NHS- renowned experts but no world class hospitals
Britain lacks any world- class hospitals because the culture of the National Health Service is still too much one of central direction and control, according to William Moyes.
Having spent six years overseeing the creation and regulation of self-governing NHS foundation trusts – which in theory are Britain’s best hospitals – the chairman of Monitor said that, while the UK had at least four or five real world- class universities, “I do not believe we have any world-class hospitals.
“They may have world experts here and there . . . but I just don’t believe that any of our best hospitals could genuinely demonstrate that they are world class across the whole range of what they do.”
Mr Moyes said he would probably come in for heavy criticism for saying that. But given how much is spent on the NHS “there’s something wrong in a framework that doesn’t produce that kind of quality”.
In the US, he said, the universities of Oxford, Cambridge, the LSE and Imperial “would be recognised as on a par with anything in America”. He was speaking on “a hunch and a feel” rather than hard data, but added: “I just don’t think you would have that kind of reaction to British hospitals.”
It was not money, he said, because hospitals were probably more generously funded than universities in the UK. It was that even self governing foundation trusts spent too much time worrying about what the government was doing and what the secretary of state for health wanted.
Mr Moyes said that when he was on the council of Surrey University, the council “acknowledged the existence of the government” and its policies. “But we felt very much that we were in charge of the university, and as long as we didn’t do something manifestly stupid, we would be left to get on with running it. Whereas I don’t think anyone in any hospital – foundation trust or not – feels they are that distant [from ministers]. They still feel the heavy hand of the secretary of state is coming in their direction.”
That underlined the need to see through a reform of the NHS into a much more decentralised system – one “where you tell the hospitals what you want to buy, and you let them get on with it. Your political ambition is expressed as a commissioning ambition, rather than operational ambition” – the goal being a hospital system “as good as the university system in Britain”.