Crisp's 'improvements' are hard to see
Sir Nigel Crisp may be doing his job in blowing the trumpet of his department and this government when he says in his annual report that the NHS improved in leaps and bounds in the last year. Voters as well as frontline staff do not believe that the tens of billions of pounds being poured into public services are being well spent and are sceptical about improvements in the NHS.
The NHS has become such a parched land that it swallows all the funds it is fed without demonstrating any increase in output. The truth is that the NHS is in dire straights. Look at the interminable queues, the dirty, paint-chipped hospital buildings and the worn-out, demoralised staff.
The target culture is unrealistic and prevents the extra billions from trickling down to where they are most needed. Centrally set targets lead to creative accounting, allegations of cheating, perverse consequences, distortions and unfair pressure on professionals. League tables are often seen as untrustworthy and misleading. Star ratings have been thoroughly discredited.
Targets can never be a substitute for a clearly expressed strategy and set of priorities. The underlying problem seems to be that central departments often do not understand what life is like for those who deliver services.
The public will be astonished that doctors and nurses are unable to treat the sickest patients because ministers dictate who they should treat and when. The NHS has been reduced to a target-chasing organisation rather than an effective health care provider.
Dr Kailash Chand