I’ve been ignored again. The Government has appointed Amanda Pritchard as the new NHS chief executive.
I can think of three reasons why I did not get the job.
First of all, I have no experience in NHS management and would be completely useless.
Second, I’m far too geriatric and finally, I did not apply.
Other than that, I would have been perfect.
The role will be as easy as setting up a protestant mission in the Vatican.
I confess that I did not enjoy medical politics and found sitting on committees as interesting as watching the icon go round in circles waiting for my laptop to boot up.
Some years ago I wrote a cynical piece about NHS managers in a national GP magazine.
It was meant as a satire but the following week I received a furious letter from a manager at Torbay Hospital.
If I had a problem with his management style, I should talk to him personally rather that criticise him in a national magazine.
I apologised but explained that it could not have been aimed at him because I had never heard of him. I decided not to add 'if the cap fits'.
When trying to keep up to date it was always tempting to attend a course where I can pat myself on the back and say 'aren’t I clever' but what I really needed was to go on courses based on my weakest areas.
I might actually learn something.
And so I applied for a GP leadership course. How did our 'leaders' manage?
I was not sure whether it was the right course for me and so I rang the course organiser.
I had met him many times at various meetings.
“Do apply,” he said. “We’ve not yet had all the applications in, and we may get someone who’s really good but apply anyway.”
Not the most positive endorsement but presumably the other applicants were as average as me because I got on the course.
No leadership course could possibly prepare anyone for the challenges of 21st century healthcare.
Every country around the world is battling to find a way to offer good healthcare without bankrupting the country.
As medicine has improved so costs have risen dramatically.
When I qualified angina, a pain around the heart, was treated with GTN tablets under the tongue.
The tablets were cheaper than the bottle they were in.
It helped the symptoms but did nothing for the outlook. Most cases of angina went on to have a heart attack.
Now anyone with angina will have an angiography, an x-ray of the blood vessels around the heart.
They will go on to have a stent, a tube to open the blood vessel up, or a coronary artery bypass graft.
They will then be on tablets for blood pressure and cholesterol.
The outlook is dramatically better but vastly more expensive.
These breakthroughs have occurred in every area of medicine. Costs have rocketed.
So how do we pay?
We know that it is the poor who have the worst health outcomes but purely market economy in health means that the better off will get a better service.
Many countries in Europe have a private insurance-based system where everyone must be insured. It is then the private companies who ration care.
It has been suggested that the NHS is the nearest we have to a state religion, but I would rather see it as a wonderful old Grade I listed building.
We must keep it, the design is amazing, but if we want to live in it in the 21st century it needs tasteful modifications.
The problem for politicians is that any change to the NHS is political suicide.
If in the unlikely event the Government had rung me and offered me the job of NHS chief executive I would have politely said 'no thanks'.
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