments, “firefighting” is the norm.

The British Medical Association’s view on the matter is equally bleak. According to the BMA, staff under pressure to deliver only good news to target-driven managers are sometimes reluctant to speak up about flaws in the system.

The SNP has, since coming to power at Holyrood in 2007, staked a claim to be the true guardian of the NHS.

The Scottish Government’s cautious, managerial approach to the NHS has not allowed the system to develop and evolve in step with the changing needs of an ageing population. If A&E staff are scared to raise concerns in case they provoke management anger, then something has clearly gone terribly wrong.

The Scottish NHS is tired and under-resourced and staff morale is oftencrushinglylow. Firstminister Nicola Sturgeon and her Health Secretary Shona Robison can no longer ignore the need for radical reform.

If politicians continue to neglect the service, then crises such as the one developing in A&E departments will become more common.