If you live in the UK that may seem like a rather silly question but I’ve been thinking a lot about the NHS recently and I’m not sure it’s such a straightforward answer.
Let’s get a couple of things out of the way first:
- we all have an emotional reaction to the NHS, as an institution it is well loved.
- we nearly all also accept it isn’t performing to it’s best ability at the moment & needs to change.
So taking those two things as read ( if you disagree on either please let me know by commenting) let’s have a look at who the NHS’s customers actually are. If you think a service user is a customer then patients are the customers but if you believe the money wields the power it’s the Government of the day. To complicate things even further we don’t like the NHS to be used for political gain yet we also judge governments on how it performs. If we look at it in business terms there are numerous strongly involved stakeholders to please all at the same time with different priorities. That’s without including the internal stakeholders too such as staff, GP’s, PCT’s etc.
In the private sector organisations have to adapt to survive and those that don’t eventually lose their customers and that’s the end of that. With public sector such as the NHS this process is suspended, no government could ever contemplate getting rid of the NHS so each successive government attempts to adapt it from their political stance. The problem is none of this adaptation is driven by the end user, the patient. It is hard to think of any other organisation which is in a similar position. Even education, the sector I work in, is not as protected from market forces. Even if we accept that the NHS should never be privatised (a given for virtually everyone in the UK I think) we must accept that market forces can have beneficial effects on organisations.
My experience of the NHS has unfortunately led me to believe that the system is operated with the organisation’s needs in mind rather than the patients, except in emergency situations where it really does come into it’s own. The minute there’s time for bureaucracy again, well I’m sure we’ve all been there. So what’s the answer? I’ll be honest I don’t know but we need to be talking about it or things will just get steadily worse.
What do you think? Have you any ideas on how the NHS could adapt to better service patients? I’d love to hear your thoughts.