The 'Hot-Air-ometer' is set on 'High'

The verbal diarrhoea that eminates from the corridors of management is sometimes simply astounding. Just this week we have been informed over the organisation's e-mail updates that someone 'only' achieved 97.3% of their target and that that 'listening clinics' have been set up. I also cringe when I hear of the poor souls who frequent this place being referred to as 'customers'. They are not here by choice.

Targets are the unrealistic and non-clinically driven attempts by people far removed from the coalface to assess what we do. Usually they create a cottage industry of other people measuring those targets and a raft of new measures to help a department achieve them. None of which ever helps the patient. Usually these arbitrary figures look at a single parameter without taking into account the multiple factors that govern them. The result of these targets can be clinically damaging. Consider a patient being moved out of the Emergency Department at the 3:59 hour cut-off to avoid 'failing the 4-hour wait' target. If the only bed available for them is on a ward of an entirely different speciality then that is where the patient will go. No matter if an appropriate bed is scheduled to become available in half and hour. Or even ten minutes. How can this help patient care?

And what on earth is a 'listening clinic'? What do we do all day in the outpatient department and in the surgeries if not listen? But no - this is a great buzz phrase that will generate managerial slaps on the back all round. The mandarins love it.

An organisation that truly succeeds is one where the bosses had to work their way through the shop floor and so know every twist and turn, not one that can boast more MBAs in the upper echelons. This used to be the case for the NHS as senior doctors and nurses would manage the majority of what went on and, by definition, they came from the grass roots. These days the corridors of administration are peopled with business graduates and youths who have been trained in nothing other than 'Healthcare Management' with consequently no understanding of what it is they are supposed to be running.

There are sad times. The only solution is to take the NHS out of direct government control but that of course opens a whole new can of worms as to accountability. More of that soon.