Basic services must come first, says NHS manager

23 May 02
The modernised NHS will be built on 'very flaky foundations' if the government does not allow managers to divert more cash into propping up basic health services, NHS Confederation chief executive Gill Morgan said this week.

24 May 2002

Years of efficiency demands had undermined the fabric of services, Morgan told the Confederation's annual conference in Harrogate.

'Policy has confused cheapness with efficiency and many services are now threadbare,' she said.

'Too much management time is being spent on identifying the relatively small percentage of revenue needed to shore up the infrastructure and make ends meet, rather than on the challenging business of changing how services are delivered. We run the risk of developing the edifice of modernisation on some very flaky foundations.'

She called for efficiency targets to recognise the importance of quality as well as quantity. Targets should be set for three or five years and attention should focus on the largely untouched area of increasing the performance of clinical services.

Last month, the Department of Health gave primary care trusts free rein in spending on clinical management.

'Releasing 10% of this "real" efficiency over five years would be easier than 2% per year – particularly where "efficiency" is glibly used to cover the difference between the available resources and the true cost of delivering the targets,' Morgan said.

She also urged politicians to stop tinkering with the structure of the NHS. 'There is no perfect structure: give us some stability; set us clear simple targets and give us the space to deliver what we know needs to be done,' she said.


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