The NHS is one organisation !

In my working life I have often been involved in integration projects - that is, bringing together teams from former competitors to form a single team in a new organisation. (One case that springs to mind is the shotgun marriage of Lloyds Bank and HBOS.)

The teams in the 'unmerged' organisations have evolved to be rivals, and do not trust each other. Moreover, they are trained to control costs in 'their' organisation. When they belong to the amalgamated organisation these behaviours can cause problems.

I see the same thing in the NHS: individual doctors and nurses do things the way favoured at 'their' hospital. Pride in their work is a good thing, but there comes a point when this needs to be challenged.

Viv is currently in the Lister, needing neurosurgical work. The Lister doesn't have neurosurgery facilities. She is also 'on the books' of the Addenbrookes neurosurgery team, as an outpatient. The ward doctors at the Lister are trying to get her transferred to Addenbrookes, but the neurosurgical registrar there has rejected this (despite the consultant there having said she may need the surgery that the consultant at the Lister says she needs). The impression I have been given is that this rejection is an almost instinctive reaction, based on a misjudgement of the capabilities of the team at the Lister. There's been no direct contact between the consultants.

Meanwhile Viv - the patient - seems to have been forgotten, her condition is certainly not getting any better.

This mess may perhaps be due to the way each hospital is funded ( 'I'm not paying for your patients operations'-type bickering), if it is in needs to be resolved - because not every hospital provides every type of treatment.

I believe that the teams in the NHS need to work as one; they need to be able to see each other's scans (if you go into any branch of a bank you can enquire about your account; why can a consultant at one hospital not see scans taken at another without all sorts of hoops being jumped through?), they need to share responsibility, and those best placed to help a patient should willing take ownership of the necessary activities.