Part One: Chapter Three NHS

In part three I’m going to look at the NHS. The health service has been ruined, in my working lifetime by the people and decisions I’ll list and then develop below.

a) The cult of managerialism along with its tools; slavish reliance on policies & procedures, ‘corporate governance’, performance targets, bonus culture, intra service fake competition instead of collaboration, micromanaging employees, audit, the internal market, commissioning, external regulation and a war on professional values, has been forced into the NHS, without debate or an honest risk and benefit analysis. Managerialism, (which is only one of many business theories), when put to the real world test, does NOT do what it says on the tin. From Thatcher until the present day, the cult of managerialism has been granted the power to relentlessly push the mantra that managers can do no wrong, they must be at the top of the tree with complete executive power. Shudder when you look at this through the lens of this quote from no less than Thomas Hobbes, “The definition of liberty is power cut into little pieces”.

b) Permitting psychopaths and other PDs to run the NHS by promoting them, accepting the values THEY told ministers were the ones they should be judged by, allowing them to control hiring, firing and professional standards until they were too embedded to remove. These are corporate psychopaths, the snakes in suits written about by Dr. Robert Hare, the world No 1 authority on psychopaths. In an evil game of snakes and ladders, the snakes have climbed to the top of the NHS ladder. Once established, this led to the promotion of sub-weasels and snakes by their snake bosses who required hatchet men and women who were not too ambitious or talented that they’d overtake them. These snakes have been handsomely rewarded for failure, failure that is by any measure except their own. They have wrecked the NHS.

c) Managers aping and obeying their political masters have forced social engineering into what is supposed to be a National Health Service, something tasked with meeting the health needs of the UK population. Instead of doing that, because you cannot serve two masters, we are now forced to concentrate on equality and diversity, political correctness, rescuing the victim, championing feminist values and the promotion of women managers for political reasons regardless of their actual skills, competence, experience or knowledge.

d) The values of the neo-liberal marketplace were forced into the NHS, forcing out the value system that operated before, namely professional medical ethics.

I aim below to demonstrate that the market values of managerialism are antithetical to the ethics of the professions, specifically medicine and nursing and because of this, professional values were not merely left to wither, but were targeted and smashed. Well known Australian economist John Quiggin puts it this way,

“Managerialism systematically erodes both altruism and professionalism.”