Industrialised medicine: a step too far?

摘要

In a system hard-pressed to cut costs and make efficiency savings, healthcare professionals are being urged to be more ‘productive’. The King’s Fund NHS productivity challenge aspires ‘to close the funding gap through improved productivity’ and ‘ensure the greatest value for every pound spent’ .1 This is essentially the language and ethos of the production line. Indeed the Health Secretary recently hinted that a future rise in nurses’ pay might be linked to productivity.2 But the growing crisis in nurse recruitment and retention is surely evidence enough that an industrialised work culture, even if it did temporarily stoke industrial-style productivity and efficiency, must soon enough become unsustainable. And so we are left wondering what the term ‘product‘ refers to in the context of health care and what the metrics of such ‘productivity’-related pay might look like; and altogether whether the NHS, to quote Oscar Wilde, has become an organisation that ‘knows the price of everything and the value of nothing’ .As the burden of long-term disease soars in an ageing population,3 the quest for industrial-style efficiency might seem like a reasonable response. In which case, faced as it is with relentless demand,4 is medicine destined to change from ‘a craft concerned with the uniqueness of each encounter with an ill person, to a mass manufacturing industry …