Breaking down Barriers
As part of our ‘What If’ series on change in the NHS, we spoke to Programme Manager Karen Watkins and asked her: “Putting all politics aside, if you could change one thing about the NHS, what would it be?”
If I could change one thing…
Aneurin Bevan, Minister of Health in the post-war Labour government, insisted that ‘the self-contained, independent local hospital is nowadays a complete anachronism’. The implication was that the development of health services required a modern, integrated organisation with appropriate links between hospitals and primary and community services (The past and future of the NHS, John Mohan, 2003).
Nearly 70 years later I believe we still haven’t truly achieved this. Yes we have joined up technology, MDTs, system wide ops groups, patients groups, national conferences and confederations etc, but at a fundamental strategic level we still don’t truly work together.
Distrust between the various arms of the NHS remains and we never fully share information with our partners (and sometimes even within our own organisations), only ‘giving up’ what we absolutely have to. System wide decisions are made on half-truths and without the full picture and every five years or so we change everything simply because “it’s not working”.
Projects and programmes are often disbanded after huge amounts have been spent on them, because priorities in one arm of the system changes and interest is lost.
If I could change one thing (politics aside) it would be to take a sledge hammer and open the whole lot up, take away the barriers, share information openly and work as a truly single organisation, only then will we be able to get to the root cause of our problems and solve them together.
Karen is a programme manager with over 20 years’ experience working within the NHS. She has worked across the acute, commissioning, community and mental health arms of the service – working on change programmes ranging from large PFI projects, implementation of national directives (e.g. Polysystems, MH pathways) and local change initiatives
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