The problem with the NHS

Not all of them obviously, but some are just so ideologically opposed to reform nothing will ever be achieved until they are either retired or replaced by others prepared to countenance change for the better.

Last night on the TV there was a programme featuring Heston Blumenthal who was going to improve the food at Alder Hay Children’s hospital. During the initial part of the show we were treated to a few cameos of bedridden children complaining about the food being boring and disgusting spiced up with a few shots of parents feeding their children food brought in from outside. Nothing new here, jokes about the awful quality of hospital food have been doing the rounds since God was a boy.

The revelatory moments came a few minutes in when Heston went into the kitchens to meet the team of six chefs and found out that of the six four were engaged in cooking for the staff canteen and two were occupied with cooking for the children. The four who were preparing staff meals were using fresh ingredients to prepare attractive meals such as you might eat at home yet the two who were responsible for the children’s meals were busy tipping frozen chips into fryers and opening tins of beans and spaghetti hoops. Like me, Heston was a bit confused about this as we both thought that the main purpose of a hospital was to look after the sick, instead it seems as if the catering operation at Alder Hay is being run as a welfare club for the staff and when the chefs were questioned on this the reasons they gave boiled down to the fact that it had always been done that way.

Next we met who for me was the star of the show, the catering manager, Jeff something or other, who had been at the hospital for around 30 years, who was convinced in his own minds that there was nothing that Heston could teach him about catering and that in fact it would be Heston who would learn from his interaction with the NHS caterers and not him. He was clearly bitter at having had this imposition foisted on him from above and was set upon a course of action that seemed to involve him sticking his fingers in his ears and going la la la la! However despite Jeff’s best efforts, Heston had at least engaged with the chefs a bit and was able to persuade them to go up to the ward and meet the children they were supposed to be feeding. I was amazed that despite some of them having had tens of year’s service in the hospital’s kitchen, none of them had ever been onto a ward and met a patient to find out what they thought of the food. It was at this point that one or two of the chefs finally realised that there was a problem and more importantly they could help to fix it.

From about here on in the programme got into the happy feely mood with the chefs thinking about and ultimately creating food that the children wanted to eat and Heston coming up with his typical fruitloop ideas. We were treated to a final appearance from Jeff decrying the idea that kids like to eat tasty food and that Heston could learn from him before the programme moved towards its inevitable dénouement with kids happily tucking in to the Heston inspired menu and like Oliver Twist coming back for more and the senior managers (way higher up the food chain than Jeff) agreeing to change their ways for ever.

Anyway to cut out further rambling, the problem with the NHS is people like Jeff. They have been in the NHS since leaving school and who be sheer hard work combined with natural talent have hauled themselves onto the bottom rung of management by their mid fifties and are content to serve out their time doing exactly as their predecessors have done for decades. They are not intrinsically bad or evil, far from it, instead they are happy to sit in their little office doing as little as possible, creating nothing nor thinking about what their job should entail. They are calcified in their outlook and not open to any form of change, their only response being that they know what is best because it has worked for years.

As most people know at heart, the NHS is in desperate need of major surgery, and a good place to start would be to get rid of those who say things cannot change and replace them with people who believe that the NHS should be about caring for patients and not about providing safe unchallenging jobs for people trying to fill out the hours between leaving school and drawing a pension. The people who matter most in the NHS are not the doctors or nurses, not the managers or caterers, not the porters or receptionist, not the Trust board members, not even those in Whitehall and Government; the most important people are the patients and the whole shoddy crumbling edifice needs to be redesigned around them and their needs.

For more information about the programme and to watch it on Channel 4 version of iPlayer