What do our managers read?

As far as Grumble knows the only journal our managers read is the Health Services Journal. Dr Grumble cannot read this rag. It is not something he subscribes to. But the little snippets he reads from their blog make it seem like the Daily Mail. It seems to be one of those 'journals' that reinforces the mistaken models of the world that some people stubbornly carry in their heads. It might even be responsible for creating these falsehoods.

There are general themes which run through the HSJ output. Doctors are bad is one. GPs are idle money-grubbers is another. And the canard that markets are always good persists despite all the recent overwhelming evidence to the contrary. Doctors are just out for themselves and not interested in the welfare of their patients is another brutal allegation that really hurts. Dr Grumble has decided that he can no longer stand by and ignore the garbage that forms the output from the HSJ. Managers and doctors need to work together. Managers need to support doctors. How can we expect this when the HSJ publishes such falsehoods about us?

Doctors more than management want good care for patients. It's our raison d'etre. It's the overarching focus of our daily work. We, unlike managers, see the consequences of poor care. We more than managers have to communicate the consequences of poor care to our patients or their relatives. How can these people have the effrontery to educate us that patient care is paramount and accuse us of just being out for ourselves? They are the ones who sometimes fail to grasp the primacy of patient care. Not doctors. Unbeknown to our managers concern about patient care is a cardinal reason for the divide between us. We want to provide good care regardless of the cost. Managers always want to keep the lid on spending. That is a constant cause of friction. Doctors are bound to lobby for their patients to see that they get what they need. We are always battling for our patients. But we do live in the real world. We do see that costs must be contained. But what chance is there of our working together when we are constantly being undermined by HSJ blather?

It's a strange irony that it is managers who seem intent on trying to turn us from public servants with a genuine interest in patient care into the money grubbing people the HSJ likes to portray us as. Managers were the ones who essentially forced new contracts onto consultants resulting in our being paid for the very first time (on paper anyway) for all the work that we do. Doctors who were reluctant to move from a professional and vocational contract are now being paid more. Did our masters expect us to be paid less? Perhaps they really did. Perhaps managers just cannot grasp that doctors do whatever is necessary to meet the vital needs of our patients whether we are paid or not. And the same people made similar mistakes with GPs. For it was managers who forced GPs to jump through ever more hoops to be paid - which they promptly did. The BMA dutifully told the government that it would result in their being paid more. But the BMA was not believed. Yet the HSJ continues to distrust them.

The problem is that the HSJ has repeatedly fed a very wrong model of the world into our masters' minds. It has come from a number of inaccurate sources. Sometimes these have been blatant perversions of the truth. Below is just one small example of how the HSJ twists the truth. It is a quote from the editor's blog from a post entitled Public services failing to satisfy customers:

Figures from the UK Customer Satisfaction Index revealed that national public services, including the NHS, achieved the second lowest score among the 13 sectors measured.

The picture was repeated for local public services such as GP surgeries, which were also in the bottom half of the customer satisfaction service league table.

Now from that you would get the impression that GPs are a pretty bad lot, wouldn't you? Like the Daily Mail HSJ reader you might think that something must be done. But if you take the trouble to look at the facts, you would be surprised to learn that GPs were in the top ten of local services just behind the ambulance service:

1. Your local Ambulance Service — 81.6
2. GP surgery / health centre — 77.5

They were not only in the top ten. They were second! And, if you want to compare them with other categories, they scored more than Starbucks, VW and Virgin Media. But the HSJ won't tell you that. Now why do you think that could be?


The Jobbing Doctor describes another unwarranted attack on doctors in the HSJ. And like a sheep a manager weighs in and puts his misguided boot in only to have to back down when the redoubtable Clive Peedell puts him right. Read JD's post and put your blood pressure up.