Even when there is a correct analysis, the speaker dare not mention the word rationing. Central dictate ensures that she never will until permission is given from “on high” and the knee jerk response is already initiated. In the same Times 9th April, Surabh Jha opines: Imaginative use of private money would rescue the NHS. He omits to mention the effect of knee jerk co-payments on the poorest.. The Hit man is Mr Hunt?
The NHS is failing because of “gross incompetence” among hospital executives and poor leadership at every level, one of its most respected figures has said.
Dame Julie Moore, head of the University Hospitals Birmingham and Heart of England NHS trusts, said that some of her peers needed to be sacked and attacked a “culture of indecision” in which managers made their way up the hierarchy by avoiding responsibility.
She also argued that too many hospitals were failing to carry out basic medical research duties. This could leave the UK struggling to cope with new viruses and the increasingly complicated patterns of common diseases such as diabetes and dementia.
The NHS is running a combined budget deficit of more than £2.3 billion, including £1 billion of overspending on agency staff, with three quarters of hospitals and other providers in the red. It faces a growing burden of chronic and often overlapping diseases that it was simply not set up to handle, according to Dame Julie.
Speaking at an event organised by the Academy of Medical Sciences in London this week, she was asked by an audience member why the NHS was in such a perilous state.
“You’re right that it’s failing,” she replied. “A lot of it’s down to the failures of leadership I have seen on every level. There’s generally between 10 and 15 per cent of chief executive jobs vacant, and I would also say that some of the jobs that aren’t vacant should be, because they are filled by people who are grossly incompetent.
“I have actually met one who said: ‘I have made a career out of never making a decision’. . . We’ve created a culture of people who are terrified of making decisions because you can’t be held to account for making no decision, but you can if you make a decision. We’ve got the leadership model wrong.”
After the lecture, Dame Julie laid much of the blame on moves by previous governments to centralise power, which she said had left many of her colleagues “waiting for a command from God on high” instead of taking the initiative for themselves.
Many hospitals were hampered by IT systems so poorly designed that she “wouldn’t touch them with a bargepole”, while others treated their obligations to carry out research as little more than an “intrusive obstruction”.
Over the ten years since she was appointed chief executive of the University Hospitals Birmingham trust, which includes the flagship Queen Elizabeth hospital, she has brought in a pioneering computer system in which every detail of the doctors’ and nurses’ days is logged. She said that the reforms had drastically reduced superbug infection rates and clinical mistakes.
The trust’s success prompted the NHS to parachute her in to five failing organisations in the Midlands as a troubleshooter. Dame Julie argued that while some of the government’s targets helped to keep up basic standards, many others were counterproductive. Hospitals urgently needed funding for steps to prevent diseases from happening in the first place, such as gyms and diet plans for the middle-aged and elderly.
Sir Robert Lechler, professor of medicine at King’s College London and president of the Academy of Medical Sciences, said Dame Julie was right and that the NHS was creaking under the strain of its financial and clinical problems.
“We have an unsustainable healthcare system and just doing more of the same is not going to deliver solutions,” he said. “What the NHS does need is really strong, effective leadership in order to bring about transformational change.”
Womans Hour Interview with Dame Julie