It is fashionable in some quarters to denounce the ‘inefficient’ way the NHS runs itself. ‘Administrators’ seem to attract particular attention. But this is nearly always unfair. And ultimately self-defeating.
Anyone who practises medicine is keenly aware that they do so not as a right but as a privilege, borne on the efforts of many others. This includes the often publicly unseen but always present support and administration colleagues, whose work constantly ensures doctors and other health professionals can carry out their tasks. As for the NHS as a whole, their work changes with technology. Medical secretaries no longer accompany the Consultant on their rounds, no longer use typewriters or (surprisingly recently) coax ancient fax machines. The power of information technology has taken the ‘medsec’ out of the ward and into the back-office, often some distance from the clinical areas. But one critical distinction remained: they knew the doctors they worked with, and they were the interface between the patients and the place of treatment, in many cases.
Increasingly not so. In a misguided and misapplied attempt to make the admin process ‘more efficient’, often at the behest of central government and with much fanfare about ‘cutting admin posts to save money’, many Trusts have made the mistake of outsourcing their ‘medsec’ work to remote, usually completely anonymous agencies, who use online labour to transcribe clinical letters, amongst other tasks. There is also much interest in removing the human medsec completely, and turning to AI apps to do much if not all of the medsec’s role.
That way lies folly. Doctors for the NHS is not luddite – we support change where it makes the NHS better. But if you remove the human completely, does anyone seriously believe this will somehow remove the human problems that beset any NHS function? The NHS is about helping people, and thousands of unseen dedicated people work hard – often, admittedly, with kit that is increasingly not fit for purpose – to make sure health professionals can do that as best they can. Removing them does NOT mean savings. It inevitably means the very people such misapplied policies were meant to help more – doctors, nurses, and other health professionals – have little choice but to do the work themselves. Because no AI can be caring, no AI can know a Trust and a consultant as well as someone who works there and with them day in, day out. Apps are not continuity of care nor do they offer compassion. People do that. People count. And any Consultant – or government – who ignores that, or thinks ‘admin can be cut to make things more efficient’ rapidly discovers the true costs of doing so. More suffering, not less. Give the right people the right tools and watch how they finish the job, with impressive efficiency. Don’t regard these vital staff as a working component which can be stripped out and updated with the latest plug-in.
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