terça-feira, julho 11

Destruição do Profissionalismo


Recentemente fizemos referência à notícia do Guardian sobre o anúncio publicado no jornal oficial da união europeia a convidar empresas privadas para a gestão de vários serviços do NHS, incluindo PCT (primary care trust), mandado, entretanto, retirar pela ministra da Saúde, Patrícia Hewitt, ao mesmo tempo que negava a sua intenção em privatizar o NHS. link
Um editorial The Lancet (8 July 2006-14 July 2006) “Mismanagement as a prelude to privatisation of the UK NHS”, faz uma análise deste episódio e das vicissitudes do processo de reforma do NHS. Do máximo interesse para compreendermos muitas das coisas que se passam entre nós .link

On June 30 The Guardian newspaper reported that the Commercial Directorate of the UK Department of Health had placed an advertisement in the Official Journal of the European Union inviting expressions of interest in managing the purchase of clinical services from health-care providers in the UK. The intentions of the UK Government have now been made abundantly clear. The advertisement was subsequently withdrawn to correct “a drafting error”, but this apparent gaffe should make it blindingly obvious to all who were not previously aware that the National Health Service (NHS) is being rapidly, cynically, and deceitfully privatised. The repeated assertions to the contrary by the latest ministers of the UK Government, Patricia Hewitt and Lord Warner, are no more than that assertions that convince few who have anything to do with either the delivery, or receipt, of health care. As a former Secretary of State for Health of the Labour Government, Frank Dobson, is reported to have said, “If this is not privatisation of the health service, I don't know what is”.
The whole structure of the once great NHS is now a worm-infested sham a crumbling edifice which consumes increasingly vast sums from the national purse while delivering a service which is progressively shoddy. The NHS was once a phenomenally successful institution which came close to providing first-rate care, day and night, to all rich and poor, in home and hospital. It was once the envy of much of the rest of the world. The NHS was also remarkably cheap. It harnessed the underpaid professionalism and dedication of health-care professionals and ancillary workers, and was administered by a minimalist system of management. Today's NHS is a shadow of what it was, with the attention of general practice distracted away from the provision of clinical care by constant reorganisation, while those in failing hospitals are demoralised to the point of despair abused, threatened, and hampered by armies of non-clinical staff whose increasingly obvious role is not to facilitate the care of the sick and needy, but to implement the directives of central government. The purpose behind those directives is privatisation.
It is not just the edifice of the NHS that is being destroyed, but the professionalism of the people it employs. Managerial failure of monumental proportions has been justified by putting the blame on front-line clinical staff for failing to work efficiently. And yet these same clinical staff have actually been doing their utmost to preserve the service, despite the crippling financial and managerial constraints placed on them. They retain the professional (and legal) responsibility for the quality of care, while having little power to influence that which is being administered. They witness daily the decline of clinical standards, triggered by inability to cope with the steadily increasing work-load. They witness daily the staff reductions achieved by not renewing the fixed-term contracts of some of the lowest (in terms of salary), but hard-working and completely dedicated, staff. They witness daily the cynical use of staff re-grading (Agenda for Change) to downgrade clinical staff to remove the salary increments that were otherwise due in the following financial years. They witness daily the demoralisation of the good caring people on whom health-care depends, and when these people are demoralised, they leave, and their posts are frozen. Those who remain behind are told that they have to make do not that they have to work harder (which would be politically incorrect and a potential breach of contract), but that they have to work “differently” more efficiently. And all of this has had to be endured in a climate of complaint encouraged by Government and thoughtlessly echoed by the press, and therefore adopted by the general public. The result is that clinical staff who have hitherto said little are now getting to the limit of what they can endure. Not only are increasing numbers of ancillary and professional staff leaving, but much more seriously it is apparent that doctors and nurses are coming dangerously close to losing the principles of care and dedication which were once so deeply ingrained. Some are even setting up businesses themselves. Who can blame them?

1 Comments:

Blogger tonitosa said...

Diz o Raven que não se renovam contratos a termo!
Será mesmo assim? Ou será que só se renovam os que convém e se admitem novos colaboradores para os lugares dos "depedidos"?
É que, nos casos em que se conhece o número de trabalhadores ao serviço nos hospitais, ainda não vi onde esta a redução do número de trabalhadores.
PS: muito se tem falado dos excedentes na Função Pública. Quem esteja mais atento não pode deixar de surpreender-se com as preocupações manifestadas, tendo em conta o número de aposentados de acordo com a informação constante no site da CGA.
Até apetece dizer: os "Deuses" devem estar loucos!

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