By stewartb

From the disingenuous article in the Times yesterday: ‘In England Wes Streeting is demanding change in return for extra funding.’ What change? Something called ‘zero-tolerance’ and the introduction of ‘league tables’!

Source: Nuffield Trust – ‘responds to announcement of new “zero tolerance for failure” NHS reforms‘ Press release November 13.

‘.. there is a danger the actions announced by the Secretary of State will worsen some of the patterns that got us into this mess. We know from the special measures for quality regime that “naming and shaming” NHS trusts can make it harder to recruit staff, which doesn’t help patient care at all. It’s unclear what new league tables will measure – a table based on general waiting times doesn’t add much if you need to know how good heart surgery is.

‘Many of the drivers of poor productivity are systemic – from the dire state of social care stranding people in hospital, to crumbling roofs and worsening population health. They happen across England – which trust is worst affected is often a matter of luck and history as much as leadership. We need a system that encourages leaders to go to the most difficult and challenged trusts to improve patient care – not one that rewards them for choosing easier places to work.’ (my emphasis)

Source: Nuffield Trust – ‘responds to latest NHS performance statistics’. Press release November 14. (‘NHS’ = ‘NHS England’)

‘Yesterday the Secretary of State laid down the gauntlet to the NHS to ensure patients see real improvements in the quality of healthcare. But with systemic issues like crumbling buildings, profound problems in the social care sector and continued pressure on community and primary care, today’s figures underline once more just how far the health service has to go to really turn things around and offer the quick access to care that patients need and deserve.” 

Source: The Kings Fund – ‘NHS performance issues are endemic across the country’ Press release November 14.

‘.. league tables alone will not lead to better and faster care this winter and could result in the unintended consequence of health leaders becoming too focused on reporting upwards to national bodies instead of outwards to what their local communities need. The mix of measures will need very careful implementation to avoid perverse incentives.’

In an opinion piece in the Guardian (November 13) under this headline ‘The plan to introduce league tables is a simplistic, retrograde gimmick that will demoralise NHS staff – and sideline their incredible work’ a palliative care doctor wrote:

‘Seriously, Wes Streeting? After 14 wretched years of Tory austerity, stealth privatisation, draconian outsourcing, the Brexit staff drain and the horror and trauma of Covid from which – as you know – staff haven’t remotely recovered, the big NHS plan is to be … naming and shaming? Complete with inflammatory language that’s designed to scapegoat staff, such as the bad managers you’ve branded the NHS’s “guilty secret”? Do you genuinely think this is constructive?’

‘There is colossal cognitive dissonance at the heart of this plan. Streeting himself is the first to acknowledge the impact of structural inequalities on health, recognising that disadvantaged groups in British society are at greater risk of ill health and premature death.

‘Yet his return to hospital league tables presumes that underperformance is all the fault of those deplorable “bad managers” and somehow divorced from the socioeconomic realities of the population they serve.

‘He must know that hospital performance is intricately bound up with the availability (or not) of social care in a region, the prevalence of poverty, the availability of staff, local unemployment levels and innumerable other factors beyond senior hospital managers’ control. Pretending otherwise is disingenuous.’

Helen Puttick, ‘Scottish Health Correspondent’ in her Times article appears to be intent on misinforming readers and voters: she and her ilk in the mainstream media that supposedly ‘serve’ Scotland are working on the basis that persistent, negative framing of stories about NHS Scotland will trump facts, defeat the SNP and by extension help to defeat any move towards independence. To Ms Puttick and her ilk, their journalism is legitimate and ethical as it serves their partisan. political ends.