Why do so many politicians wish to stamp their name across a department and install fundamental change with targets to institutions that aren't performing that badly. This week has seen the Government back down over its NHS reforms after failing to underestimate the public goodwill towards the institution. The cynic in me fears that they will press ahead with their ideas but by the backdoor with no fanfare. The point is that any large organization whether in the public or private sector is bound to be a bit flabby with room for improvement but to overhaul the whole system can only destroy the good that it does. With regard to the NHS targets are set and league tables drawn up to highlight underperforming hospitals similar to that with schools then we are told that we have a "choice" as to where we get treatment as well as where our children are educated.
The trouble here is that this is an area where choice is not necessary - we simply want to be treated or taught to the best standard no matter where we are in the country in the local hospital or school. Having to travel a further 30 miles to a hospital that was a few places higher in the league table is not choice: It is failing to take responsibility for the services you provide. Politicians, like business leaders, feel that they must appear to be proactive so talk about cutting waste and improving efficiency as if previous managers were simply burning money to keep warm and never had their own cost cutting exercises.
I work for a medium sized company that has been around for nearly 150 years and there have been a number of changes of ownership in the last few decades each time with a new idea on how they could save more money with mixed results (one before I started was particularly disastrous as they bought in cheap ingredients resulting in poorer quality product and less custom). Each time the upshot is that there tends to be fewer staff doing more work between them but there is only so far this and various updated time and motion practices can go (despite how earnestly the latter are studied with their Japanese terms).
Similarly with the Health Service the major way of saving money is by employing less people and increasing the workload on those that remain which can only undermine morale as well as annoying patients (or clients or customers or whatever they choose to call them). Why would patients be annoyed? Surely they would benefit from a better service. But why would it be a better service with fewer resources? In the private sector the onus is on producing generic product A cheaper than company X which is all well and good until company Y comes along and produces it even more efficiently and cheaper. The problem is that for all the talk of choice we are having the number of options limited as we are left with a number of companies all producing Product A ever more efficiently rather than a variety of products and services that people may actually want.
The NHS is one of the great institutions of this country like the BBC which whilst they do have their faults perform a great service and will own up to mistakes, often too freely in response to the slightest criticism. By contrast private companies will deny any wrongdoing for fear that their share price would suffer. League tables and targets do not help the public sector as the nature of tables means that someone must come top and someone bottom. In the case of the former that hospital or school may become oversubscribed and the latter can only be stigmatised. Rather inspectors should merely report on the potential failings of institutes and show where improvements are required. If the standard is so poor that the public would suffer from attending then drastic action would be necessary but until then a more laissez faire attitude would be better all round.
The trouble here is that this is an area where choice is not necessary - we simply want to be treated or taught to the best standard no matter where we are in the country in the local hospital or school. Having to travel a further 30 miles to a hospital that was a few places higher in the league table is not choice: It is failing to take responsibility for the services you provide. Politicians, like business leaders, feel that they must appear to be proactive so talk about cutting waste and improving efficiency as if previous managers were simply burning money to keep warm and never had their own cost cutting exercises.
I work for a medium sized company that has been around for nearly 150 years and there have been a number of changes of ownership in the last few decades each time with a new idea on how they could save more money with mixed results (one before I started was particularly disastrous as they bought in cheap ingredients resulting in poorer quality product and less custom). Each time the upshot is that there tends to be fewer staff doing more work between them but there is only so far this and various updated time and motion practices can go (despite how earnestly the latter are studied with their Japanese terms).
Similarly with the Health Service the major way of saving money is by employing less people and increasing the workload on those that remain which can only undermine morale as well as annoying patients (or clients or customers or whatever they choose to call them). Why would patients be annoyed? Surely they would benefit from a better service. But why would it be a better service with fewer resources? In the private sector the onus is on producing generic product A cheaper than company X which is all well and good until company Y comes along and produces it even more efficiently and cheaper. The problem is that for all the talk of choice we are having the number of options limited as we are left with a number of companies all producing Product A ever more efficiently rather than a variety of products and services that people may actually want.
The NHS is one of the great institutions of this country like the BBC which whilst they do have their faults perform a great service and will own up to mistakes, often too freely in response to the slightest criticism. By contrast private companies will deny any wrongdoing for fear that their share price would suffer. League tables and targets do not help the public sector as the nature of tables means that someone must come top and someone bottom. In the case of the former that hospital or school may become oversubscribed and the latter can only be stigmatised. Rather inspectors should merely report on the potential failings of institutes and show where improvements are required. If the standard is so poor that the public would suffer from attending then drastic action would be necessary but until then a more laissez faire attitude would be better all round.
