‘Not up to the job’

Post-war Labour prime minister, Clement Atlee, was a man of few words. A junior minister, who had just been sacked, asked him why. ‘Not up to the job’, was alleged to have been the terse reply.

I cannot claim to have read the three volumes of Robert Francis QC’s Mid Staffs report, nor indeed all of its 290 recommendations. From what I have read, however, it could be summed up in Atlee’s four terse words. Those involved, be they doctors, managers or nurses, were ‘not up to the job’.

The former boss of Tesco, Sir Terry Leahy, built it into the largest grocery retailer in the UK and quadrupled the number of its stores. Whatever you may think of the company he was a superb manager.

One of his hallmarks was to visit one of his stores every week. He mixed with staff and customers and knew what was going on. How often did the managers at Stafford tour the wards talking to nurses and healthcare assistants, patients and visitors?

Many relatives felt powerless to complain. Many of us have felt the same when confronting any large company or organisation. We now have an ally, social media. A letter of complaint will be seen by a couple of people at the company and receive an anodyne reply.

A critical remark on Twitter or Facebook may be seen by thousands. Enlightened company executives and managers realise this and fall over themselves to remedy faults. There have been calls for care homes to be given the ‘Tripadvisor’ treatment.

When will you be able to comment on your local hospital, GP or pharmacy on a comparison website? I would suggest that this is an ongoing trend and will in time extend to dental practices.

In the meantime, the prime minster has promised a new Chief Inspector of Hospitals and more inspections to make healthcare providers more accountable.

In dentistry as in the rest of the NHS, we will have to look forward to more regulation, more inspections.

What the NHS really needs though is not more management, but better management. Whether the existing hierarchy can provide this is open to serious doubt.

Michael Watson, news correspondent


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