We need to reform the NHS, comment if you agree or object. If objecting, please say why and what you would do instead.
First of all, there are too many layers of authority between the Government and the surgeries & hospitals at the end of chain.
Once we are out of the EU, we need to get back to the “county level” of running things.
Ministry: there should be an NHS Department in charge of all purchasing and payments. Now that the NHS is fully computerised, both sections could be run with no more than a staff of 100 for each section, although this would have to be greatly increased whilst setting up.
Purchasing: senior executives of Amazon should be approached to set up an Amazon style operation. Not to run the supplies department but to advise in setting it up. And to inspect (but not oversee) it on a regular basis.
Payments: the department should be responsible for two areas. And two areas only, everything else should be handled at the local level (surgeries and hospitals).
First of all they should be responsible for the payment of all salaries which are paid into the bank, and the issue of all payment instructions to the surgeries and hospitals for weekly cash wages.
Secondly they should be responsible for the payment of all purchasing incoming invoices.
County Council: There should be no other levels of management until we come to Country Level in the local Country Council offices. This is where they decide whether hospitals should work individually or in groups, and the number of surgeries required for the local demographics. Nothing else. The Council themselves can make those decisions, but perhaps a manager (one only) could be based there, using the council’s secretarial services when required?
Surgeries should be responsible for the running of their surgeries, other than the actual payment of salaries, equipment or medicines. They already have a practice manager so would only need one extra member of support staff.
Hospitals: should be responsible for the running of their hospitals, or hospital groups, other than the actual payment of salaries, equipment or medicines. They already have a managerial staff so would only need to expand their support staff.