Put doctors back in charge of NHS management
Elliot Bidgood, 24 June 2013
In a publication posted today by Civitas, Time for a reformation of NHS management, Dr Christoph Lees of the new Doctors’ Policy Research Group has argued that in light of recent care quality failings in the NHS and the seeming inability of the Care Quality Commission (CQC) to prevent them, fundamental change is needed in the way the NHS is managed and inspected.
The Doctors’ Policy Research Group is a medically-led health policy research unit affiliated with Civitas, made up mainly of doctors calling for reform of the NHS from within the service. Dr Michelle Tempest, Dr Paul Charlson, Dr Mark Slack and Magnus Boyd are the other founding members of the group.
Dr Lees outlines how less than a few decades ago clinicians were for the most part in charge of day-to-day management of the NHS and experienced professionals from the Royal Colleges were trusted to handle inspections, before these old systems gave way to the imposition of top-down central targets by politicians and the rise of a ‘corporate’ culture of general management by non-clinical officials. Worse, these managers were often not as professionally accountable as doctors had been when inspections and quality had been their purview.
Dr Lees also outlines four simple steps for fixing NHS management:
- Reduce the role of the CQC and empower clinicians and patient representatives to perform inspections
- Make clinicians, not managers, ultimately responsible for standards of care
- Assess NHS managers by asking colleagues who have seen them in action whether they are qualified and trustworthy
- Open up senior NHS posts to clinicians and non-NHS professionals, rather than just the same old insiders
The Doctors’ Policy Research Group believe that if these straightforward recommendations are followed and real clinical leadership is restored in the NHS, the service could start to recover from the current steady drumbeat of care quality scandals. Put simply, it is high time for a fundamental reformation of NHS management.