The frustration game
What we all need right now is a dose of good leadership, says Sid Dajani
Iâ€™ve had a few adverse comments about my last piece being a bit too harsh. Friends have contacted me to say the people I have criticised and keep criticising are intelligent with wise heads trying to get some changes in place for the betterment of all. Iâ€™m sure they are but there is a huge difference between experience, garnered from years of fieldwork, and wisdom. Iâ€™ll explain.
Knowledge is knowing a tomato is a fruit; wisdom is not putting it into a fruit salad. Understandably you wouldnâ€™t expect anyone to know everything. However, good leaders have the intelligence to know their shortcomings and therefore seek the experience, the wisdom, the intellect and the intelligence they need to have.
Good leaders are listeners; they bring others with them when strategising and test hypotheses before implementation. They have the cajones to roll-up their sleeves, communicate and look at options before they innovate and navigate their way to efficiency and better outcomes. Thatâ€™s what we are lacking in the NHS, the DH and even our very own pharmacy organisations.
The mess pharmacy and the whole NHS is in is not down to health tourism, immigrants, a lack of funding or even management. Sure, they all play a part but from my experience the lionâ€™s share of failure lands at the door of bad leadership. Bad leadership results in a poor, vague and confusing vision. Bad ideas around the board table donâ€™t improve out in the field; they actually get far worse.
My experience of leaders in the NHS are the types who can sing the hymns but have no idea about the religion. They are the kind of people who spell science with a â€˜yâ€™ and who are immune to good advice. Philip Hammondâ€™s recent volte-face on National Insurance must surely go down as one of the most jaw-dropping, humiliating and embarrassing u-turns in years. And the same level of disconnect and lack of understanding is evident in Jeremy Hunt, particularly during the junior doctor debacle. And now we have the pharmacy cutsâ€¦
Politicians and NHS leaders may have the intellectual resilience to pursue unpopular ideas, but they donâ€™t have the nous to first exercise the discipline of being their own strongest critic and pressure-testing their ideas before forcing them on us.
Just one signature
I have never known cost cutting clothed as efficiency savings ever do any good. We have an ever-ageing population, widening health inequalities, the doors of social care coming off their hinges, an NHS creaking worse than a pantomime dameâ€™s corset, A&E under crisis, staff pressures going through the floor and healthcare demand going through the roof.
Needs will only increase and therefore we need capability and, with it, capacity. It would only take one signature to introduce a national common ailment service that would help save lives, save time and save the NHS. Instead poor leadership has opted to work in a solution-free zone and spend billions on ineffective reorganisations that have made matters worse by adding layers of failed and costly bureaucracy.
The NHS is a vehicle for health but itâ€™s now also a vehicle with four steering wheels, driven by the Marx brothers, going down hill at breakneck speed with no brakes, no compass and nowhere to go! Have the politicians and their mandarins learned anything? I doubt it. They are still putting the cart before the horse and being asked to make a decision without knowing the shape of the cart or even the name of the horse. Like all poor leaders, they have a lack of understanding of the issues and at best, perhaps, an overdose of ideology.
As a pharmacy politician I am regularly struck how absolute lunacy could serve as absolute reason. Pharmacy is already complicated, working within an ever more complex NHS â€“ a set of complications made all the more byzantine by politics. We may be Great Britain but thatâ€™s not down to our current leaders or even passed ones. I just hope future generations donâ€™t inherit a Broken Britain along with a cut-price, horror healthcare system.
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