How have it’s highly trained and respected staff been rendered powerless to prevent services being dismantled, privatised and patient and public safety put at risk?
Both these questions can be answered when you consider and understand the central importance of New Public Management (NPM)
Thatcher’s government commission the Griffiths Report in the 1983 which introduced General Management and marketisation and provided the framework for the destruction of the public sector by installing a bloated, unaccountable and ruthless management structure which would:
Establish itself and grow inexorably by removing those with expertise, morality and integrity to be replaced by marketers and privatisers
Split up institutional structures into directorates providing lucrative job opportunities for cronies (e.g. neoliberal, old Etonians, Blairites) motivated by self interest and having no qualms about betraying the public interest. This also served to help divide and rule the workforce
Performance related pay and bonuses – Through PRP the NPM elite would be incentivised to pursue self interest and promotion whilst enforcing dangerous policies. Those not willing to blindly follow political dictat soon hit a promotion ceiling or worse whilst watching their less morally-sensitive colleagues progress. Perverse incentives abound to cover up failure, commit fraud and neutralise whistleblowers.
Outsource critical functions such as audit, financial and legal expertise
Ethos – corporate goals not public interest were to be served. Any obstacle to the pursuit of corporate & political objectives to be eliminated.
Culture – Public services transformed from serving the public interest to corporate operating style
Public relations – Truth and objectivity have no place in NPM. Manipulation, misrepresentation, spin and deceit now rule.
Corrupt agents – Management Consultants, Accountancy firms, lawyers, Public relations firms, think tanks, regulatory bodies and media pump out truck loads of ‘information’ to create a false impression of probity, openness, independence and rigor but in fact all these players have huge conflicts of interest in the further demise of public services, successfully diverting a greater proportion of public funds away from the stated purpose i.e. providing healthcare into the fees and profits. More and more of these leeches are being attached to our public services whilst in-house expertise which could challenge the fraud and misappropriation no longer exists
Billions have been spent creating the ‘enemy within’ whose goal is to destroy the much needed public institutions for personal gain.
As an NHS insider, it has struck me that intelligent and well qualified staff are often led by their intellectual, moral and ethical inferiors. I have lost count of how many good people I know or have read about that have been sacrificed for acting to protect the public interest and patient care whilst those responsible for the failures and the subsequent silencing of these brave souls get promoted. These ‘NHS re-treads’ go on and oversee destruction elsewhere within the system wearing a badge of honour earned through cover-up, intimidation, silence over failure or spin. Meanwhile the majority of staff that actually see patients and deliver care, plod on despite this toxic leadership, grinding themselves down trying to provide a safe service deliberately depleted of resources much of which diverted to line the pockets NPM elites.
I strongly recommend all NHS defenders to read the book: ‘How Corrupt is Britain’ edited by Prof David Whyte which covers NPM Without such overview we seriously underestimate our opposition with their wide reaching tentacles and despicable tactics.