Researchers have suggested that competition between NHS hospitals may lower the quality of care and found that death rates from heart attack actually rose. In a paper published in Economic Journal, Professor Carol Propper of the University of Bristol said that the “internal market” led to a decline in standards, despite waiting times being reduced.
A lack of leadership, inadequate team-working and focusing too much on targets have also emerged as common themes in the Healthcare Commission’s review of 13 investigations between 2004 and 2007. The watchdog said that poor leadership was a problem in nearly all of the investigations it carried out over the three years and that some boards were focused on mergers or targets at the expense of patient care. The Learning from Investigations report stated that there was a lack of clarity on who was responsible for certain procedures and frequent management changes also affected the quality of care.
Commenting on the review, Gill Morgan of the NHS Confederation said: “Organisations must be given the real autonomy necessary to enable them to take ultimate responsibility, rather than being dominated by central targets.”
