NHS Code Black
- Thread starter merlin
- Start date
Tim Jones
pfm Member
Oh for heaven's sake
I simply said "people like Tim" - go back and read the "offending post" for clarity.
I'm a cyclist. If someone referred to cyclists as "people like Merlin" would anyone have an issue with that? I certainly wouldn't. I would defend my position if I felt there was a case to do so but the poster would be right. He or she would be referring to a group of people through a character familiar to those involved in the conversation.
I will "insult" Tim personally for running at the first sign of his profession being criticized for failing to perform. That's symptomatic of much that is wrong with the system. Fresh minds are needed and a fresh approach.
Huh? Your inversions here are becoming so complicated that I think you're disappearing up your own fundament. You don't come across as a fan of efficiency and then insinuate that I should be fired because I haven't done it properly (there are a few other people involved in this btw...). And there was a bit more to your post than that - accusing me of 'political arse covering', even though as others agree, this isn't really about politics.
For the time being, despite my better instincts, I haven't 'run' as you put it. And, back on topic (slightly) - any chance of answer to the question I (among others) have posed...several times? In other words, why not give me and my colleagues a taste of what you think that fresh approach should be, please.
merlin
Avatar changed - Town names deemed offensive.
So there's the question from some days ago Tim - the place where you measure efficiency. How about you answer that first and then we can start to look at weaknesses from a position of knowledge?
Markus, if that's what I'm accused of then there is a serious problem with interpretation of the written word here. I've tried to explain what "people like" means in my language but if that's not clear to all then there is little more I can do. Just to be absolutely clear, of course I'm not blaming Tim alone for the failures of the system and the resultant tragedies.
I am however saying that those involved with the running of the NHS over the past 30 years have failed miserably and it's time for them to be held to account. All of them - even those that own nice hifi systems and listen to early Bowie.
Tim Jones
pfm Member
Despite the fact that I initially replied to you in a what I hoped was a sympathetic and explanatory way, and subsequently tried to describe what we were trying to do, you are basically saying that I (and the many people who are trying to do some fresh thinking, again as I set out above) should be sacked.
I did answer your points about efficiency. You didn't like the answer, but you got one. If demand is rising faster than resources, we have to see what we can do to manage demand better, and the current answer on the table involves creating integrated budgets and care models. To illustrate this, in most western health economies, some 5% of patients drive c.50% of costs (and around 1% of patients drive some 20% of costs). In the NHS we are not managing these patients well because we have a process that is still basically designed to incentivise acute admissions. This is all pretty evidence based.
Your 'position of knowledge', however, seems to involve waiting until you get an answer that you like. One might not be on the table I'm afraid, unless you would like to specify (quite reasonably) that we simply need to tax and spend more. You're then left with the issue I've raised more than once - how, given that medical costs are likely to go on rising faster than growth, do you stop health spend simply taking a larger and larger chunk of GDP?
Above and beyond a distinct sense that this is really now just a thread about your own verbal gymnastics, I'm clearly not going to get any answer at all to this important set of questions, so, ok, I'll give up.
Tim Jones
pfm Member
Absolutely spot-on. This is why 'NHS efficiency' is about a lot more than budgets, and is precisely why the system is looking long and hard at alternative ways of doing things.
merlin
Avatar changed - Town names deemed offensive.
I'm not bullying anyone. If people really think that then there's a lot of over sensitive souls here.
Let's try another analogy.
If you take over a football club that's fifth in the First Division and, after having ten years in charge ,the club is facing relegation from the Third Division and on the verge of going into administration, would you expect people to come to you for advice on how to take the club forward? Honestly?
Let's try another analogy.
If you take over a football club that's fifth in the First Division and, after having ten years in charge ,the club is facing relegation from the Third Division and on the verge of going into administration, would you expect people to come to you for advice on how to take the club forward? Honestly?
doctorf
left footed right winger
The NHS is fvcked.
There are too few doctors & too few nurses to be able to provide a comprehensive service.
Coupled with the lack of resources that makes it unsustainable.
That is the problem with a publically funded service perceived as free; it is abused to the point of bankrupcy.
Yes we could pour more money into it by increasing taxation (not that the current lot would) but that still leaves a shortage of medical staff which in my view is the main reason why we need to ration care or at least make the end user feel some responsibility when using it by charging.
Free at the point of access is unsustainable when demand is rising exponentially.
So keep asking Tim questions but he has no solution.
If there was a solution it would have been done by now.
There are too few doctors & too few nurses to be able to provide a comprehensive service.
Coupled with the lack of resources that makes it unsustainable.
That is the problem with a publically funded service perceived as free; it is abused to the point of bankrupcy.
Yes we could pour more money into it by increasing taxation (not that the current lot would) but that still leaves a shortage of medical staff which in my view is the main reason why we need to ration care or at least make the end user feel some responsibility when using it by charging.
Free at the point of access is unsustainable when demand is rising exponentially.
So keep asking Tim questions but he has no solution.
If there was a solution it would have been done by now.
Brian
Eating fat, staying slim
Good to hear it.
Patrick Dixon
Imagineer
I'm afraid I completely disagree with you for the following reasons:
1) The people implementing the change and the budgets are just doing what the politicians tell them to do with the money the politicians give them. They are doing their best under difficult circumstances and trying to keep their jobs.
2) Even if they have failed miserably it hasn't been through negligence or lack of effort or possibly even lack of ability (to use your football analogy if the manager makes Messi play in goal rather than midfield then the team is probably going to under-perform). Therefore 'holding them to account' is pointless. Sort out the strategy and get the team playing to the best of its ability.
Patrick Dixon
Imagineer
There may not be a solution but there are almost certainly better approaches. And surely we shouldn't give up on finding a better approach? God help us if we end up with the US system; even with the NHS's problems at least we are not taking money from ill people to buy doctors collections of classic cars, or money from people with imperfect smiles to pay dentists to shoot lions (with arrows) for fun.
Brian
Eating fat, staying slim
I believe Tim said somewhere the problems aren't political. Lurching from strategy to strategy that don't work implies it is political.
Derek Wright
pfm Member
Re Bed Blockers - one of the emotive topics of the day.
It is possible to get a Premier Inn hotel room for between £50 to £120 per night according to the locale.
So why do not the hospitals take a block booking of a floor of rooms and move the patients that only need rations and a bed that the local authority cannot immediately look after into these rooms.
Station a nurse at the hotel for overnight duties and have district nurses (or whatever they are called now to look in during the day.
Only move people that are expected to move into community / family care in the following week or so.
It is possible to get a Premier Inn hotel room for between £50 to £120 per night according to the locale.
So why do not the hospitals take a block booking of a floor of rooms and move the patients that only need rations and a bed that the local authority cannot immediately look after into these rooms.
Station a nurse at the hotel for overnight duties and have district nurses (or whatever they are called now to look in during the day.
Only move people that are expected to move into community / family care in the following week or so.
eternumviti
Insufficient privileges to reply.
You are not a million miles away from what will very soon be happening, except it will be on the public/private fringes of the NHS.
russel
./_dazed_and_confused
Except the people responsible for overall supervision are like yourself, free market fundamentalists who are reluctant to believe a problem with it when one crops up.
Russel
People like me are rarely involved in the day to day running of the contract.
In the case of cleaning, there would be a representative of the cleaning company and one for the hospital running the contract. If something goes wrong then it is usually resolved by a phone call etc.
The reality is that the same people carry on with the cleaning and are TUPE protected so most of them have done it for years and percentage wise, the level of complaints are low.
However if there is a complaint that cannot be resolved by the two reps, then the hospital rep holds the trump card and will instigate a failure. If the failure is not resolved, the cleaning company gets a fine and a red tick in the file which is noted at contract renewal time.
The simple reality is that the hospital still controls the service and the only people who object to it are the ill informed.
If someone like you were to let the contract run its time, the same people would do the cleaning, the service levels would remain the same but the cost would slowly slide up due to the hieratical management structure of the NHS.
Even the NHS concedes this point.
Regards
Mick
merlin
Avatar changed - Town names deemed offensive.
Or get in a new team. A breath of fresh air. My personal opinion is that wholesale sackings are in order given the time these people have had to make a positive contribution.
It's clear there are many who disagree with me. That's fine. We all have our opinions. I hope no one on the forum ends up on the wrong end of NHS mismanagement.
How anyone involved can allow the GP situation to become so precarious and ineffective is a mystery to me. We still have no answer to any of the questions posed, only criticism and abuse for having the temerity to suggest accountability. That in itself (based on experience in business) suggests a cultural problem that needs to be eradicated before real progress can be made.