NHS and PHE bureaucracy holds back effective health care

The bureaucracies of both the NHS and PHE are not fit for purpose argues Paul Ormerod in his latest article.

Paul writes:

The praise for health workers dealing with Covid19 is universal. From cleaners and porters to the most distinguished consultant, all have played their part.

But they are working in an administrative system almost Kafka-esque in its lunacy.

An early example was when NHS workers turned up to be tested at the huge PHE complex at Chessington. The staff were all there, with no-one to test. But the health workers were turned away. They did not have a letter of appointment.

I can echo this from my own experience. I had minor surgery to my hand at the start of last month.

Every single person I dealt with in the NHS was friendly and efficient. But the administrative process was grossly inefficient.

First, I had to see my GP to see if the operation should be done. Fair enough. He had to write a letter to the consultant saying so.

I received a letter from the hospital to see the consultant, who confirmed an operation was needed. I was sent another letter for a pre-operation check.

After this, a letter came with the date for the operation. I had told the hospital I would be in Australia all of February. It arrived mid-February.

Fortunately, my wife was following on the very next day and brought it. The letter told me to phone the hospital to confirm the date and also to sign and return yet another letter saying the same thing. There was an email address. I copied out the wording of the return letter, signed it and emailed it.

I phoned and explained I was in Australia. I had sent an email, would this do? No, I had to return the letter. Why? The woman was honest. She did not know, but that was the rule.

The minor operation was duly performed. The consultant saw me while I was waiting to leave. I would need to fix a follow up appointment. Could I do it now? Well, you have surely guessed: no, I would be sent a letter.

Almost all the mail people get these days is junk. Most serious communication is by email. But the 20^thcentury technology of letters is deeply embedded in the NHS administrative system. At least they have moved on from semaphore.

It is only last year that Matt Hancock, the Health Secretary, had to instruct the NHS to stop purchasing fax machines. It was the largest single buyer of them in the entire world. Few people under 30 even know what they are.

The system appears unable even to provide accurate information on the daily number of deaths and new infections. The Centre for Evidence Based Medicine at Oxford goes through the records meticulously. Quite a number of deaths announced in mid-April actually happened in March. The Centre believes peak death rate was reached on 8 April.

It is no wonder that the task of providing a suitable amount of protective equipment seems insurmountable. The bureaucracies of both the NHS and PHE are not fit for purpose.