While the NHS will always need money, that is not the primary requirement, but is an important requirement.
The NHS is fundamental in the delivery of CARE. So CARE is the primary requirement and when the NHS was created everyone employed, especially the nurses, main wish was to provide care to their patients. It was viewed as a vocation, not just a job.
During the economic expansion in the UK during the 50’s and 60’s, immigration was encouraged to ensure job vacancies were filled. In fact if it was not for the immigration many areas including the NHS would not have been able to continue. The people recruited to the NHS had what was required, the compassion for the job, not necessarily educational qualifications. The training could be provided on the job. This ensured the excellence of the NHS was maintained.
But with extensive Government intervention over the last 30 years, the NHS has concentrated too much on chasing targets and not sufficient in maintaining patient care.
Also when the NHS was created the degree of care was, while very good, was limited to the available knowledge of that period in relation to the health conditions of the patients, the health practices available and there were hardly any expensive drugs. The level of immigration was minimal and foreign travel to exotic locations was hardly heard of outside the ruling classes and the intrepid explorers. Today the range of medical conditions which patients may be suffering from have increased considerably. With the advancement of medical science, not only are people living longer, but people who would have died at birth or soon after are surviving into relative older age, with many having varying disabilities. Our hospitals are no longer small cottage hospitals, but are extremely large, with many specialising in certain conditions. There is now extensive foreign travel by a large section of the population to exotic places.
Due to the extensive increase in size of our hospitals, the management structure as had to be changed. Whereas previously the cottage hospital was run by a Matron, now no one person can undertake sole direct charge. Matron could look at all aspects of the running of the hospital and maintain day-to-day control. She would immediately notice if all was not progressing to her satisfaction. Also there would not have been any noticeable financial constraints. Hardly any of the health measures, treatments and operations would have been very costly.
Today there are masses of managers each undertaking responsibility for their own area of operation and do not always take into account other related areas when making decisions.
Due to the targets culture, while these managers are consumed in endeavouring to reach and maintain these targets, other areas of operation, where there are no targets, are left to progress, or not, on their own to some extent.
Many say, bring back Matrons, which they have in some instances, but these Matrons are not the Matrons of old, their areas of control are limited and there will be a few Matrons in the hospital, where previously there would have been only one.
It is said there is a shortage of nurses in the UK and moves are being undertook to recruit from abroad. But how can this be when some UK nurses are likely to be made redundant due to cash restraints in the NHS.
So what is the answer?
Ensuring all staff give ‘a dose of kindness’ would be a start, but it is not the total solution. Effective management would be another and an end to continued Government intervention would be another.
What would also help would be a major change to the working culture of the UK. Today how many take pride in their job, ensuring they perform to their best ability and adhere to getting it right the first time.