NHS management is a bullying, incompetent cult
NHS management is a bullying, incompetent cult
The Letby inquiry must range wider than her awful murders and investigate a chilling cover-up culture
The status of the Lucy Letby inquiry, which will consider how a nurse was able to murder seven babies, has been upgraded to statutory. That is welcome news but, really, it should never have been in any doubt. Heinous attacks were committed against the most vulnerable patients in the care of the National Health Service. Managers at the Countess of Chester hospital were told by paediatricians that something sinister was going on.
A run-of-the-mill inquiry would not have been able to compel witnesses to give evidence under oath. For example, the former £175,000 per annum medical director, Ian Harvey, who has been accused of having “fobbed off” victims’ parents, would have been able to go on residing pleasantly at his French villa, glancing up from his glass of Malbec to issue the standard concerned platitudes. Ah yes, “open, inclusive and transparent”, the three monkeys – see no evil, hear no evil, speak no evil – of the morally unaccountable NHS.
Former managers at the Countess of Chester who, according to consultant Dr Stephen Brearey, obliged him and other clinicians to attend mediation with a baby killer, should have no place to hide. But the remit of the inquiry must be far wider than merely adjudicating the bitter war of words between hospital executives and senior doctors.
What the Letby case has revealed is no less than the systematic and deliberate disenfranchisement of the medical profession. As one despairing consultant emailed: “The NHS ‘leadership’ is now staffed predominantly by over-promoted, under-qualified people, especially nurses, but also others with inadequate skills. Many are incompetent bullies (so many bully to hide their incompetence), part of a back-slapping self-congratulatory club which presides over a culture of ‘no bad news’.”
In other words, the brightest, most well-qualified members of staff have to answer to an elite class of numpties which has gained institutional and personal control of the system while rewarding itself with vast salaries, especially for failure. (In fact, technically you can’t really fail if you’re in NHS management; you’re often just moved to another important role where you can fail better.) Incredibly, Tony Chambers, the former CEO at Chester, went on to get three senior NHS jobs after presiding over the Letby calamity.
I asked a current member of staff at the Countess of Chester what Chambers was like. “Total gobshite,” he practically spat. That’s the technical term, I believe. “The number of clueless nonentities in senior positions in NHS trusts is unbelievable,” the medic continued. “They are obsessed with reputational management and preoccupy themselves with empire building, wasting time on the plethora of talking shops and obsess over bureaucracy and process to ensure that, under no circumstances, does anything get done. This all takes place alongside absurd gimmicks and virtue-signalling.”
Paediatricians raised concerns about an unusual number of babies dying on Letby’s shifts and nothing happened for three months. “That’s how they operate,” my source says. “Ask them what day is it tomorrow and they’ll come back to you in two years.”
NHS management is a cult, I have come to realise. They ruthlessly attack any heretics (aka doctors or nurses raising safety concerns) who dare to deviate from the theology of true believers. “They believe they are untouchable,” one doctor says, “because they think the public loves them and politicians daren’t do anything about NHS failure."
I am not easily shocked, but what I have found out since the Letby verdict about the way the NHS treats whistleblowers has shaken me to the core. One trust chief executive was heard boasting he had £1 million to spend “if consultants raise issues”. A former lawyer who used to work on clinical negligence claims for neonatal deaths and injuries, being brought against her firm’s main client, the NHS, said that cases were deliberately dragged out for as long as a decade with “both sides billing huge sums”. Grieving parents had to fight to get anywhere with discovery (the medical records paid for by you and me, the taxpayer).
“The sheer incompetence of the NHS staff was shocking,” recalls the lawyer, “and there was definitely a culture of cover up.”
How a nurse was able to get away with murdering at least seven babies at the Countess of Chester hospital is a grave matter for the forthcoming inquiry. None graver. But I have been given the names of numerous hospitals, all with equally awful management, where clinicians claim exactly the same thing could happen.
What kind of organisation gets away with an estimated 340,000 of its customers dying on a waiting list while spending millions of customers’ money making sure that failings and negligence never come to light?
Open, inclusive and transparent? Don’t make me laugh. It’s time to bring down the untouchable numptie class of the NHS. If its managers remain untouchable, how long before there’s another Lucy Letby?
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The Torygraph is propaganda
Even a stopped clock is correct twice a day.
Maybe for certain issues. But something like this bridges the political divide, and I think the article hits the nail on the head regarding NHS management and the culture that surrounds a lot of them.
Well, when the tories would love to paint the NHS as incompetent so they can sell more of it privately it's less of a bridge and more just an excuse.
I'm married to a doctor, who subsequently went into NHS management. My impression of NHS management (and I've worked in both private and public sector) is that the default position is to bend over backwards to do the right thing. Certainly, I've seen worse behaviour in private sector management than I have in the NHS. What makes yoiu think differently?
Based on my experiences (13 years, 3 Trust's) the managers fell into two broad groups. The first were amazing, well established in their profession and worked their way up through the ranks. They cared for their team, had professional pride and enabled everybody to do the best job possible (it was actually one of these people who sent me the article). The second group were as the article describes. Invariably not very good at their core role so moved towards management and admin to escape it, invariably failed upwards, made poor decisions which they weren't around long enough to see the impact of, and were insecure in their position so responded poorly to any challenge.
But in this situation, it wasn't the managers who were challenged, in particular. From what I can see A group of doctors put in a complaint about Letby. Letby then played the system by putting in a bullying complaint that the system then had to investigate.
I have no doubt that these managers were incompetent and defensive - I suspect heads should roll. But the headline charge of 'bullying' seems a bit off. It's a weird story and I'm looking forward to the results of the enquiry
Absolutely, for me I think the link is the line "many bully to hide their incompetence ". The best managers accept that sometimes problems arise and mistakes happen (or in the worst case someone acts maliciously), and they take the short term aggro or reputational damage to improve the long term outcome. The bad managers are the exact opposite, they don't want to deal with the short term problem and will actively bury it regardless of the long term risk to patients. I think that is what has happened here, and sadly often the next step (in my experience) is bullying those subversive elements.