Mr Hunt is a breath of fresh air at the Department for Health. As a strong believer in the NHS, he wishes to raise the quality of the service and support high professional standards throughout our hospitals and surgeries. He has been shocked by reports of poor treatment and lack of care in some wards and some hospitals, and is seeking ways to ensure patients do not suffer in future as some have in the past from hospital infections, lack of food and water, or bad medical interventions.
The Secretary of State has decided the best way forward is to encourage and require honest reporting of incidents. Hospitals which fail patients need to record and report the problem, and then make sure it does not happen again. In the private sector many companies use quality systems which seek to design out any error in their process or performance. When someone reports an accident or mistake, the first issue is how do you put right what has immediately gone wrong, and the second is how do you redesign the process so it cannot happen in future. The main purpose of reporting is to improve, not to have a witch hunt over who made the mistake.
There are many parts of the patient expereience in some of our hospitals that needs improving. Do they control the drug round properly? Is eveything logged so the right medicine in the right dose is always offered? Is there a fail safe system to prevent the dispensation of the wrong mediicine, or the wrong quantity or at the wrong time? Do they control hospital stocks and supplies effectively, to ensure lower costs and shorter periods holding the items so they are fresher for use? Are staff used to best effect? How easy is it to transfer staff from less busy to busy wards or periods of the day? Are the staff effectively led and do they understand what good quality service looks like? Who checks that patients have the water and food they need? Who is responsible for ensuring reasonable patient requests are responded to promptly?
Shining a light onto poor performance is a necessary part of improvement. I would be interested in your obsaervations on the successes and weaknesses of our hospitals.
June 13, 2014
Which NHS ?
June 13, 2014
The World Health Service which is overwhelmed by people who receive the service without contributing to the UK tax pot. Fly in get treated and fly out. The one where no politician was held to account for people unnecessarily dying in Staffordshire and where Hunt has not held the CEO to account or any minister. Presumably because the former was acting under the instructions of the latter?
June 14, 2014
John, after all the comments you have received on the subject could you please do us the courtesy when talking about the NHS to say the NHS England. As you know, the 650 UK politicians sitting at Westminster including the 117 ‘representing’ (?) Scotland, Wales & NI only control the NHS in England.
Last weekend on Andrew Marr, we had William Hague telling us the Government was making important changes to education in Britain when he knew full well as with health any UK Government’s remit on education only extends to ENGLAND.
As has been said many times on this sight, it seems our politicians will go to any lengths to avoid having to say the word England but we expect you to be an exception John.
June 13, 2014
There has to be accountability for mistakes. The NMC and GMC support this.The mistakes are correctable usually unless they are the few very bad cases highlighted in the press.The problem is truth telling, rebounding of mistakes on to others and the collective making of martyrs .One trust I work for puts forward their philosophy as a no blame culture. Of course these are words only.
Another problem is investigation of problems. I worked and enjoyed time on an Intensive care unit. A problem occurred on my day off. I did not work this shift , yet the staff collectively said it was the agency nurse. I wrote letters to the staff in charge , then I wrote a letter to the executive when the union said the evidence from the substantive staff was overwhelming .The executive said that the matter could not be investigated as there is not a need to do this for p/t temporary staff. I had agency details and time sheets for shifts signed which were not on the day when the problem occurred. The lies are the problem.
As a student nurse many years ago the teaching of drugs was controlled by the nurses.Every nurse had to know the drugs being given , from what group of drugs they belonged to, how they worked physiologically, the side effects and the conditions which they were used for. This continues into qualification.There has to be this knowledge a Nurse is responsible for the drugs she gives. It is her responsibility to withhold inappropriately prescribed drugs drugs. She has the British National Formulary with her to aid her memory at the times of administration.
There are unqualified staff now giving out medicines in some establishments and they know no better than to keep on doling out medicines time after time whether there is a negative effect or not.
June 13, 2014
Cameron seems to have forgotten about his in three letters N H S sound bite recently. Rather like his £1M threshold IHT promise.
The main problem with the NHS is it is free at the point of use, so most part of it ration their “services” or just make it very inconvenient or very slow to access them. Much effort is put into these delaying and inconveniencing systems. Lots of staff to say we will put you on stage one of the 6 part waiting list or we cannot give you an appointment today please can you call back tomorrow between 10.00 and 10.01 please when we will be engaged!
It needs some charges at the point of use for GPs and Hospitals for all save the few who really cannot pay. It need to charge main who have not paid in the full costs.
It needs a new open blame reporting system like the one pilots use.
It needs a no litigation compensation scheme that patients have to accept before NHS treatment. Then the NHS can be open about their countless mistakes. Patients can buy extra insurance for compensation if they wish too. Lots of parasitic lawyers and compensation people are thus released to get a useful job.
Ten thousand needless deaths it is reported a crash of two Jumbos a month!
It need real competition which is killed by the free at the point of use NHS
It needs to be run more like a Japanese manufacturing company, far fewer lawyers, compensations staff, cover up staff, delaying staff, bureaucrats and more medical staff actually doing useful treatments.
It need to stop doing vanity treatments and all quack treatments as pushed by Prince Charles types.
People should get tax relief for private health cover to free up the NHS and encourage competition. Insurance premium tax should also be abolished.
Patient to the NHS are mainly an inconvenience to be discouraged from attending. They already have you money after all and have killed nearly all the competition (and many patients), rather like education but even worse than education.
June 13, 2014
You’ve pretty much nailed it Mr. Logic.
With such a logical and common sense approach to problems you really ought to consider joining ukip (if you haven’t already done so).
June 13, 2014
Daniel Hannan claims today there will be no negotiation with the EU and Cameron has opted back into the EU arrest warrant. If his article is correct there is no need to wait 3 years for a referendum it could go ahead now. Opting back into the EU arrest warrant appears to me to be a serious loss of power to the citizens of the UK and should trigger a referendum in itself.
Come on JR, is Hannan correct? If so what are the Tory Eurosceptics going to do?
June 14, 2014
I would expect nothing less of say one thing, but do the complete opposite Cameron. He can only be judged from his actions and judged on those he is a complete disaster.
June 13, 2014
My personal experience this week was such that I have nought but praise for my local NHS hospital (Shrewsbury). Taken in by ambulance with a suspected heart condition, I first received immediate attention in A&E, subsequently transferred, efficiently, to a medical ward and then to yet another ward whilst various examinations were taking place. In every instance, I found the care extended to me by all of the staff, from consultants, house doctors the nurses (especially) and catering staff was first-class and provided with good humour and much courtesy. All needed controls (eg on drugs) seemed adequate.
To find something to pick on, I would mention the plethora of paper-work which my two-day visit engendered. Doubtless for my own good as a patient, the box-ticking forms and questionnaires did seem to add an enormous amount to the staff’s workload.
June 13, 2014
Duyfken ,
I collapsed up in Wokingham town centre a couple of months ago and the ambulance arrived in about 10 minutes and I was in the Royal Berks CCU within 30 minutes of my collapse .
Was very please with my care and very pleased with the follow up in the heart hospital in London as an NHS patient .
The NHS fitted implantable cardioverter defibrillator (cost of device and fitment to the NHS of over £20,000) had kicked in and saved my life .
I could never afford private healthcare with my preexisting condition . I will spend around £1,000 on travel insurance this year just to service foreign clients as a self employed I.T. guy who makes a very modest living ) .
Of course the NHS is not perfect . About 30 years ago I worked in the Central Vet Lab’s and we alwayswore (and changed) latex gloves to avoid cross contamination when taking animal blood samples – something phebotomists rarely seem to do with humans .
Overall the NHS is NOT broken so I hope politicians don’t try to fix it .
It’s a bit of a victim of it’s own success in keeping people alive so long that they cost lots of money in old age .
I wonder how much of the NHS resources go on inpatient care towards the end of life which would be better delivered in old peoples homes ?
June 13, 2014
Indeed this is very sensible. Up until now and especially during Labour’s period in power, it was a heresy to criticize the NHS or its employees (except the managers of course, who could rarely be praised). So despite overwhelming evidence of poor performance relative to many other countries and terrible performance to point of tragedy in some hospitals such as mid Staffs, official denial of problems and perhaps cover up continued. Such was the level of propaganda about the NHS and browbeating of any dissent that opinion polls continued to tell the left what it wanted to hear – that if only there was a bit more tax for a bit more money for the NHS all would be well.
Like other monolithic statist enterprises in the UK and elsewhere the NHS is in fact in need of radical reform in order to get the best out of its many dedicated and able employees (including the managers). Much more measurement of performance, transparency regarding problems, choice for patients and competition between providers is needed. Much better results are achievable from the huge resources committed to the NHS.
June 13, 2014
In terms of quality control I suggest you apply IS 9000 and or QS 9000 to the way hospitals operate. These systems have sorted out the car industry worldwide and many other industries in addition.
Next step would be to privatise the whole of the NHS hospital service. You would eliminate a ton of bureaucracy and perhaps emulate that hospital in the eastern counties that has gone from NHS basket case to patient friendly efficiency in two years. Doing this need not effect peoples free access to the NHS. As we have seen this week government cannot run a piss up in a brewery whatever it’s colour.
June 13, 2014
I have often thought that NHS hospitals (and indeed doctor surgeries and other clinics) should be run on similar lines to vehicle garages. Set prices for procedures which can then be invoiced to government to be settled. Each hospital or outlet can then forecast income, expenditure and stock in transparent traceable manner, probably reducing the finance and other management staff required. There would need to be caveats and restrictions to ensure that lower value procedures were not put off in the pursuit of revenue but garages have managed to build a business model which generates operating revenue through checks and minor fittings as well as more complex operations. Their aim is to be busy for as much of the opening time as possible. A hospital should be able to be busy round the clock.
By adopting a model where output generates revenue the emphasis of the organisation should move towards ensuring processes to mitigate risk are in place rather than a grant based system which more encourages blame culture as the funding does not have to be generated.
The covenant with the taxpayer would necessarily entail the taxpayer picking up any additional costs that the efficiency generated in hospital turnover. The politicians’ covenant with the taxpayer would guarantee that health tourists paid their way.
June 14, 2014
Very interesting proposition and better than privatisation.
June 13, 2014
I have seen good quality treatment given to elderly relatives, with the surrounding support and administration also done well and sensitively and whilst favourably impressed, I would have been concerned if that was not what I saw.
The efforts of the same hospital to deal with shortening waiting lists for clinical procedures by using outside contractors with the result that exceptionally high failure rates were seen and remedial operations required is by contrast very disconcerting.
I acknowledge that people have high expectations of the NHS and it undertaking so many and complex tasks will see shortfall, error and failure from time to time and sufficiency of funding will be an ever-present issue but a good number of the bad reports point to weak management practices and perhaps also a deformed culture.
June 13, 2014
Unexpected meeting with my old GP at a local station when travelling to London a couple of weeks ago.
He retired more than 12 years ago, he looked in good health and not a day older, so asked him if he was enjoying retirement, answer absolutely, asked if he missed working at all.
Absolutely not, as the NHS was getting far too political, which he thought at the time interfered with patient treatment.
Further comment, even worse now, glad I am out of it !.
Family member recently had cause to require an urgent CT scan, Royal Berks Hospital has two such machines, but one seems forever to be breaking down.
Thus scans delayed for many patients by weeks, urgent cases referred to a private hospital for scans to be completed.
Meanwhile a scanning machine is underused within the same health authority at an extension facility in Bracknell I am reliably informed, apparently it lies idle for 6 days a week as they do not have staff to man it.
When Consultant is seen for results, I ask why NHS owned Bracknell machine not used when Reading one was out of action, surely it would have been more simple to transfer staff attendance and outpatients to the Bracknell facility (10 miles distant) to use the one they had there, rather than paying a private hospital for such scans, especially when the hospital is already £ Millions overspent, and is being fined for such.
Informed by Consultant, yes I know it sounds daft, but that is internal politics at work.
Happily for our family member the end result was an all clear, but how many patients had delayed results, and thus delayed treatment.
Someone responsible for this organisation needs to get a grip and a grip fast of what is going on both at local and National level.
Happy to provide evidence and further details for you JR should you want it.
June 13, 2014
Circle have turned around the basket case which was Hinchingbrook Hospital. It has recently been judged the best in the UK.
June 13, 2014
My wife has just had her hip done. The operation and the physiotherapy side was outstanding. She is now well on the way to recovery. So are most of the other people who were done at the same time. Full marks NHS.
But – there’s always a but – the ward where she convalesced for a couple of days afterwards was fascinating.
I got the impression, and I may well be very wrong here, that the wards are now a very second eleven sort of place. Nursing is a dirty, unpleasant and rather disgusting job is it not. I got the impression that most Health Service Employees would rather sit in an office away from the ward and not get their hands dirty.
Until something is done to raise the morale on the wards, I think the situation is going to remain the same. What can be done there?
Government regulation, exhortation and lazily pouring money into the offices beside the wards is not going to do the trick.
June 14, 2014
Nursing is not a dirty and unpleasant job. If you mean that people have to be washed an toileted ,so does everyone else. These jobs are carers jobs and Nurses do not object to joining in. It is about time everyone realised that Nurses train for a very clinical job which requires input from all staff in total patient care.We do not take degrees, learn to take clinical responsibility in monitoring the progress of patients , undertake many physiological investigations , to have others ideas of what Nurses should do. If basic care is not being undertaken then more of the specialists employed to undertake these basic duties should be employed.Remember whilst Nurses join in to help with these basic duties , something else is being omitted or quickly brushed over which may mean life or death.We trained with auxilliaries, to carry out basic tasks , State enrolled Nurses to handle the bedside care and State Registered Nurses to manage the clinical aspects of care and management of wards. Being so clever 2 whole tiers of those who look after care were wiped out .
Ask a radiographer to do a porters job , ask a manager to carry a bed pan, ask a Dr to stay on one ward all day and steadfastly monitor a patients progress in relation to treatment and medication all day They won’t so why ask Nurses to do the jobs they have not been educated for?
June 13, 2014
Well Basildon Hospital has apparently just been taken out of special measures. I have been a regular visitor over the last few years and recently. It is still sub-standard, and not at all of the quality which would be tolerated in any other Western country. I have seen first-hand a long list of failings.
The inertia in the system and the fake propaganda about how great the NHS is and how bad the rest of the world is a shame, as it stops us seeing the obvious.
So many things that really need looking at urgently, off the top of my head the eye accident clinic the first day after a bank holiday weekend would be high up my list. The treatment of the terminally ill. The treatment of diabetic pregnant ladies. All are obviously sub-standard at even a casual glance for anyone caring to look.
I hope as people travel more they will see how many much better ways of doing it there are and we will admit to ourselves that the NHS is not the great national invention we are often told.
For the vast majority of elective stuff patients need to control the buying decisions. Individual patients having buying power is the only way to force ongoing optimisations and innovation, top down will never do it.
I still have no choice of GP whatsoever.
I actually think the electoral position is more complex than the party election gurus think, if a party was actually honest enough to say the NHS is substandard we are going to do something radical I think the people would support it.
June 13, 2014
Here are some cases from just one hospital where the people in the front line have been extremely neglectful and cruel to vulnerable people.
http://www.itv.com/news/2014-01-27/fresh-claims-of-serious-neglect-at-princess-of-wales-hospital-in-wales/
If it was just one nurse in a hospital it would be bad enough but when you have 3 nurses arrested and 7 more suspended then there is something drastically wrong.
There needs to be a humongous shake-up of the NHS. It worked more or less perfectly for donkeys’ years, until someone (who?) decided to change things. Let’s go backwards and have Matrons and PROPER cleaners (I could tell you quite a few incidents that I have witnessed that would shock) and shake up the Teaching Hospitals. But for heavens’ sake, do something.
June 13, 2014
I take it you have private medical insurance? I just renewed mine. It would be nice to think I didn’t have to pay twice for medical care. Perhaps NHS ministers and senior Civil Servants should be required to use the NHS for the rest of their lives in order to focus their efforts?
The NHS seems to run on fear. Everyone is covering their back and making sure they are seen to do their bit but the different parts fit together poorly. The actual hospital stay can be short but nowadays patients with very complex and serious aftercare requirements are being discharged from hospital after a few days into a community care system that is woefully ill prepared for these demands. I know one nurse who returned to community work after a break but left after two weeks as the care she was trained and equipped and allocated the time to offer was so far behind what is now needed.
And locally, pray that you don’t need to go to A & E at the Royal Berks on a busy day. The demand is way up but as ever with government funded entities the time taken to respond with an increase in beds lags years behind the need. How will your manifesto commitments on NHS funding account for the demands of our increasing population? When the houses get built, where will the hospitals be?
June 13, 2014
Does Mr Hunt think tax payers like myself should have to pay (under threat of imprisonment) for homeopathy and other “alternative” on the NHS? I would not even pay for them for my own family!
If so he should clearly go away and just dance with the goblins, fairies and Prince Charles. I understand that he is a strong supporter. Would he care to fly on a homoepathic or acupuncture inspired plane too?
Not to mention the vanity treatments and hundreds of hymen replacement operations carried out on the NHS. Yet they cannot even feed and water people properly in the other wards. Another rich boy, son of an Admiral, Charterhouse, Magdalen College, Oxford PPE I see.
Get some real scientist, doctors and engineers to sort the bloody mess out please before another 10,000 die next year.
June 13, 2014
I have met some ex Toyota people who are expert in Lean techniques who are doing work for the NHS. The opportunities are absolutely enormous.
As you say let’s get some people involved who have achieved real world improvements, not more professional scapegoat hunters that haven’t even run a corner shop.
June 13, 2014
I get the impression the main aims of the NHS is the deterring patients, the convenience of staff (in not having to work weekends for example despite the extra resultant deaths), the controlling of the public image of the NHS, the covering up incompetence & negligence and the defending of legal claims from patients or staff.
But then perhaps I am too cynical sometimes.
June 13, 2014
What I find strange is the large number of staff of non-ethnic British employed in our hospitals. I went in for a day-patient eye operation and only saw one white nurse. The receptionist, the nurse who went through my medicines and risks, the nurse who put the drops in my eyes, the anesthetist and the surgeon were non-ethnic British, and I suspect all were born abroad except the surgeon who had an impeccable upper-class English accent.
Why is this? I’ve nothing against any of those who treated me and all appeared to be extremely conscientious and caring, in fact I had excellent treatment. But why? Are we no longer training sufficient nurses to meet our requirements, or is nursing no longer considered a worthwhile occupation by many of our school leavers?
If these nurses have actually been recruited from abroad, I think that there is something morally wrong with the NHS. Countries which are far less wealthy than Britain fund the training of nurses and doctors which they desperately need, and then the NHS tempts them to come here.
I think the issues of staff training and recruitment need to be addressed as a matter of urgency. We are told there are now insufficient doctors being trained, and this is very quite apparent when one has to visit one’s GP. Have administrators decided that it is cheaper to recruit from abroad than to train our own staff, and this is a good way to save money? If so I consider that it is an indefensible decision.
June 13, 2014
You make a very valid point OP.
The question is…Is it morally fair to poach staff from overseas who have been trained by their often less wealthy nations and employ them here?
I saw on a recent visit to a Caribbean country articles and letters in their papers complaining that the UK pinches staff by offering higher wages than they can afford to pay to staff they have trained for several years at their expense.
Similarly our own expensively trained NHS staff are off to better paid jobs in USA Canada, Australia and New Zealand
June 13, 2014
I once had the unfortunate experience of visiting my Son in hospital to find that he had a tube in his nostril and was also on a drip. I was not prepared for that and the Auxilliary Nurse saw that I was worried. She said that she would get the Staff Nurse to come and explain, but when the Staff Nurse came, along with with my Sons’ medical notes, she was unable to read them, because English was not her first language. She then asked the Auxilliary Nurse to read them for her. That was a long time ago but have things changed? I doubt it, very much!
June 13, 2014
Where are all the British trained staff ?
They seem to get poached a lot by the US, Australia, Canada and New Zealand.
Clearly these people are the ones we want as they are in demand in squeaky clean health systems in first world countries, so why aren’t we benefitting from the highly expensive training and selection that we’ve provided for them ? We should be grateful for staff imported to fill the gaps but, as your article indicates, the present NHS is in such a state that it needs root out corruption and raise quality of the services it provides.
If the method worked then we wouldn’t need to be having this conversation now, would we ?
June 13, 2014
“They seem to get poached a lot by the US, Australia, Canada and New Zealand.”
Sometimes it is difficult to overcome the prejudice on selection in hospitals where the senior staff are almost exclusively vibrants. I spoke to a Registrar at a London Teaching hospital, with an immaculate CV, looking for a Senior Registrar’s post without finding one at the time I spoke to him.
June 13, 2014
The deaths and illnesses caused by the NHS has been a tragedy and has gone on for many years.
The problems appear to be endemic.
For years Labour/BBC have shied away from acknowledging these problems let alone scrutinizing them.
Even now, multiple deaths are given throw-away coverage by the BBC. Had it been an airplane crash in which so many people died, the story would have run for days.
We need to shine a light on the NHS and it looks like we will have to do without the BBC’s help as it is reluctant to do any more than a cursory look at the problem.
The singing and dancing at the olympics that the BBC was so proud of looks like a sick joke by comparison.
June 13, 2014
I can only comment by comparison from my life.
As a youngster, the hospitals I knew were at Lewisham and a local cottage hospital. They seemed to run like clockwork…..but of course I was young, but in awe really.
Military hospitals and sick quarters – similar to the above, and seemingly clean with smartly dressed staff. Pleasant people but clearly well disciplined.
That changed dramatically for what I saw last year at a big new PPI hospital in SE London:
1. Bunches of nurses sitting about unable to recognise the presence of a visitor and unable to use a nearby PC to locate my mothers room/ward. Just left to wander.
2. Often difficult to understand the spoken words although I come from that area.
3. Bunches of nurses performing shift changeover at visiting time and awkwardly unable to answer a visitors question about …anything really.
4. Ad hoc loud arguments between doctors and visitors about patients condition/treatment.
5. Visitors carrying flowers through wards/corridors.
6. Hailing a nurse was lengthy with long response times.
7. Hot dingy rooms…modern build for wrong purpose I thought. Litter( rubber gloves) on the ground – a lot. No ventilation/air con.
8. TV in room that won’t be used…pricey stuff! Is scruffy clutter.
9. Car parks – staff have to pay? Visitors cars parked in places forbidden near A&E entrance.
10 Ward managers (?) or whatever who spend an awful lot of time on the phones. I mean a very long period of time in open areas.
11. Floor sweeping/cleaning proceeding during visit time.
12. Doctors staring/typing at PCs scattered around corridors. Messy
Apart from that some staff I met there were good and helpful. But I don’t want to enter one for any reason again. I believe due to PPI this hospital is seriously in the red.
I’d just guess that this hospital is seriously over loaded. Its much worse than that though and goes back quite some years.
June 13, 2014
Hunt is brave – any highlighting by him of any poor performance of any kind will be labelled by the opposition as an “attack” on the NHS and part of his campaign to privatise it. This latter is a curious claim because given the choice, and if both were free at the point of delivery, I’m sure we’d all choose a private hospital. It is not as if vast areas of the NHS aren’t “privatised” already and run by private companies making big profits – all NHS drugs are made by the likes of AstraZeneca for example (that vital UK company which must be protected from takeover apparently but only has 15% of its workforce in UK). Surgeons and consultants also make big profits (salaries) out of the NHS. When Labour make the “privatisation” claim someone should ask them to spell out exactly which NHS functions they don’t want privatised. Cleaning ? Buildings maintenance ? IT ?
June 13, 2014
It is a misapprehension to claim that all NHS drugs are made by the likes of AstraZeneca.
The NHS is extremely reluctant to buy patented medecine, deeming it too expensive. So they buy generic copies which are made in Spain, India, Hungary, anywhere but England.
June 13, 2014
We have been visiting an elderly friend who fell and had a very painful leg for several weeks. Initially diagnosed by A+E as muscular and given the wrong sort of pain medication, she was eventually found to have cracked her hip joint and, having fallen again and broken it completely, was operated on by an excellent home trained young surgeon and is now waiting to go home. However, they have to keep her in the same ward in order to help her walk confidently, as she has no-one at home to help.
Does it take managers, paid more than some surgeons and 4 o5 times as much as nurses to work out that this is needlessly expensive. Correct diagnosis using routine scanning and convalesent facilities would be far cheaper than a series of wrong treatments and keeping patiens on an acute ward.
Hospital management should not be any more difficult than commercial, and may be less so. Why do we not have 6 month courses in hospital or health management for the many management graduates, many struggling to find interesting jobs. Then the ridiculously high pay, and re-emloyment after redundancy that goes on after every reorganisation would be eliminated.
June 13, 2014
The NHS suffers from the same sort of problems that the other nationalised industries used to suffer from.
The solution is also the same.
June 13, 2014
The Army, Navy and RAF too, Colin ?
June 14, 2014
I have worked in military HQ’s, and I can tell you for free the admin and political layers of the military are just as bad as any of the old nationalised industries, if not worse. The way the defence business works is also too self selecting. The way security clearance is administered tends to restrict roles to those already holding clearance and is a major barrier to the culture being exposed to the best of the outside. Corsham, Abbey Wood, and a lot of the other places are worse than the nationalised industry sites I saw 30 years ago.
June 13, 2014
Quite extraordinary that so many Conservative “free marketeers” still support this outdated socialist inspired institution.
Whatever makes them think that Government can run a health service? Why should a politician with little experience of the business make much of a difference?
It is said that if the managment of the NHS were as efficient as the private sector then there would be no crisis however, this is not right. The emphasis is not on competition, return on capital employed and profit; instead the emphasis is on having a good story to tell the bosss and any private sector managment would quickly change their ethos to fit those requirements.
The model is flawed and politicians will never be able to put it together again.
The task in hand should now be preparing to clearly enunciate why the NHS must be a part of the private sector albeit with continued Government mandate to ensure all are privately insured with an allocation of NHI premiums to nominated private sector insurers and that there exists a safety net for those unable to afford insurance.
There can be absolutely no doubt that within a short time a government run NHS will end in cataclysmic failure and then addressing the problem will be a herculean task well beyond the capability of the political class.
June 13, 2014
It always helps to look at the facts:
http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita
So if we want to improve the health service and at the same time keep an eye on the costs we need to look at what others are doing, what they are paying and the kind of service they receive in return.
If we want an American style health system we can have it but it will cost twice as much. I’d go for a French style system which is only slightly more expensive than the UK’s.
The idea that we can have a Rolls Royce system of health care at for the price of a Ford Fiesta does need to be challenged. Imposing re-organisation after re-organisation on the NHS is unlikely to improve matters.
June 14, 2014
Perhaps there should be the means at the end of your NHS treatment to leave a voluntary tip for great service, with PayPal, mobile phone payment, whatever makes it easiest for people that support the service to leave some additional support, a percentage going to staff welfare projects with the rest going to maintain scanners and buy new equipment that wouldn’t be in the budget otherwise.
June 15, 2014
Hospitals are infested with the worst kind of managerialism, delivered by nurses who do not want to nurse any more, preferring the tyranny of the clipboard instead.
Meanwhile, medical leadership becomes weaker and weaker, with self interest being the order of the day. Woe betide any doctor who tries to speak out. Managers who cover things up and hit targets no matter what the consequences will eventually reach the very top of the NHS.
It is a strange and terrible place the NHS. Stick to your instincts, John. Convince the country to dismantle this Marxist organisation.
June 17, 2014
Very recently, I had a hip replacement operation at one of our leading NHS hospitals, staying 3 days as an in-patient during the initial recovery phase. As far as I can tell, the doctors, occupational therapist and physiotherapist were all excellent.
However, I found the behaviour and organisation of the nurses disconcerting. There is the problem that a shift system is in place and that the nurses come and go. I lost count of the number of times that my blood pressure was recorded – all readings normal except when a nurse attempted a reading while I was listening out for a request on the hospital radio and I lost my temper.
Every evening a nurse came round carrying a tray of pills – morphine, other pain killers, paracetamol, blood thinners, aspirin etc. There was a bit of ‘hard sell’ about her advocacy, as if she was an agent for the drugs companies. I dubbed her Sister Morphine, not to her face of course. I wonder how much of the NHS drugs bill comes from over liberal dispensing and prescriptions.
Before admission, my GP had warned me not to take any anti-inflammatory drugs because they could exacerbate my kidney problem. I told this to two different nurses and assumed that this request had been noted. However, on my final day in hospital, a nurse added an aspirin to my two paracetamol pills. Apparently, aspirin comes into the anti-inflammatory category, so someone slipped up.
So eight marks out of ten but I think that management of the nurses and control of pill dispensing needs looking at.