The business of running the NHS should be separated from the government, according to one of Britain's most successful businessmen, in a TV documentary screened last night (12 December).
In the BBC programme, Can Gerry Robinson Fix the NHS?, Sir Gerry Robinson, the former chairman of Granada, Allied Domecq and the Arts Council, expressed opposition to primary care "polyclinics"and the apparent disunity between hospital trusts and PCTs in service provision.
Last night's programme, funded by the Open University, showed Sir Gerry Robinson's return to the scene of one of his most daunting challenges – to reduce waiting lists at an NHS Hospital in Rotherham, South Yorkshire, within six months and with no additional funds at his disposal.
Sir Gerry found performance improvements, reduced waiting times and a new "can-do" attitude from staff and management. He met old faces and saw how the management and staff adapted to new ideas with energy and enthusiasm.
Rotherham Chief Executive Brian James has continued to follow Sir Gerry's advice about getting out and about around the hospital, meeting his staff and maintaining a visible presence in the organisation.
Sir Gerry said: "One unexpected side-effect of my time at Rotherham is that I now give regular talks to NHS managers and leaders throughout the country about achieving results.
"Frankly, if you haven't got people feeling great, not good, great about what they are doing, then you are failing to manage."
But Sir Gerry was visibly frustrated at the creation of a £12m "walk-in" polyclinic, providing some of the same services as the hospital, to be built only two miles away.
He heard how many of the hospital's staff and patients feared this could put many of their existing services in jeopardy.
His findings led Sir Gerry to the singular conclusion that "the NHS – the most important institution in the country - has to be separated from government".
Professor John Storey, from the OU Business School and academic advisor to the programme, said the programme "most starkly" showed "the apparent massive uncertainty expressed by both the hospital trust and the PCT chief executives about the purpose, role, value for money and consequences of the new community clinics designed to divert some of the work from the district general hospitals."
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"It was refreshing to see someone from 'outside' succinctly reviewing the NHS and concluding with many of the issues that many staff working within the NHS have known for many years. Of course, such clinics will potentially threaten income streams for hospital trusts. The announcement of 38 new health centres in 'underdoctored areas' with potentially 150 being created nationally is an indication that more and more of these types of clinics are destined to be created. These schemes are likely to be offered under APMS and create the opportunity for more private sector firms to bid for the contracts. Clearly, there is almost certainly a financial reason for putting such bids out to tender. The obvious message that is coming out from this is that, whether you are a secondary care hospital or primary care practice, a new tier of service provision is being given the opportunity to develop. To complicate matters, new players from the private sector are being invited into competing for services under the NHS 'brand'. There is a real danger that the NHS will become completely fragmented, and thereby it will be more than just funding that will be affected" – Steve Williams, London