As a workforce planner in the NHS, I know that one of the biggest barriers to creating accurate plans is the fact that it takes around a decade to train a doctor, yet the standard parliamentary term is five years. Therefore we've been constrained, wanting to plan decades in advance but knowing that the policies on which we're basing those plans might change at a moment's notice. A politics-free governing body for the NHS would enable the genuine long term planning that the health service so desperately needs.
Another problem with the current arrangement is that policies are often drawn up based on perceptions of the NHS rather than the real situation. You often hear people talking about doctors and nurses as if they are the only people that are required to run a hospital. But that ignores the thousands of therapists, scientists, cleaners, porters, caterers, information technology staff, human resources advisers, planners, secretaries, receptionists, accountants and so on that are all equally essential. The BMA have criticised Gordon Brown's plans, which is not surprising. With new technologies, better training and imrpoved ways of working, the role of doctors carries less emphasis than it did a few years ago. Jobs that only doctors could once do can now be carried out by other staff, with much smaller salaries, therefore providing much greater value for money. An independent governing body for the NHS would recognise the value in this reassessment of skill mix, and would be able to make tough decisions (like cutting the numbers of highly paid doctors and replacing them with cheaper staff who can do the same job just as well) without fear of the publicity backlash that politicians are so scared of. This is the reason the BMA are critical of Brown's plan.
General practitioners in the UK are now the highest paid in Europe, yet work fewer hours than their European counterparts. This is due to organisations like the BMA holding the government to ransom when negotiating contracts and making key decisions about the NHS. Without the politicians involved, the BMA would have less influence over the direction of travel of the NHS, and the interests of patients would trully come first. Unfortunately the reaction of the BMA to Brown's announcement indicates that they are more interested in looking after number one than looking after their patients.
Gordon Brown's NHS Plan
Now that Tony Blair has announced that he'll be standing down within the year, his probable successor, Gordon Brown, has started making noises about what he intends to do when (and if) he becomes Prime Minister. Recently he declared his plans for the management of the NHS, namely taking control away from the politicians and setting up an independent body to oversee the health service. Here's what I think of that idea, and the British Medical Association (BMA)'s reaction to it.
