Today’s ‘Irish News’ has another article exposing the poor management of Belfast’s health services with reports that the old Belvoir Park hospital, which was closed five years ago, has been abandoned without being decommissioned properly. This has meant that patient files have been taken from it and have appeared for sale on the internet. Despite this, management in the Belfast Trust has claimed that there was no need to inform the Information Commissioner that there was potentially a breach of data protection legislation.
This is the latest in a long line of articles in the paper taking shots at the management of the health service and the Belfast Trust. Not all the criticism has been warranted and sometimes the big things have been mixed with minor issues. Often however the criticism has been well deserved and I thought I would write about it today because it raises some interesting questions that will no doubt go unasked never mind answered during this election.
Like – what is the solution to all this and if the health service is such a good thing, which most people seem to agree, how come it seems to screw up so often?
Let’s take the second question first. The health service is popular because if you’re sick you really, really need it. This might seem obvious and so it is, but it means that a certain amount of its popularity is because for most people it’s all we have to save us from illness or much worse. If something else existed it might be quite popular as well. What makes it unpopular is when it fails to do what we need – waiting too long to get seen and sometimes poor services when we do get seen. There was a report recently in Britain that the care given to elderly people is very often appalling and lack of adequate funding is only part of the problem.
Generally we all agree that it’s not the fault of staff so what is the problem?
The ‘Irish News’ columnist Patrick Murphy says at least part of the blame lies in the fact that senior managers sit on the Board of Directors along with non-Executive Directors and will therefore give each other an easy time. This is what prevented questioning to ensure the issues at Belvoir Park were not flagged up and solved. He proposes a Board consisting of only non-Executive Directors to bring the senior mangers to account.
The question is however – why didn’t they do it in this case? There were plenty of these non-Execs on the Board already. It looks to me that they failed just as much as the senior managers everyone loves to criticise. These non-Execs are the great and the good of our society and include politicians from all the main parties. Will we be hearing which of the candidates in the election sat on the Board of the Belfast Trust and also failed to deal with this matter? Don’t think so. (Google it yourself if you want to find out)
The truth is that these non-Execs are political appointments and often know nothing about the services delivered by the state bodies they are supposed to supervise. The senior mangers do know about the services but will make mistakes like anyone and there is obviously a question about making them accountable.
There is of course an obvious solution. Who knows most about the services provided by the NHS? Well, two groups spring to mind. The first are the workers who work in it and the second are patients who use it. Why isn’t the health service run by the workers with patients organised to review and inspect their work and report on any failures? Why don’t we have a Board composed of workers elected by all the staff and subject to instant recall if they don’t perform? This would provide real expert management. Management could be replaced by a democratic vote whenever the majority of workers thought that it wasn’t working as well as it should. This would provide full transparency and accountability.
So why don’t we have a democratic health service? Well, the answer is obvious. If workers were allowed to run the health service they might demonstrate how good it is to have a democratic workplace and encourage other workers to look for the right to do the same. We couldn’t have that because that is what is called socialism.
The sort of socialism I’m standing for in this election.
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