This was revealing. This is a huge voluminous report on excessive maternal mortality rates. Healthcare makes news only when the constituents get affected.
As public satisfaction with the NHS hits a 25-year low, perhaps we can be more honest about the problems in a service which combines world-beating excellence in some places with appalling management failure in others. This week’s British Social Attitudes survey showed overall satisfaction with the NHS at 36 per cent, down 17 percentage points from two years ago. The NHS has been our national religion, partly because it treats us without payment in our hour of need. But the idea that it’s “free” has sometimes made us too grateful, and allowed the system to close ranks. The NHS is not actually free: we pay for it through our taxes. This should give patients the right to ask questions, and not to struggle for years, as the Stanton-Davies and Griffiths families courageously did in Shrewsbury, to find out why their babies had died.
The western model of healthcare delivery is failing. NHS has possibly reached the status of “too big to fail” and will require considerable infusion of funds to keep it propped up. Again from the linked Financial Times write up:
There is a culture of fear in parts of the NHS which helps neither patients nor the dedicated staff who are sick of working with bullying colleagues and box-ticking managers.
When I was at CQC, hospitals would hire management consultants to game our inspections.
On some visits, Professor Sir Mike Richards, the first Chief Inspector of Hospitals, would advertise his mobile number because doctors with stories to tell were frightened to be seen meeting him. That’s not to defend the CQC: Richards told me this week he wished we had found a better way to measure culture within individual departments, rather than at the Trust level, which might have picked up the failures in Shrewsbury.
But there is a toxic brew of stress, long hours, and limited respite which can turn very sour. In the latest staff survey, two out of five NHS workers say they would not recommend their organisation as a good place to work. Astonishingly, that represents an improvement on previous years.Emphasis mine
So it depends on the different Trust hospitals on how well they game the system. I can’t comment further on NHS because I have never worked in the UK – but this is instructive.