In reply to toad:
The latest from Roy Lilley with a useful link at the bottom......
Make your voice heard - News and Comment from Roy Lilley
It seems there is only one question. My in-box is overflowing and last week, as a guest at four conferences (different topics and different places), the only conversation.... should the Big-Beast quit? He took another hammering in the papers at the weekend (
http://www.dailymail.co.uk/news/article-2279415/If-wont-quit-just-sack-MPs-... ).
The NHS' reputation is damaged. In many NHS establishments front-line care is in a bad way. Let's take a pace back, have a cuppa-builder's and a think about the issues. First, the structural stuff.
Reorganisation; unnecessarily complex, half-baked CCGs granted authorisation with more strings than a marionette, in a desperate attempt to meet arbitrary political timescales. Little GP buy-in, over 80% of CCGs will be bossed by a non-GPs Accountable Officer. There is a dislocation between what the Carbuncle thinks is happening and what is actually happening.
Clinical Support Units, or Services, or whatever they're called; set to Hoover-up fortunes in administration fees that would be better used at the front-line. Their future, as private concerns, outside the H&SCAct, the reach of Parliament and the purview of the NHS... unregulated and unchallengeable.
Foundation Trusts; many 'too big to fail', sitting on huge surpluses that would be better used at the front-line. Wanna-be FTs, mostly a rag-bag of no-hopers shoe-horned into FT status by the Trust Development Authority (
http://www.ntda.nhs.uk/ ) which, itself costs millions to run. There is no organisational imperative for all hospitals to be FTs, only political embarrassment if they don't. More money leaching out of the front-line.
Monitor soaks up more front-line cash by pretending to regulate a market whilst fighting a turf war with the Office of Fair Trading who claim it is their job (
http://www.oft.gov.uk/news-and-updates/pressstatements/2012/94-12 ). More money dredged way from front-line care. The Francis Report has made it pretty clear; he'd like to see Monitor dismantled. The boss of Monitor earns circa £200k - for what?
The CQC, unable to move a tray of food within reach of a patient, or provide a bed-pan, powerless to stop the quality failures that are destroying public confidence. Their budget is eye watering; more money syphoned from front-line care.
Woeful Boards with useless NEDS who've gone native, turn a blind eye to desperately poor care and a deaf ear to those who would protest. They owe their jobs to the DH and their political networks; their distorted perception of loyalty creates a dysfunctional climate of fear. Boards conference-call their lawyers when they should be speaking face-to-face with patients and staff.
Money; the very idea that you can take £20bn savings out of the budget without damaging the front-line is ludicrous. We are probably 10,000 nurses short, care is suffering. Flat-line funding against 4% growth p.a., with the squeeze set to continue after 2015 means the NHS has been hobbled and unlikely to recover.
Second there are the management issues. Bullying is rife. Time after time I get emails that start with, 'Please don't mention my name, but I have to tell you.....' If half are from axe-grinders and grudge-bearers that still leaves about 20 a week that are genuine. The tip of an ugly iceberg that will sink the NHS. The NHS is managed up-wards obsessed with not embarrassing Ministers or senior management with even a whiff of failure. The DH exists to suck-up to Ministers and blow hell-fire on everyone else.
Staff; undervalued, frightened to speak up, let alone speak out. Thought of as dispensable and disposable when they should be seen as partners-in-care. Their numbers slashed, others dumped into the private sector, ignoring their sense of vocation. People traded as commodities. A woman centric workforce and customer base, management dominated by middle-aged men in suits.
This is Our-NHS and its failures and foibles are excused buy the old fashioned notion that there is enough good going on for us not to worry about the bad.
So it is, we are left with the question; is the Big-Beast the man to fix all this? A fix that might take five years or more. Does he have the time, the energy, the health, the strength, the skills, the vision, the support? If the answer to any of these questions is no, then expect him to be gone inside three months.
What is your view?
'Is it time for Sir David Nicholson to step down?'
You can vote, anonymously here.
http://survey.constantcontact.com/survey/a07e72mzukqhdaft0rx/a01phhdbgo32p/...
Three clicks and tell us;
Vote here.
We will publish the results later in the week.
Make your voice heard.
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Feel like having a rant?
Please be my guest! Use this e-address
roy.lilley@nhsmanagers.net
Know something we don't - email me in confidence.