In a knowledge industry where talent is recognised as critical, why is NHS management deliberately antagonising its key staff? Are managers incompetent or are they deliberately trying to break the NHS? Or is something else going on?
Every business has a job to do. The reason it exists. For the NHS, the reason is to get people better (or as better as they can be) as quickly as possible. As a country, its role is to stop people worrying about their health so they can get on with contributing to society. To do this, managers should be looking after their teams, nurturing resident doctors and building their skills and commitment.
But instead, doctors at all levels feel betrayed and frustrated. They are exploited by crushing workload, taken advantage of financially, and feel exposed and humiliated when the system conspires to make it impossible to look after their patients properly. Caring is weaponised as a weakness to force them to compromise their own health to protect the people they serve. The only way to survive is to get out.
So, why is this happening? Why is the long-term capacity of the NHS being destroyed? The answer is that the incentives driving the NHS are to reduce spend as much as possible without harming the vote for the government of the day in the next election. This has spawned repeated damaging reorganisations to give the appearance of progress while hiding that the amount of care is plummeting.
This is not an attack on NHS managers, many of whom are great people. But leadership needs to come from those pockets of good culture where patients and colleagues come first. And people are prepared to rebel against institutionalised stupidity.