Patrick Keady

Cormorants and the NHS




After watching the BBC2 programme Wild China, I was left wondering if there are similarities between NHS teams and the fishing team featured in the programme.


The BBC2 programme introduced men in their 70’s and 80’s. They chant and dance on rafts and are assisted by their well-trained team mates ….. a group of Cormorants. Between them, the team catches up to 30 decent-sized fish in a morning.


On Friday morning, the NHS England Chief Executive published The Year 2007/08. In his annual report, David Nicholson confirms that NHS England is on track to reduce waiting times to one sixth of what they were 10 years ago. By the end of 2008 all patients will wait less than 18 weeks from the date that they are referred by their GP, to date that they are treated.


In the opening paragraphs, the Chief Executive mentions that NHS England went through one of its most significant restructures in 2007/08. With the introduction of Modernising Medical Careers, 30,000 NHS Junior Doctors were left to compete for around 23,000 posts. About half of the pre-merger Strategic Health Authority employees have gone. Up to half of the pre-merger PCT employees are no longer there. And in the 2006/07 financial year, 1000’s of NHS Trust employees became surplus to requirements. Do we know where these people today?


NHS England successes during 2007/08 include rates of MRSA bloodstream infections in acute hospitals being reduced by 50%. All NHS patients in England are now free to choose where their elective care takes place. The median waiting time for diagnostic tests is 2.1 weeks, compared with 6.1 weeks in April 2006. All patients wait less than 4 hours in Accident and Emergency Departments.


While these are fantastic improvements, Mr Nicholson adds that more needs to be done. Lord Darzi’s plans for the next 10 years, are being published. They provide an excellent opportunity to bring about real and lasting improvements for all patients in England. The Chief Executive acknowledges that his job – and that of every leader and member of staff in the NHS – is to seize this opportunity and to make it happen.


The fishermen in Western China seize their opportunities too. But the Cormorants on the Lee River are aware. They keep a tally of the number of fish they catch, up to 7. And after that, they expect to be rewarded, or they withdraw. We know that NHS staff are keeping a tally too and that it has far exceeded 7! The reward that NHS staff often want is simply to be thanked for yet another job well done. NHS staff value job security, job satisfaction, good working conditions and appropriate training.


Many NHS organisations are responding well to the expectations of their staff. The NHS is clearly improving its services to patients. But after one of the NHS’s most significant restructures, an important challenge for all NHS organisations is to continue motivating and acknowledging the successes of their employees.



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