Tuesday, January 09, 2007

Can Gerry Robinson fix the Health service?

Although last night was only the first of three episodes, I suspect that BBC2’s “Can Gerry Robinson fix the NHS?” should be made compulsory viewing for all the parties involved in delivering health services in the Republic.

Not only do the positions of the various vested interest groups seem familiar, but it’s quite likely that any solutions developed could be highly relevant to Irish hospitals.

All parties involved in the delivery of medical services - consultants, surgeons, anaesthetists, nurses, administrators - think that they’re working both hard and effectively, that the problems with waiting lists arise because of failings in someone else’s domain.

Similarly, all interest groups seem to have some feasible solutions to offer, but no mechanism to have these moderated within the wider hospital medical community. There is no effective mechanism for agreeing and implementing change.

It was clear that the hospital administrators have responsibility without any real authority. This results in a reluctance to push for change because of the risk that a public rebuff by consultants etc will undermine whatever limited authority the administrator may have with the wider hospital population. So they are forced to pussyfoot about - avoiding confrontation by avoiding proposing anything approaching radical change.

The presence of the cameras means that Robinson’s task should be a little easier; the Hawthorne effect will probably cause people to co-operate somewhat more in achieving change than would normally be the case.

However, a trailer for the next episode showed a couple of consultants chatting about the problems. One was querying the capability of the administrators, as in “why should someone with a couple of O Levels be directing the activities of professionals who each have several university-level qualifications?”.

One to follow.

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