POSTSCRIPT & APPENDIX
A recent Report published by the NHS Federation “Governing the Health and Care System in England” (11) announces the introduction of Integrated Care Systems (ICS’s) and yet more changes in administration, management and bureaucracy. A considerable amount of text concentrates on studying the obvious NHS shortcomings. “Excess bureaucracy exacerbated by duplicative or disproportionate assurance systems” and principles for “System Oversight”, “Mandated Support”, “Nuanced Understanding” and “Political Management” are all listed as possible causes or panaceas.
However, we must not abandon all hope, as the Nobel Prize Winner Elinor Ostrom is quoted late in the Report “recommending the principle of self-organisation rather than being instructed by others how to do so and allowing different arrangements to emerge in different communities”. And guess what? “Within provider organisations, clinicians are best placed to lead improvements in care”.
The American satirist PJ O’Rourke learned “how to make everything out of nothing” and he was clear that “Government does not create wealth” to which can be added “or health”.
Appendix
1) https://www.dentalhealth.org/thestateofmouthcancer
2) https://www.england.nhs.uk/2013/07/call-to-action/
3a) http://www.maniffesto.com/wp-content/uploads/2015/09/Conservatives-manifesto-uk-2005.pdf
5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362737/
6) https://files.digital.nhs.uk/publicationimport/pub17xxx/pub17137/cdhs2013-executive-summary.pdf
7) https://www.gov.uk/government/collections/national-diet-and-nutrition-survey
8) https://www.england.nhs.uk/2014/02/improve-dental-cta/
10) https://en.wikipedia.org/wiki/Healthcare_in_the_Republic_of_Ireland
11) https://www.nhsconfed.org/publications/governing-health-and-care-system-england
12) Dental X-Roads
15) https://www.nhs.uk/conditions/baby/babys-development/height-weight-and-reviews/baby-reviews/
Dr Nigel J Knott 20 September 2022