[Closed] NHS just coasting along

He's right in one sense there's too many pointless targets to meet that Trusts spend far too much time and money on them. Concentrate on patient care that's what we're there for.

I suspect he will prescribe a dose of arnica to all NHS workers

http://www.woodlandherbs.co.uk/acatalog/homeopathy_remedy.html

Run an organisation that couldn't be less like a business, like a business.

Run an organisation that couldn't be less like a business, like a business.

....but could probably benefit from a bit more customer focus in some areas.

Isn't that a surprise? Jeremy Hunt (sic) who tried to hire (can't remember if it actually happened) the former head of Circle as an advisor and who intervened to expediate Virgin Care's takeover of hospitals in Surrey launches a fresh attack on the NHS.

Tory in attacking the NHS shocka. 😯

It was bad enough when this buffoon was given the Culture Brief, but it was bordering on criminal when he was given our treasured NHS to screw around with.

[i]"Coasting can kill. Not straight away, but over time as complacency sets in, organisations look inwards, standards drop and then suddenly, something gives," Hunt will say in a speech to a conference organised by the Nuffield Trust health thinktank to debate the future of healthcare.

"The lesson of Mid Staffs is surely that we need to understand why they fail in the first place, which means tackling mediocrity and low expectations before they turn into failure and tragedy."[/i]

Given the utter cluster-**** that led to the tragedies at Mid-Staffs, and let's not kid ourselves that similar isn't happening elsewhere, he's right though isn't he?

Doesn't seem to be too far from the mark in my family's experience. But Hunt was trumped by Sir David Nicholson's own testimony this week when he stated in order of priority the interests of the NHS were:

1. Having well-supported staff (whatever well-supported means) but no surprise whose interests came first
2. Systems, measurement, accountability (the irony?), processes - the bureaucracy second

......and finally,....

3...oh yes, the sick people. At least the patients made it on to the list albeit in bronze medal position

I'd say being given increasingly difficult targets to meet while staff levels drop probably also contributed a fair bit to the current issues.. Plus the increasing levels of admin/levels of managers..

[quote=IHN said]
Given the utter cluster-**** that led to the tragedies at Mid-Staffs, and let's not kid ourselves that similar isn't happening elsewhere, he's right though isn't he?

No, he's "attacking" the NHS, do keep up 😉

Yeah, sorry, my mistake. As the Minister responsible, what he should of course be saying is "No, no, everythings absolutely hunk-dory, honest. No problems here, it's all going swimmingly" 🙄

Given the utter cluster-* that led to the tragedies at Mid-Staffs, and let's not kid ourselves that similar isn't happening elsewhere, he's right though isn't he?

So giving the bloke responsible for said utter cluster-* the top job at the NHS would seem like an utterly inspired idea

Jeremy Hunt is an absolute [url= http://blogs.telegraph.co.uk/news/iainmartin1/100153447/the-night-i-saw-jeremy-hunt-hide-behind-a-tree-before-dinner-with-james-murdoch/ ]muppet[/url]. But also a complete free-market evangelist! He's a hatchet man with one brief only, and its nowt to do with hospital standards. Its about privatising the NHS once and for all. If people will insist on being ill, and we're then tasked with caring for the bastards, then at least our mates should be able to make some money out of it. Its only fair

Nice of Andy Burnham to remind us that this is nothing to do with Labour. It was all running smooth as silk a couple of years ago!

Bunch of lying, self-servings ****s, the lot of them 👿

[i]So giving the bloke responsible for said utter cluster-**** the top job at the NHS would seem like an utterly inspired idea[/i]

Agreed, and it's only a matter of time before he (rightly) goes.

I know Hunt is a twunt, and I know that the Tories plans for the NHS have been slightly unhinged (although I think 'privatising the NHS once and for all' is leftie hyperbole). However, I don't disagree with what he's saying in this instance.

"Here's some money. Not enough to currently manage your needs, or enough to future-plan in order to save money in the future."
"With this sum of money (with which you'll struggle to manage current minimal standards) I want you to excel above and beyond...."

Oresum...

🙄

DrP

(it's the equivalent of needing 4 new tyres on the car, having the budget for only 3, and being told to replace the spare too...)

Agreed, and it's only a matter of time before he (rightly) goes.

Given his utterly shameless, almost delusional, self-justifications so far, I wouldn't hold your breath.

(although I think 'privatising the NHS once and for all' is leftie hyperbole)

They tried to blatantly privatise it, laying it open to European competition law, so that everything has to be competitively tendered, or private healthcare firms could legally demand access. After opposition from pretty much everyone, they backed down. Only to then try and sneak the same clauses in [url= http://www.guardian.co.uk/society/2013/mar/02/doctors-bemoan-nhs-privatisation-by-stealth ]through the back door.[/url]. They were rumbled though, so they've had to back down again

Given the free-market ideological zealotry of this lot, especially the likes of Hunt, do you seriously think they're going shrug, say 'oh well.... we tried", then just leave it at that?

What's your ideological zealotry then? 😉

Plus the increasing levels of admin/levels of managers..

That's the received wisdom, but in my view it's completely fallacious. If anything, the NHS is under-managed, both in numbers and in terms of the quality of management. The proportion of 'managers' is around the 4% mark (much lower than in other organisations), and I believe that includes a lot of clinical managers who have dual roles - ie they're still delivering patient care.

A massive organisation needs to be well-managed, so that clinical staff can devote more of their time to doing what they are supposed to be doing - looking after patients.

It's true that clinical teams look up and see an endless stream of shite bureaucracy falling on them, then blame that on the managers handing it to them - but a lot of that crap comes directly from central government, and it is the lack of effective management which stops much of it being filtered out and dealt with separately.

I won't argue with the idea that there are quite a few 'management' roles in the NHS which are completely redundant and unproductive. I did one for two years and it was an eye-opener.

geoffj - Member
Run an organisation that couldn't be less like a business, like a business.
....but could probably benefit from a bit more customer focus in some areas.

We are not customers - we are receiving treatment not services...

Nice of Andy Burnham to remind us that this is nothing to do with Labour. It was all running smooth as silk a couple of years ago!

Patients, not customers!
Martin- agree with what you're saying bud- meant more management/admin taking up staff's time as opposed to the ole too many managers cliché.
Dr P speaks the truth!

An organisation the size of the NHS could always be improved on and helped tweaked.

I doubt anyone thinks the Tories hold the NHS dear in their hearts or him in particular

They will hive of the piss easy stuff to deliver to the private sector to show how much better it is than the NHS etc

Hopefully the Lib Dems will stop them

Pre labour, the big issue was hospital waiting lists. Not somethign you've heard about for quite a while. There is a reason.

Yes, there is - the hospitals focused on hitting the waiting list targets as they were told to, see Mid-Staffs for an example!

Hopefully the Lib Dems will stop them

Well they've been doing really really well on that score so far. And not at all just nodded through everything like the spineless little poodles they are. God help us if its down to them!

Dr P has it!

Binners you are being harsh - they have stopped the more draconian aspects of shafting the poor and rewarding the rich
They temper how right wing they can be - I agree the negotiated weakly initially and should have demanded more than the vote change referendum tbh and are crap. However imagine what this lot would be doing if they could to benefit scroungers and competition in the NHS ete
It would be far worse

It would be far worse

^^^^This

NHS would probably be OK if some ****er didn't try to reorganise it every ten years.

However imagine what this lot would be doing if they could to benefit scroungers and competition in the NHS etc

But that would require the mandate of a parliamentary majority, which Dave, rather amazingly given the opposition, failed to deliver. And something they should be reminding him of on a daily basis, but don't seem to be doing. They're complicit in the lot of it, as they seem to have spent most of their time, enjoying their ministerial cars, sucking their thumbs, and quietly wishing that their partners weren't quite so nasty.

Certain Lib Dems seem to have gone native and completely embraced the Tory philosophy

[img] [/img]

I think this:

[i]NHS would probably be OK if some **** didn't try to reorganise it every ten years[/i]

Is the key point. And if only it were every ten years; it's every parliament.

just in the interests of balance sky had harriet harman on the other night for her tuppence worth about what was wrong with the nhs. setting of targets really nothing to do with them and if it was they were on holiday at the time and we should be really, really sure that it wasn't their responsibility even if it was them in power and making the changes. it's like the pair of them were stamped out of the same mould, a pair of hunts if you will

NHS would probably be OK if some **** didn't try to reorganise it every [s]ten[/s] two years.

FTFY

Awesome picture never noticed that likeness before

And something they should be reminding him of on a daily basis, but don't seem to be doing. They're complicit in the lot of it, as they seem to have spent most of their time, enjoying their ministerial cars, sucking their thumbs, and quietly wishing that their partners weren't quite so nasty.

I dont disagree they had them over a barrell as dave could not get power without them and he negotiated very very weakly indeed.he should have driven a really hard bargain but he caved

that said they do limit how extremely right wing the Tories can be but YES they have done it baddly and turned a position of strength into one of weakness - they are crap but so much better than nothin gor a fully Tory govt

Methinks Jeremy Hunt is deliberately exchanging the term "coasting" for "keeping head above water amidst meaningless and unhelpful targets and KPI's".

My 'niche of a niche' clinical speciality runs on small numbers (12 beds for all of Devon and Cornwall) so one or two patients in a year can and oiften do completely skew any meaningful statistics you might try and generate. We have very few [i]reliably[/i] and quickly (ie <12 months post discharge) measurable clinical indicators/outcomes, this is common to the other 30 or 40 places that do the same thing as we do and frequently a topic of discussion in our national peer-review network.

We are therefore usually judged by our parent organisation (now a social enterprise trust) and our commissioners on some fairly irrelevant and therefore poorly named KPI's (there is nothing 'key' about them whatsoever ffs!), aided currently by the fact that we have turned in a roaring profit (for we are paid in bed days by the four different health authorities whose patients we take) over the last 18 months which has been reinvested in other clinical areas. We also have outstanding hygeine/infection control 'figures', chiefly because we have the infection vectors and wounds/bugs/germs profile of a primary school not a surgical ward, so frankly it is pretty hard not to be spotless.

Yet somehow all this currently makes us a "good" service because no-one knows how else to judge us. 😕

jamj1974 - Member
geoffj - Member
Run an organisation that couldn't be less like a business, like a business.
....but could probably benefit from a bit more customer focus in some areas.
We are not customers - we are receiving treatment not services...

*sigh

What gets me in this is the language used by the Guardian in the article, its so inflammatory, it is simply designed to get people angry and turn against each other and clouds the debate before it starts

Can you point out which bits you feel are inaccurate?

I would say it's the speech that's inflammatory, not the presentation of it. Does anyone seriously believe that Hunt would like to see the NHS being highly successful in its current form?

What gets me in this is the language used by the Guardian in the article, its so inflammatory, it is simply designed to get people angry and turn against each other and clouds the debate before it starts

In what way are people turning against each other? Opinion in the medical profession seems pretty much unanimously against this creeping privatisation, as does pretty much all public opinion, when surveyed

The divide and conquer tactic is slightly more the preserve of the good old Tory party, we all know and love, rather than the Guardian

[i]Does anyone seriously believe that Hunt would like to see the NHS being highly successful in its current form? [/i]

I don't believe that he [b]doesn't[/b] want it to be successful in its current form, I think that he believes that it [b]can't[/b] be successful in its current form.

My company is a major suuplier of 'products' to the NHS yet we also tender to run services (and win many), last year we were asked by DoH to supply more services. This year will see the first contract awarded to start 2014 in Telehealth, ringing customers (aka patients) at home to do 'visits' without the need to come to the Dr's surgery. Guess what? its an American idea and its worked over there for years (apparently) and its coming here soon despite the opposition by some groups within the NHS.

Think of the NHS as your high street all those friendly butchers and bakers you used to visit for your groceries until the supermarkets decided they would have a slice of that action cos they could make a profit and close down the little guy with Government blessing. The staff all leave the fruit and veg shop on the corner and got a job stacking shelves at the new shiny ever so slightly off the high street superstore along with the man from the bakers and the girl from the papershop.

I don't believe that he doesn't want it to be successful in its current form, I think that he believes that it can't be successful in its current form.

I think you'll find he thinks that about every organisation that doesn't have profit as its overriding priority.

There's no such thing as society, don't you know?

I don't believe that he doesn't want it to be successful in its current form, I think that he believes that it can't be successful in its current form.

So if statistics came out showing that the NHS was actually performing amazingly well, you think he'd go 'oh ok let's forget about all this privatisation stuff, just get on with the great job you're doing'?

Hmmm....

Fundamentally there is no right answer, the NHS is always going to an enternal compromise between money, quality, volume, staff t&c, central control, local freedom etc.

For example, take targets. Targets work, in the sense of set NHS bodies a target, make it count, count it and the NHS will deliver it. But it may delivered at the expense of other stuff not covered by targets. What if it's the wrong target, has unforseen consequences.

So set no targets, let the NHS locally get on with it. You end up with a real disparity between organisations, a mish mash of delivery priorities driven by individual powerful clinicians or local pressure groups.

But the number of times you hear that clinicians should set prioirities and that there should be no postcode lottery in the same article. In a money constrained system the two are unlikely to be achievable at the same time.

The irony of what Hunt is saying is that a commercial organisation would deliver to but not above spec. If there are minimum standards set for delivering NHS care, why spend more to over deliver? The only reason would be if premium added value attracted more patients to your provider and so competition drove up quality. But realisrically patients don't use enough of NHS services to make an informed choice and outside ofLondon and a couple of other big urban areas real choice doesn't exist

Another motivaror to over deliver to create a public service ethos where everyone buy into socialised healthcare and works to there best to deliver - in some senses this is the underpinning philosophy of the NHS. But this can be inefficient and unfocused.

Social norm versus market norm if you like

The right answer is in earlier posts - stop changing the structures of the NHS for dogmatuc reasons - no system is perfect but if left alone will evolve to operate increasingly effectively without the unavoidable limitations

Just my two penneth's worth....

[i]So if statistics came out showing that the NHS was actually performing amazingly well, you think he'd go 'oh ok let's forget about all this privatisation stuff, just get on with the great job you're doing'?[/i]

Well, after taking credit for it, yeah I think he would. What politician wouldn't?

The thing is, those stats never appear because there is always stuff that can be improved. That brings many ideas of how that can be done from both left and right and the cycle continues...

[i]There's no such thing as society, don't you know?[/i]

Oh, come on Binners, it's pretty common knowledge that that's one of the most out-of-context quotes bandied about politcial debate.

I know I'm coming across as a Tory apologist here, and I'm really not. It's just that 'idealogical zealoutry' is not defeated by dogmatic posturing.

So if statistics came out showing that the NHS was actually performing amazingly well, you think he'd go 'oh ok let's forget about all this privatisation stuff, just get on with the great job you're doing'?

Well, after taking credit for it, yeah I think he would. What politician wouldn't?

Erm..... A Tory One? They are ideologically straight-jacketed into a private good/public bad mind-set that completely refuses to countenance any alternative, no matter what the actual evidence suggests