Why governments' attempts to pick winners produce more losers than winners.
The NHS crisis is growing by the day - problems with IT systems, funding issues and misuses of funds, ineffective use of nurse and doctor resources, the list is seemingly endless. A story today has managed to combine all the worse parts of the NHS and highlights the desperate need for comprehensive reform of our health system.
8,000 young doctors will not be offered a job in the NHS as a result of a government initiative that has caused a glut of applicants as those who started training two years ago are competing for the same jobs as those who began three or four years ago. It means not only are there going to be 8,000 highly skilled workers completely unemployable in their chosen field with massive debts (of up £40,000 each) but it has cost the taxpayer £2bn to train these people to go on and not use their skills.
To further the problem, the application process for young doctors is completed flawed by the online application system which is clearly not picking out the best candidates. The system is happy to ask questions on personal experience, it is reported, but take little interest in qualifications, references and independent appraisals. As a result, some highly qualified junior doctors have not been invited to interview. And, incredibly, because of technical problems others have been offered interviews for which they did not apply! Anyone can con a computer system when it comes applying for a job, but it is much harder in a one on one interview. But the NHS is used to taking short cuts and this is a classic example. They maybe saving money in the short term with the IT system, but it is causing massive problems in the longer term and is wasting our money, ruining the prospects of highly trained professionals and may even be putting patients at risk. At the core of this problem is way the NHS is funded and mismanagement.
Dr Tom Dolphin, the deputy chairman of the BMA junior doctors' committee, said: "The system is going disastrously wrong. Highly qualified doctors with huge amounts of experience haven't been offered any interviews.
"Others have been offered interviews in the wrong speciality or at the wrong level. There are reports that the confidential marking system has been leaked and that unqualified people are being asked to short-listing. People's entire livelihoods are at stake."
So:
Problems with IT systems - check
Funding issues and misuses of funds - check
Ineffective use of doctor resources - check
When will a leading member of one of the parties come up with a serious, sustainable and effective solution to the NHS? It is so desperately needed.
Society cannot contribute anything to the breeding and growing of ingenious men. A creative genius cannot be trained. There are no schools for creativeness. A genius is precisely a man who defies all schools and rules, who deviates from the traditional roads of routine and opens up new paths through land inaccessible before. A genius is always a teacher, never a pupil; he is always self-made. He does not owe anything to the favour of those in power. But, on the other hand, the government can bring about conditions which paralyse the efforts of a creative spirit and prevent him from rendering useful services to the community", Bureaucracy (1945)
Does anyone have the stomach for a "serious, sustainable and effective solution to the NHS". The answer probably involves freeing hospitals from government control, but that will be interpreted as "privatisation of the NHS", which is apparently still heretical. There's an awful lot of reclaiming lost ground in the intellectual battles to do before it will be politically feasible to make any significant improvements to the NHS. And none of the mainstream parties is even fighting the broader intellectual battle, let alone saying anything good and original about fundamental reform of our approach to healthcare provision.