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NHS Code Black

merlin said:
From my own point of view, I've seen such horrendous waste with absolutely no result. This appears to be primarily a case of clinicians being afraid of not following NICE guidelines to the letter. There seems to be a fear culture that overrides the application of common sense. How do you get common sense back into a nationalised industry? What would happen if you stripped out some of the levels of management and gave those funds to the medical professionals?
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I've only been with the NHS for 10 years (Pathology, so we only get to see patients in small pieces!), and I know what you mean re common sense - however, two of the problems are that we live in an increasingly litigious society, which makes Trusts very nervous about doing anything other than following all guidelines very closely, and the other is that there's a marked difference between appearing at a Coroner's Inquest (for example)and saying "We followed NICE guidelines", and saying "We applied what seemed to be common sense".

I'd love to see more common sense used in the NHS, but getting from Here to There will be difficult.
 
clifftaylor said:
I've only been with the NHS for 10 years (Pathology, so we only get to see patients in small pieces!), and I know what you mean re common sense - however, two of the problems are that we live in an increasingly litigious society, which makes Trusts very nervous about doing anything other than following all guidelines very closely, and the other is that there's a marked difference between appearing at a Coroner's Inquest (for example)and saying "We followed NICE guidelines", and saying "We applied what seemed to be common sense".

I'd love to see more common sense used in the NHS, but getting from Here to There will be difficult.
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but someone's common sense is another person's disaster hence the guidelines.
I always had difficulty with guidelines when I was unsure whether they were there to save money rather than to provide best care.
 
merlin said:
If Tim has been involved in efficiency studies and recommendations over recent decades vis a vis the NHS then I'm not sure his area of "expertise" is necessarily of a great deal of use when discussing the current crisis.

I can't be the only one who wonders how much of the current fiasco is down to people like Tim getting areas of healthcare provision so horribly wrong over the past thirty years or more.

Straight answers to straight questions would be a start IMHO - I see far too much politico arse covering for my taste both in threads like this and in the discussion in general.
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I'm not and have never been a politician. You might not like my answers, but they are informed by twenty years of trying to improve the NHS, through thick and thin.

How depressing that your response to my attempts to address the issues is to blame the crisis on me. I'll make no further contribution to this or any other thread on this topic, as it so predictably ends up being ad hom - in this case in a profoundly insulting way.
 
Tim Jones said:
I'm not and have never been a politician. You might not like my answers, but they are informed by twenty years of trying to improve the NHS, through thick and thin.

How depressing that your response to my attempts to address the issues is to blame the crisis on me. I'll make no further contribution to this or any other thread on this topic, as it so predictably ends up being ad hom - in this case in a profoundly insulting way.
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Sorry that you take my comments to be "ad hom" Tim. They are aimed at the management structure of the NHS and people brought into address efficiencies.

In a privately run operation, I doubt the continued failings of management to address the real issues effectively would be tolerated. Again I'm sorry if you find that to be a personal slight - I can't help that. Such a point however should not be kept out of any discussion aimed at improving services that we, the end users, experience. Why would you think that it should be?

WRT the litigious society that we live in Cliff I sadly agree. I would like to see a limited liability "contract" - I would certainly be happy to sign one and have no desire whatsoever to sue a company in which I am effectively a shareholder.
 
merlin said:
Sorry that you take my comments to be "ad hom" Tim. They are aimed at the management structure of the NHS and people brought into address efficiencies.
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Merlin, you said:

"If Tim has been involved in efficiency studies and recommendations over recent decades vis a vis the NHS then I'm not sure his area of "expertise" is necessarily of a great deal of use when discussing the current crisis.

I can't be the only one who wonders how much of the current fiasco is down to people like Tim getting areas of healthcare provision so horribly wrong over the past thirty years or more"

Which sounds pretty ad hom to me.
 
Cliff

If I were to come onto a public forum and state that I was involved with the deliberations aimed at efficiency improvements in the NHS, and I were to have been so involved over a lengthy period of time, I would expect people to ask me just why the process has resulted in a health service in crisis.

I would not expect to be above criticism simply because I enjoy audio equipment and I would be prepared to have to answer difficult questions. I asked Tim a number of questions regarding the measurement of efficiency, all of which AFAICT he failed to answer. Politicians need to be that little bit more thick skinned than Tim seems to be.

I consider "ad hom" to be simple personal attacks. I question the efffectiveness of management consultants and civil servants in certain roles and ask that they justify their cost - but I do so without kid gloves. I consider that to be a reasonable request given the crisis the service finds itself in. Maybe the fact that some appear to be offended tells us more about the culture that exists in these operations than words of appeasement possibly could :) ?
 
merlin said:
Politicians need to be that little bit more thick skinned than Tim seems to be.

I consider "ad hom" to be simple personal attacks. I question the efffectiveness of management consultants and civil servants in certain roles and ask that they justify their cost - but I do so without kid gloves. I consider that to be a reasonable request given the crisis the service finds itself in. Maybe the fact that some appear to be offended tells us more about the culture that exists in these operations than words of appeasement possibly could :) ?
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Tim has stated that he isn't a politician, and I see no reason not to believe him - do you??

You also said "I can't be the only one who wonders how much of the current fiasco is down to people like Tim getting areas of healthcare provision so horribly wrong over the past thirty years or more", which suggest that you think he's to blame for the current NHS crisis.

Anyway, I'm not his representative, but I understand why he was, and has, pissed off.
 
Cliff. I assume Tim means he's not a party politician. I don't see this as a party political issue.

So Tim is and has pissed off. I'm pissed off that my friend has 30% of the life expectancy of someone with the same condition who pays German taxes so that makes two of us :)

Those responsible for the decline of the NHS need to be accountable. The current system is shambolic. What's even more frustrating is the bluster and blame culture one encounters when issues are pointed out. There is no acceptance of liability anywhere within the system to the point of being dishonest. That I find personally offensive given that those involved are public servants.
 
merlin said:
Those responsible for the decline of the NHS need to be accountable. The current system is shambolic. What's even more frustrating is the bluster and blame culture one encounters when issues are pointed out. There is no acceptance of liability anywhere within the system to the point of being dishonest. That I find personally offensive given that those involved are public servants.
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So if "Tim" posts on an audio website re the NHS, and doesn't give you the answers you require, then he's avoiding his responsibilities? He isn't obliged to tell you anything at all - and for all you know, he may have spent 30 years fighting for the NHS, mightn't he?
 
Then tell us. Makes sense don't you think?

At the end of the day, he's the one who chose to enter this thread telling us how he had been helping a CEO at a nearby hospital that day. He put himself in the firing line so to speak and, speaking personally, I tried to keep him on board by avoiding the political name calling. Yet I was not getting answers to simple questions. I think it's valid to question the efficacy of the NHS's upper management structure and culture.
 
I don't always see eye to eye with Mike but the point he's making is very obvious and entirely valid. No ad-hom in there anywhere.

Many appear to think the NHS is inefficient, surely people actively involved in setting out changes to working practices supposed to improve efficiency but which fail to deliver need to reconsider their approach? I appreciate it's difficult when ideology comes into it.
 
merlin said:
Cliff. I assume Tim means he's not a party politician. I don't see this as a party political issue.

So Tim is and has pissed off. I'm pissed off that my friend has 30% of the life expectancy of someone with the same condition who pays German taxes so that makes two of us :)

Those responsible for the decline of the NHS need to be accountable. The current system is shambolic. What's even more frustrating is the bluster and blame culture one encounters when issues are pointed out. There is no acceptance of liability anywhere within the system to the point of being dishonest. That I find personally offensive given that those involved are public servants.
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I think Tim is a civil servant and thus not a politician.
 
gosh tim . please please don`t stop posting . it is incredibly important to have your views with such experience at the coalface . I learn a lot from them
many on here have had many frustrations with the nhs system and it sometimes boils over
 
Tim has made clear before what his role is, I doubt Mike has missed it. Tim has also made clear his low opinion of 'the left' in general but that's ok.

Do you think the people who have introduced changes to working practices in the NHS over the last 2 decades aimed at improving efficiency have got it right? I may be wrong but it looks to me like all Mike has said is that he thinks maybe they haven't.
 
Seeker, just to clarify what for me personally is obvious, there is the career of being a politician and there is the quality of being politically minded when dealing with issues in life.

I consider Tim to have the latter quality. I tend to just call as spade a spade which some people find a tad too blunt and possibly offensive.
 
Do you think the people who have introduced changes to working practices in the NHS over the last 2 decades aimed at improving efficiency have got it right? I may be wrong but it looks to me like all Mike has said is that he thinks maybe they haven't.
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I think that changes have been made with all the best intentions (ie no conspiracy to discredit the NHS or push a privatisation agenda) but are always a compromise to accommodate Health Secretary's concerns, local concerns and interests and the Treasury's long-handled screwdriver approach.

And we have no way of knowing what the result of doing nothing would have been.
 
Brian said:
Tim has made clear before what his role is, I doubt Mike has missed it. Tim has also made clear his low opinion of 'the left' in general but that's ok.

Do you think the people who have introduced changes to working practices in the NHS over the last 2 decades aimed at improving efficiency have got it right? I may be wrong but it looks to me like all Mike has said is that he thinks maybe they haven't.
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What a litany of weasel words from you and merlin. If you think all done in twenty years is try to change working practices in order to improve efficiency then you're very wrong. And like anyone, I have real, painful, personal experience of the NHS.

My main problem with the broad left as it exists in these threads is not necessarily the content (I'm entirely unsure what that content is here by the way - my requests for clarification about your own long term economic approach above having been completely ignored), but the inevitable reversion to ad-hom, calling people 'tories' and the rest of it, which are omnipresent on this board. You have, not for the first time, turned what could be a reasonable discussion into a personal attack.

Any Government that you care to support will face similar long term issues in running the NHS. They are not 'ideological'. The NHS is not in its current condition because of people like me - we are here because we don't have sufficient money to spend to respond to demand.

So, let me have one final try at this. What would you actually do about that? I don't mean the usual blame-game about what happened in 2008. I don't mean answering by saying "no...you!". I mean what would you do?
 
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