Don Berwicks review of patient safety in England makes many good points, and highlights the scale of change required if we are going to improve patient care, not just within the public sector but also the burgeoning private sector of health and social care provision.
Berwick outlines the role of organisational culture when seeking to bring about positive change. There needs to be a clear vision at the heart of any organisation, one that everyone is fully committed to. Belief in the positive role and purpose of the NHS needs to be sewn into the fabric of this unique organisation. From Cameron to the cleaner, the pediatrician to the porter the preciousness of the NHS to us a nation has to underpin any changes that might be proposed and implemented.
The NHS is not just a healthcare system, it is an expression of our values, our belief in a social institution based on equality and collectivity, it’s also a proven alternative to free market competition. Lets not forget the reason for the existence of the NHS, it was founded on the failure of the free markets in a period of financial austerity – a time of new government and new political agendas. Any suggestion we cannot afford a principled system of healthcare is perverse in one of the richest countries in the world, the real issue is what do we as a nation want to afford?
Bevan said ‘Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community’
The NHS is not an indulgence, it tells the world something about us as a nation, it tells us something about ourselves.
Reform is required, certainly, but please, lets just try to make sure reform builds on the success of the NHS, not just recent failures.