Public Sector waste ?
Discussion
There are lots of mentions of the NHS and front line staff, and what a wonderful job they are doing in this crisis, which is absolutely true.
However, also many mentions, and its been a thing for a long time about the number of managers, pen pushers, administrators and whatever in the NHS taking huge salaries and not adding much value. Same with the MOD it seems, and I guess Police, Education and councils.
Is this really the case ? are there in every NHS trust, people on 150 grand a year who dont do anything ?
The front line staff in the NHS have to have support in many forms, procurement, admin, IT, cleaning, laundry, porters and all manner of other functions to do their job, all those folk need some kind of management, budgets need to be balanced, HR functions performed and wages paid.
It seems a bit populist and unfair to only single out staff actually dealing with patients, I expect there are all manner of folk working hard, must be demoralising to be referred to as pen pushers, though I am sure if they are adding value, they will know and if they dont they should.
I know a lot of private companies end up using the NHS as cash cows, is that still the case, the famed 20 quid loaf of bread and all that ?
I worked in the Police for 12 years or so and cant say I saw much in the way of wastage, the managers I had all tended to be hard working people intent on providing systems and support for front line policing.
Are there legions of pointless managers all on the take in the NHS that could be sacked to save millions ?
However, also many mentions, and its been a thing for a long time about the number of managers, pen pushers, administrators and whatever in the NHS taking huge salaries and not adding much value. Same with the MOD it seems, and I guess Police, Education and councils.
Is this really the case ? are there in every NHS trust, people on 150 grand a year who dont do anything ?
The front line staff in the NHS have to have support in many forms, procurement, admin, IT, cleaning, laundry, porters and all manner of other functions to do their job, all those folk need some kind of management, budgets need to be balanced, HR functions performed and wages paid.
It seems a bit populist and unfair to only single out staff actually dealing with patients, I expect there are all manner of folk working hard, must be demoralising to be referred to as pen pushers, though I am sure if they are adding value, they will know and if they dont they should.
I know a lot of private companies end up using the NHS as cash cows, is that still the case, the famed 20 quid loaf of bread and all that ?
I worked in the Police for 12 years or so and cant say I saw much in the way of wastage, the managers I had all tended to be hard working people intent on providing systems and support for front line policing.
Are there legions of pointless managers all on the take in the NHS that could be sacked to save millions ?
Certainly valid questions.
Are all the support staff necessary, they may be busy but are they doing a useful job.
I remember a previous Prime Minister saying he was going to get rid of unnecessary red tape (think it was Blair).
What Brown did, he put in an extra layer of paperwork to monitor the level of paperwork. (and it's still there).
It also happens in the private sector.
Are all the support staff necessary, they may be busy but are they doing a useful job.
I remember a previous Prime Minister saying he was going to get rid of unnecessary red tape (think it was Blair).
What Brown did, he put in an extra layer of paperwork to monitor the level of paperwork. (and it's still there).
It also happens in the private sector.
I was once told that the difference between a Public Sector CFO and a Private Sector CFO was that the Public Sector CFO was there to spend as much money as possible in order to ensure an increase in next years budget allocation, whereas the Private Sector CFO was there to spend as little money as possible so as to ensure that the company actually existed next year.
J4CKO said:
I worked in the Police for 12 years or so and cant say I saw much in the way of wastage, the managers I had all tended to be hard working people intent on providing systems and support for front line policing.
Are there legions of pointless managers all on the take in the NHS that could be sacked to save millions ?
I left the NHS decades ago. I did most of my Accountancy Training exams whilst there so I got to see where most of the money went. A few issues and comments from what I can remember;Are there legions of pointless managers all on the take in the NHS that could be sacked to save millions ?
- the level of control freakery from Central Govt. was insane (in terms of targets, outputs, "Finished Consultant Episodes" was a big thing when i was there.
- The Purchaser/Provider split and the introduction of GPFH resulted in an additional layer of bureaucracy. It was great for penpushers like me but it was pointless having Hospitals having teams of people invoicing and paying each other
- the NHS (and the Public Sector as a whole) tries to operate on a zero-risk basis. Nobody is going to risk their job in the interests of saving money. So every time "lessons are learnt" means that additional processes are put in place to prevent the same thing happening again. Which all adds to cost.
The salary for senior management isn't that good when you compare it to the responsibility (IMHO). There are easier ways of making better money in the Private Sector.
I've worked with the Public Sector for nearly 20 years. My conclusion is that there are lots of very capable, passionate and talented people who are sub-optimised by a management culture which is horrifically wasteful, risk-averse and ham-fisted.
One of the key causes of the management incapability is the fear of criticism, which is a disease that runs through the whole sector. In an attempt to avoid being dragged over the coals by the media, general public or external bodies, the path of least resistance is often chosen. So you get risk aversion, procrastination, obsession with cost, misleading communication and protective hierarchies taking root. Ironically, the sum of these parts often leads to the very cock-ups that attract criticism that they were designed to avoid.
Very little of this is directly linked to the Government of the day, it's endemic to the system. Occasionally, direct political decisions have bad consequences, but frequently, well-intentioned decisions made by politicians are ruined in the implementation by Central Gov or the management of the other parts of the sector such as the NHS. Unfortunately, successive Governments have either chosen not to directly intervene or have attempted to do so by using the very same individuals within the sector to drive the change, thus leading to more of the same.
That said, all of this is understandable. Imagine if every single decision you took in your job was mercilessly ripped to pieces by the media, general public and other stakeholders, especially if you happened to hit upon an issue that was of high importance to certain groups? How often would you stick your neck out?
One of the key causes of the management incapability is the fear of criticism, which is a disease that runs through the whole sector. In an attempt to avoid being dragged over the coals by the media, general public or external bodies, the path of least resistance is often chosen. So you get risk aversion, procrastination, obsession with cost, misleading communication and protective hierarchies taking root. Ironically, the sum of these parts often leads to the very cock-ups that attract criticism that they were designed to avoid.
Very little of this is directly linked to the Government of the day, it's endemic to the system. Occasionally, direct political decisions have bad consequences, but frequently, well-intentioned decisions made by politicians are ruined in the implementation by Central Gov or the management of the other parts of the sector such as the NHS. Unfortunately, successive Governments have either chosen not to directly intervene or have attempted to do so by using the very same individuals within the sector to drive the change, thus leading to more of the same.
That said, all of this is understandable. Imagine if every single decision you took in your job was mercilessly ripped to pieces by the media, general public and other stakeholders, especially if you happened to hit upon an issue that was of high importance to certain groups? How often would you stick your neck out?
Edited by Inaprop Riat on Monday 4th May 12:55
andymadmak said:
I was once told that the difference between a Public Sector CFO and a Private Sector CFO was that the Public Sector CFO was there to spend as much money as possible in order to ensure an increase in next years budget allocation, whereas the Private Sector CFO was there to spend as little money as possible so as to ensure that the company actually existed next year.
That's a weak myth. Budgets are never linked to how much an Organisation spends.Private Sector companies have the ability to set their own prices, choose what products and which markets they are going to supply, they can focus on their most profitable markets and, if all else fails, they can close up shop. Public Sector bodies can't do any of that.
I've no direct experience working with the NHS, so take this for what its worth, but I've spent a good deal of time working with other government departments, all in management, and I've noticed some common themes, to varying degrees, across the board.
The first of which appears to be a distinct lack of accountability to any customer or end user - probably because there aren't any share holders to answer to. In most of the projects I've experienced, the perception is that timescales are irrelevant (because nothing in government is delivered on time) and budgets are infinite (as everything always goes over anyway). It's a culture that wouldn't be tolerated in most, though to be fair not all, private organisations and means no one's in any great hurry to get anything done.
Governance is always needlessly complex; a level of this is always going to be necessary but it often feels like bureaucracy for the sake of it. An example being that I was contracted to deliver a very basic solution so departments could work virtually; in any other industry that might take a couple of weeks. But because this was a government procurement it required everyone and their mum to be consulted, have their say, ins and outs of a ducks arse etc. so that in the end the programme took several months and a hideous amount of cost for the value it actually represented. The actual development of the solution was by far the shortest part of the delivery.
On top of all that you notice that some people are extremely resistant to change, sometimes because they just can't be arsed to adapt, but also because they recognise the threat to their - often cushy - position that a change may represent. If this person has any semblance of influence or control, it can make effecting change almost impossible.
All of that being said you do meet some genuinely great people who are doing their best to do drive some change and shake things up, but they mostly lose their mojo when they realise the above - often as not making a break for the private sector.
As I say, I've never worked directly with the NHS but a penny to a pound says that the these issues will exist on a grand scale - hats off to anyone trying to change that. It goes without saying that the front line workers and carers in the NHS are, for the vast majority, caring, compassionate, competent professionals, but my concern is that post COVID the NHS will become even more of a sacred cow than it already is, and any attempts to discuss the issues above will be labelled as the mad ramblings of Tory frothers wanting to sell the lot to Trump.
The first of which appears to be a distinct lack of accountability to any customer or end user - probably because there aren't any share holders to answer to. In most of the projects I've experienced, the perception is that timescales are irrelevant (because nothing in government is delivered on time) and budgets are infinite (as everything always goes over anyway). It's a culture that wouldn't be tolerated in most, though to be fair not all, private organisations and means no one's in any great hurry to get anything done.
Governance is always needlessly complex; a level of this is always going to be necessary but it often feels like bureaucracy for the sake of it. An example being that I was contracted to deliver a very basic solution so departments could work virtually; in any other industry that might take a couple of weeks. But because this was a government procurement it required everyone and their mum to be consulted, have their say, ins and outs of a ducks arse etc. so that in the end the programme took several months and a hideous amount of cost for the value it actually represented. The actual development of the solution was by far the shortest part of the delivery.
On top of all that you notice that some people are extremely resistant to change, sometimes because they just can't be arsed to adapt, but also because they recognise the threat to their - often cushy - position that a change may represent. If this person has any semblance of influence or control, it can make effecting change almost impossible.
All of that being said you do meet some genuinely great people who are doing their best to do drive some change and shake things up, but they mostly lose their mojo when they realise the above - often as not making a break for the private sector.
As I say, I've never worked directly with the NHS but a penny to a pound says that the these issues will exist on a grand scale - hats off to anyone trying to change that. It goes without saying that the front line workers and carers in the NHS are, for the vast majority, caring, compassionate, competent professionals, but my concern is that post COVID the NHS will become even more of a sacred cow than it already is, and any attempts to discuss the issues above will be labelled as the mad ramblings of Tory frothers wanting to sell the lot to Trump.
DartyBistard said:
I've no direct experience working with the NHS, so take this for what its worth, but I've spent a good deal of time working with other government departments, all in management, and I've noticed some common themes, to varying degrees, across the board.
The first of which appears to be a distinct lack of accountability to any customer or end user - probably because there aren't any share holders to answer to. In most of the projects I've experienced, the perception is that timescales are irrelevant (because nothing in government is delivered on time) and budgets are infinite (as everything always goes over anyway). It's a culture that wouldn't be tolerated in most, though to be fair not all, private organisations and means no one's in any great hurry to get anything done.
Governance is always needlessly complex; a level of this is always going to be necessary but it often feels like bureaucracy for the sake of it. An example being that I was contracted to deliver a very basic solution so departments could work virtually; in any other industry that might take a couple of weeks. But because this was a government procurement it required everyone and their mum to be consulted, have their say, ins and outs of a ducks arse etc. so that in the end the programme took several months and a hideous amount of cost for the value it actually represented. The actual development of the solution was by far the shortest part of the delivery.
On top of all that you notice that some people are extremely resistant to change, sometimes because they just can't be arsed to adapt, but also because they recognise the threat to their - often cushy - position that a change may represent. If this person has any semblance of influence or control, it can make effecting change almost impossible.
All of that being said you do meet some genuinely great people who are doing their best to do drive some change and shake things up, but they mostly lose their mojo when they realise the above - often as not making a break for the private sector.
As I say, I've never worked directly with the NHS but a penny to a pound says that the these issues will exist on a grand scale - hats off to anyone trying to change that. It goes without saying that the front line workers and carers in the NHS are, for the vast majority, caring, compassionate, competent professionals, but my concern is that post COVID the NHS will become even more of a sacred cow than it already is, and any attempts to discuss the issues above will be labelled as the mad ramblings of Tory frothers wanting to sell the lot to Trump.
The only way forward is to take the vital public sector services out of government hands and have them run on a cross-party basis. Too much interfering at a national level that trickles down locally which inhibits long term improvements as there is always a new plan every 5 years based on how they wanted to win an electionThe first of which appears to be a distinct lack of accountability to any customer or end user - probably because there aren't any share holders to answer to. In most of the projects I've experienced, the perception is that timescales are irrelevant (because nothing in government is delivered on time) and budgets are infinite (as everything always goes over anyway). It's a culture that wouldn't be tolerated in most, though to be fair not all, private organisations and means no one's in any great hurry to get anything done.
Governance is always needlessly complex; a level of this is always going to be necessary but it often feels like bureaucracy for the sake of it. An example being that I was contracted to deliver a very basic solution so departments could work virtually; in any other industry that might take a couple of weeks. But because this was a government procurement it required everyone and their mum to be consulted, have their say, ins and outs of a ducks arse etc. so that in the end the programme took several months and a hideous amount of cost for the value it actually represented. The actual development of the solution was by far the shortest part of the delivery.
On top of all that you notice that some people are extremely resistant to change, sometimes because they just can't be arsed to adapt, but also because they recognise the threat to their - often cushy - position that a change may represent. If this person has any semblance of influence or control, it can make effecting change almost impossible.
All of that being said you do meet some genuinely great people who are doing their best to do drive some change and shake things up, but they mostly lose their mojo when they realise the above - often as not making a break for the private sector.
As I say, I've never worked directly with the NHS but a penny to a pound says that the these issues will exist on a grand scale - hats off to anyone trying to change that. It goes without saying that the front line workers and carers in the NHS are, for the vast majority, caring, compassionate, competent professionals, but my concern is that post COVID the NHS will become even more of a sacred cow than it already is, and any attempts to discuss the issues above will be labelled as the mad ramblings of Tory frothers wanting to sell the lot to Trump.
pavarotti1980 said:
The only way forward is to take the vital public sector services out of government hands and have them run on a cross-party basis. Too much interfering at a national level that trickles down locally which inhibits long term improvements as there is always a new plan every 5 years based on how they wanted to win an election
Very little of what he said related to party politics/elections. It was more about human nature.pavarotti1980 said:
The only way forward is to take the vital public sector services out of government hands and have them run on a cross-party basis. Too much interfering at a national level that trickles down locally which inhibits long term improvements as there is always a new plan every 5 years based on how they wanted to win an election
Very good point, having what is effectively your corporate strategy set at a central government level, with little to no input from the department itself, which is then guaranteed to change in 5 years (at the absolute max), is asking for trouble. J4CKO said:
However, also many mentions, and its been a thing for a long time about the number of managers, pen pushers, administrators and whatever in the NHS taking huge salaries and not adding much value. Same with the MOD it seems, and I guess Police, Education and councils.
I don't know about the NHS but since the Cameron era of 'austerity' a lot of areas of the public sector have been restructured and slimmed down significantly compared to before.Iwantafusca said:
In such a huge organisation that is set up to help people rather than make a profit , there will also be waste. IMO the problem is government of both persuasions interfering and insisting on targets etc (4 hr wait being a prime example) let trusts run without political interference.
While what you say makes perfect sense. No sensible person is going let an organisation with a budget of 100bn+ and that employs more people in the UK than anybody else, be run without ultimate accountability to government. It's either accountable to the government (or rather, taxpayers) who fund it, or it is privatised.The problem we have is that the NHS had become a sacred cow, even before Covid 19. Politicians, with one eye on the next election, are increasingly wary of being seen to do anything other than hand it more money. It largely does its primary role very well, mainly due to the large number of excellent staff, but pretending that it doesn't require change is a falsehood peddled only by the likes of Jeremy Corbyn.
Just in the last two weeks, my mother in law was admitted to hospital with CV and tested. Thankfully she was well enough to be discharged, but as they lost her results nobody can tell her whether she had CV or not and could go back to work. Similarly, close friends father had cancer diagnosed just before CV, but they can't seem to manage to organise a follow up appointment, despite much trying by his GP. In such a large organisation there will always be errors and mistakes, but even the best run organisations need constant monitoring and change, not blind faith.
As a low-level admin drone in a couple of NHS Trusts in the late 2000s/early 2010s all of this:
My first role was related to the Blair/Brown government's 18-week treatment target, which kept a whole bunch of us employed collecting, verifying, tabulating, analysing, displaying and distributing data. And it was 'necessary' because that information was demanded by central government and the Trust was held accountable for its performance by that metric.
My second role was to do with checking, reconciling and correcting data to do with the Purchaser/Provider split (where the NHS sells services to itself). All apparently to instil efficiency and cost-focussed business models into the Service, when since the money effectively comes from the same source and gets passed around it might as well be Monopoly-style NHS Fun-Bucks and, while I couldn't say how useful the system is overall, it certainly kept another few offices of admin staff busy keeping track of it all.
My third role was working as the in-department contact for a project to move all the Trust's clinical department onto a new Patient Pathway database, so in theory both 18-week and purchaser/provider data could be summoned with one click from the same source, and with much greater accuracy since it wouldn't be being collated from numerous different systems. That project had its own admin and IT staff within the Trust, plus a bevy of external experts, assistants, managers, consultants etc. In fact, in the case of 'my' department the new database was fundamentally unsuitable for their clinical needs so we ended up having to double-enter everything - onto the old database for departmental use and onto the new one for broader data and reporting. So for that department the Trust ended up retaining the license and support costs of both the old database and the new one! (It's like that xkcd strip about Standards - "There are 49 standards, that's too many!" "Let's introduce a new standard that will incorporate all the existing ones." "~~There are now 50 standards~~")
My fourth role was collecting, inputting and displaying data for the Trauma Audit & Research Network, which is a national project to collate data about treatment and outcomes from trauma injuries. My Trust had only two people working on TARN - myself as the clerk, reporting to the orthopaedic department's administrative manager, and a senior A&E nurse who had making sure the TARN forms were actually filled in and collected on top of all her other work. I don't think anyone would say that that project was unneccessary or over-staffed.
I wouldn't say any of my four roles were 'wasteful', 'pointless', 'paper-pushing' or 'unnecessary', in as much as they were all required by the way that the NHS is required to be run, as per central government policy. However I could argue that only one was strictly required to help monitor and deliver clinical care, and thus would probably exist regardless of how the NHS was managed and run.
In general, I don't think the NHS wastes any more of its resources on back-room admin and management than any private-sector business would if it was of the same size and scope, and I don't think that the level of 'waste' or 'non-jobs' is very high, while in my experience the productivity and work ethic of the individual people has been the same whether in the NHS or in private business.
This:
Edit:
Countdown said:
I left the NHS decades ago. I did most of my Accountancy Training exams whilst there so I got to see where most of the money went. A few issues and comments from what I can remember;
- the level of control freakery from Central Govt. was insane (in terms of targets, outputs, "Finished Consultant Episodes" was a big thing when i was there.
- The Purchaser/Provider split and the introduction of GPFH resulted in an additional layer of bureaucracy. It was great for penpushers like me but it was pointless having Hospitals having teams of people invoicing and paying each other
- the NHS (and the Public Sector as a whole) tries to operate on a zero-risk basis. Nobody is going to risk their job in the interests of saving money. So every time "lessons are learnt" means that additional processes are put in place to prevent the same thing happening again. Which all adds to cost.
The salary for senior management isn't that good when you compare it to the responsibility (IMHO). There are easier ways of making better money in the Private Sector.
still rings very true for my experiences. It's not that there are lots of clerks/administrators/managers sat around doing nothing all day - we were all kept busy. But you can certainly question whether much of that activity was strictly neccessary for delivering medical care to people who needed it in a timely fashion. - the level of control freakery from Central Govt. was insane (in terms of targets, outputs, "Finished Consultant Episodes" was a big thing when i was there.
- The Purchaser/Provider split and the introduction of GPFH resulted in an additional layer of bureaucracy. It was great for penpushers like me but it was pointless having Hospitals having teams of people invoicing and paying each other
- the NHS (and the Public Sector as a whole) tries to operate on a zero-risk basis. Nobody is going to risk their job in the interests of saving money. So every time "lessons are learnt" means that additional processes are put in place to prevent the same thing happening again. Which all adds to cost.
The salary for senior management isn't that good when you compare it to the responsibility (IMHO). There are easier ways of making better money in the Private Sector.
My first role was related to the Blair/Brown government's 18-week treatment target, which kept a whole bunch of us employed collecting, verifying, tabulating, analysing, displaying and distributing data. And it was 'necessary' because that information was demanded by central government and the Trust was held accountable for its performance by that metric.
My second role was to do with checking, reconciling and correcting data to do with the Purchaser/Provider split (where the NHS sells services to itself). All apparently to instil efficiency and cost-focussed business models into the Service, when since the money effectively comes from the same source and gets passed around it might as well be Monopoly-style NHS Fun-Bucks and, while I couldn't say how useful the system is overall, it certainly kept another few offices of admin staff busy keeping track of it all.
My third role was working as the in-department contact for a project to move all the Trust's clinical department onto a new Patient Pathway database, so in theory both 18-week and purchaser/provider data could be summoned with one click from the same source, and with much greater accuracy since it wouldn't be being collated from numerous different systems. That project had its own admin and IT staff within the Trust, plus a bevy of external experts, assistants, managers, consultants etc. In fact, in the case of 'my' department the new database was fundamentally unsuitable for their clinical needs so we ended up having to double-enter everything - onto the old database for departmental use and onto the new one for broader data and reporting. So for that department the Trust ended up retaining the license and support costs of both the old database and the new one! (It's like that xkcd strip about Standards - "There are 49 standards, that's too many!" "Let's introduce a new standard that will incorporate all the existing ones." "~~There are now 50 standards~~")
My fourth role was collecting, inputting and displaying data for the Trauma Audit & Research Network, which is a national project to collate data about treatment and outcomes from trauma injuries. My Trust had only two people working on TARN - myself as the clerk, reporting to the orthopaedic department's administrative manager, and a senior A&E nurse who had making sure the TARN forms were actually filled in and collected on top of all her other work. I don't think anyone would say that that project was unneccessary or over-staffed.
I wouldn't say any of my four roles were 'wasteful', 'pointless', 'paper-pushing' or 'unnecessary', in as much as they were all required by the way that the NHS is required to be run, as per central government policy. However I could argue that only one was strictly required to help monitor and deliver clinical care, and thus would probably exist regardless of how the NHS was managed and run.
In general, I don't think the NHS wastes any more of its resources on back-room admin and management than any private-sector business would if it was of the same size and scope, and I don't think that the level of 'waste' or 'non-jobs' is very high, while in my experience the productivity and work ethic of the individual people has been the same whether in the NHS or in private business.
This:
Inaprop Riat said:
I've worked with the Public Sector for nearly 20 years. My conclusion is that there are lots of very capable, passionate and talented people who are sub-optimised by a management culture which is horrifically wasteful, risk-averse and ham-fisted.
One of the key causes of the management incapability is the fear of criticism, which is a disease that runs through the whole sector. In an attempt to avoid being dragged over the coals by the media, general public or external bodies, the path of least resistance is often chosen. So you get risk aversion, procrastination, obsession with cost, misleading communication and protective hierarchies taking root. Ironically, the sum of these parts often leads to the very cock-ups that attract criticism that they were designed to avoid.
Very little of this is directly linked to the Government of the day, it's endemic to the system. Occasionally, direct political decisions have bad consequences, but frequently, well-intentioned decisions made by politicians are ruined in the implementation by Central Gov or the management of the other parts of the sector such as the NHS. Unfortunately, successive Governments have either chosen not to directly intervene or have attempted to do so by using the very same individuals within the sector to drive the change, thus leading to more of the same.
That said, all of this is understandable. Imagine if every single decision you took in your job was mercilessly ripped to pieces by the media, general public and other stakeholders, especially if you happened to hit upon an issue that was of high importance to certain groups? How often would you stick your neck out?
is also very true, regarding the overarching approach and culture, though. The reasons give are, I think, also spot on. One of the key causes of the management incapability is the fear of criticism, which is a disease that runs through the whole sector. In an attempt to avoid being dragged over the coals by the media, general public or external bodies, the path of least resistance is often chosen. So you get risk aversion, procrastination, obsession with cost, misleading communication and protective hierarchies taking root. Ironically, the sum of these parts often leads to the very cock-ups that attract criticism that they were designed to avoid.
Very little of this is directly linked to the Government of the day, it's endemic to the system. Occasionally, direct political decisions have bad consequences, but frequently, well-intentioned decisions made by politicians are ruined in the implementation by Central Gov or the management of the other parts of the sector such as the NHS. Unfortunately, successive Governments have either chosen not to directly intervene or have attempted to do so by using the very same individuals within the sector to drive the change, thus leading to more of the same.
That said, all of this is understandable. Imagine if every single decision you took in your job was mercilessly ripped to pieces by the media, general public and other stakeholders, especially if you happened to hit upon an issue that was of high importance to certain groups? How often would you stick your neck out?
Edit:
Inkyfingers said:
pretending that it doesn't require change is a falsehood peddled only by the likes of Jeremy Corbyn.
What? In what way do you think that Corbyn/Labour didn't (or don't) think that the NHS required change? It was right there in their manifesto - increased funding, yes, but also major reforms and restructuring of how the service worked and delivered. Edited by 2xChevrons on Monday 4th May 14:02
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