NHS ‘bean counting’ attacked
BMA chief’s anger at plan to change medics’hours
THE leader of Scotland’s doctors has condemned the relentless rise of NHS managerialism claiming it has resulted in patients being treated as “widgets”.
Dr Brian Keighley, chairman of the British Medical Association (BMA) in Scotland, hit out at “bean counting” and “top-down, politically-inspired targets” in the health service during a speech to the BMA’s national conference in Edinburgh.
He has now called on the Scottish Government to “abandon the worst excesses of top-down direction” and instead to trust the professionalism of doctors and other staff in the NHS.
Dr Keighley, of Balfron, Stirlingshire, is to retire from his practice after nearly 40 years in the NHS.
He talked of the unfair raid on doctors’ pensions that will see NHS employees working longer and paying more, though the main focus was the impact of the health service’s “slavish addiction to an ethos of corporatism and managerialism” on patients and staff.
Dr Keighley added: “We now see health boards talking about ‘their’ patients, almost implying that the doctors it employs or contracts with are mere technicians in the pursuit of their corporate aim.
“What an insult to those of us who came into medicine to treat patients to the best of their ability.”
Dr Keighley insisted he had “no argument with the recruitment of good managers to make best use of scarce resources”, andalso stressed he was “no enemy of efficiency or proper financial control”.
But he said: “Bean counting and clinical direction by managers with top-down politically-inspired targets are not compatible with relationships founded on trust between physician and patient. Patients are not widgets and I get upset when they are treated as such, and when I am considered a mere tool within a corporate design.
“This slavish addiction to an ethos of corporatism and managerialism has led to doctors, nurses and other clinicians becoming progressively disempowered.”
Dr Keighley argued patients, and their relationship with medical staff, should be at the centre of the NHS’s work.
He added: “What I want to see for my successors in the NHS is a return to what is at the heart of laudable patient safety and quality initiatives … the centrality of the patient and his or her relationship with their doctor, nurse or therapist,” he said.
“My message to the Scottish Government is for politicians and managers to abandon the worst excesses of top-down direction, to stop measuring only those things that can be measured, and to trust in the professionalism of its highly qualified and dedicated staff.”
He said it had the chance to start trusting its professionals andto rein in “the rampant managerialism that has crept north of Carlisle”.
“Let us start again in a new culture of trust and mutual respect and send the managers back to their calculators and let the doctors get on with treating the sick,” he added.
Meanwhile, the Royal College of Physicians and Surgeons of Glasgow signalled backing for plans which will see consultants working evenings and weekends at the new £840 million South Glasgow Hospital.
Traditionally, most NHS consultants have worked weekdays and been on call at weekends. The change was made clear by Robert Calderwood, chief executive of NHS Greater Glasgow and Clyde, in yesterday’s Herald.
In a statement, the College said it believed in a “consistent standard of care which is of the highest quality throughout the working week, at weekends and on public holidays”.
It said the issue is being addressed by the Academy of Medical Royal Colleges in the UK and the Scottish Academy, but conceded it would have ‘substantial resource implications’ for doctors and o t her heal t h professionals.
In Edinburgh, the BMA warned calls for doctors to provide all healthcare services 24 hours a day 365 days a year are “ridiculous.”
It condemned suggestions the NHS should operate a seven-day supermarket-style operation for all services.
The conference passed vote of no confidence in England’s Health Secretary Jeremy Hunt. Dr Jacky Davis said he was leading the UK Government’s “ideological attack on the service and on staff”.