Here is an alternative to our chronic impasse over the NHS (Report, 17 February): abolish the internal market, together with its draconian micromanagement and inspection culture. These are flawed and failed ideologies. In attempting to replace vocational motivation with commercial incentives we have all but destroyed the best of healthcare’s professional art, heart, spirit and intellect. Our profession’s impoverishment of morale is widespread and increasingly hazardous. The internal market is inviably complex and divisive. It has undone collegial trust and therapeutic networking, and has replaced these with dense, rigid institutional procedures and documents that are often known to be senseless, often corrupting. Increasingly I have witnessed just-legal feints and “creative accountancy” to deceive yet formally comply: redesignations to double-count, cherry-picking referrals for financial or statistical advantage, for example.
Full story in The Guardian, 20 February 2017