Published: 04/04/2002, Volume II2, No. 5799 Page 19
A giant menace, as big as the NHS workforce, is threatening the modernisation programme. It is the parlous state of staff morale. Given the service's improved level of resources and several government initiatives to improve staff 's working lives, it might appear odd that a mood of pessimism and disillusionment has taken hold. Are they never satisfied? Is it anything more than baseless whinging?
Well, yes it is. Research by the King's Fund (see feature, pages 30-31) has identified a range of legitimate grievances which are damaging staff motivation and morale. Staff no longer feel as valued as they once did, but fear exposure and vilification by politicians and the media if they make mistakes. They are weary of too much change too often, and of the gap between the policy-makers' rhetoric and the reality of frontline practice. They look askance at obligatory central initiatives which do not match local priorities. And they are fed up with not being listened to.
None of which needs a sophisticated appreciation of human resources best practice to comprehend, as neither do the consequences: a tapering-off of co-operative attitudes and the growth of a work-to-rule culture. It hardly has to be stated that that would be disastrous for the NHS if it is allowed to develop further.
The remedy is to speed that much promised devolution of responsibility and to spread it rather more widely than ministers have hitherto envisaged. And make sure those extra millions reach where they are most needed.