A toxic amalgam of 4 “health and social care” services

It seems that all the 4 health services are too toxic for any party to make a meaningful statement of how they, or social care, should be changed. The BMJ in a comparison of bribes describes the differences between the parties on Health and Social Care. Not one of them is suggesting that even with money, plant, people and cultural improvement, the system itself needs to change. It is not founded on a financial rock, and the result is a perverse incentive to deny or ration care covertly if possible, but overtly if the management cannot get away with it.

The ingredients for toxicity have been building up for years. Management, consultants, bullying, and culture etc.

Avoiding the issues Nowhere to go – The BMJ

2013 BBC News: Bullying ‘creates toxic NHS culture’ – BBC News

2013 The Independent: Watchdog warns of ‘toxic cocktail’ within the NHS

2013 Health Service Journal: NHS in-fighting is creating a toxic culture | Comment | Health …

2015 National Health Executive: ‘toxic’ bullying culture – National Health Executive

2019 HSJ: Surveillance of managers is ‘toxic’ says Don Berwick | News …

2019 The Guardian: Latest NHS maternity scandal is product of toxic ‘can’t happen …

2019 The NHS crisis of caring for staff | The King’s Fund

Miles Sibley in the BMJ: Changing the culture of learning from deaths

With the revelation that a “toxic culture” led to the deaths of mothers and babies at the Shrewsbury and Telford Hospital NHS Trust, patient safety in maternity services is once again in the spotlight…..

Was there ever a better opportunity to promote Proportional Representation?




This entry was posted in A Personal View, Gagging, Patient representatives, Perverse Incentives, Post Code Lottery, Professionals, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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