Loading Notifications...

The NHS Has Been a Catasrophe

This topic has been archived, and won't accept reply postings.

Before we start, and for the avoidance of doubt, this diatribe is not directed at the front line staff, the physicians, nurses, paramedics, cleaners and technicians, who work in difficult and challenging conditions and do extraordinary jobs, mostly for not much remuneration. Lions led by donkeys - so park that.

But this pandemic has shown the NHS to be an absolute catastrophe - no wonder it is always running out of money. There seems to be an endless stream of committees, organisations, directors of this and directors of that, all fighting each other like cats in a sack, but the few things you would reasonably hope and expect a NATIONAL health service to be able to do have been farcical. What are they?

Provide reliable data. Procure supplies (we must be one of the largest single buyers in the sodding world, and staff are still wearing bin bags!) Implement a coherent, nationwide testing program with clearly defined protocols and objectives. Develop, agree and publish short, medium and long term plans that cover testing, treatment, care homes, hospitals, primary care, distancing, employment and education - with of course the proviso that such plans need to be constantly kept under review in the light of experience, and new developments.

We really should be on top of this stuff by now, we really should. Hapless Hancock has a lot to answer for, and so do his predecessors. But right now, for me, the bureaucracy and (dis)organisation of the NHS is a source of shame that pretty much eclipses the pride we should take in having implemented one of the greatest ideas of the 20th century.  

38
In reply to Rob Exile Ward:

Add to that: an online national record keeping and appointments system fit for purpose.  If banks can do it, so can hospitals and GP surgeries. 

In reply to Rob Exile Ward:

> But this pandemic has shown the NHS to be an absolute catastrophe - no wonder it is always running out of money. 

It runs out of money because it's under funded, less per capita than many other countries. In terms of results the nhs outcomes are high relative to spending. 

The solution to the nhs's problems is more money through taxation, (clapping optional). 

14
 The Lemming 20 May 2020
In reply to Rob Exile Ward:

>  We really should be on top of this stuff by now, we really should. Hapless Hancock has a lot to answer for, and so do his predecessors. But right now, for me, the bureaucracy and (dis)organisation of the NHS is a source of shame that pretty much eclipses the pride we should take in having implemented one of the greatest ideas of the 20th century.  

I beg to differ, sir.

Despite the government, the NHS did everything possible within its power of influence to prepare and cope with the pandemic.

A month before the pandemic forced a lockdown, our hospital along with many others up and down the land, were preparing for the worst. Wards were emptied as much as possible to create bed space. Staff were preparing and planning for social distancing, creating space for the arrival of Covid patients.

In short, senior medical minds far greater that yours, mine or the government's were working the problem. The government skill-set is the world of politics. The NHS has a skill-set focused on dealing with medicine and treating the ill.

The NHS did as much as they could with the resources available to them as far in advance as they could given the indifference that the government showed in word and deed.

The NHS has not been a catastrophe, as you suggest. However if the foresight of all levels of staff within the NHS buried their heads in the sand then this truly would have been a national disaster with considerably more that the death toll at the moment.

Yes we had limited PPE, but so did the rest of the world. At least we did not resort to piracy like the USA by stealing masks that were being shipped to other countries in need.

I humbly suggest that you focus your attention on a government and judge them on their actions and propaganda, and acknowledge that the NHS did all within their power at every level from the cleaners to the consultants to avert this disaster, and sadly some paid with their lives to achieve this.

If the government were On-the-ball, like the NHS, then maybe our Care Sector could have fared better than it is right now. Could you imagine how this country would have fared if the NHS dealt with itself the same way government dealt with the Care Sector?

Post edited at 10:57
10
 mondite 20 May 2020
In reply to Rob Exile Ward:

For starters the use of "national" is a bit of a misnomer. The continued changes over the last 20 or so years have deliberately broken it up into smaller units. Thats leaving aside the GPs who have always been independent.

Although with regards to centralised buying. That was actually partially  reimplemented by the tories but the way they have done it doesnt seem to have worked that well.

Managing the testing overall is not in the remit of the NHS. Thats PHE etc

Carehomes are deliberately outside the NHS

 neilh 20 May 2020
In reply to Rob Exile Ward:

Big respect for what the NHS achieved, it was not  overwhelmed and reconfigured to cope ( which was what Whitty said it would do) for a new disease.

At the same time flaws were exposed. Procurement , care homes ,phe structures and lifestyle issues ( diabetes and obesity). But are these really all NHS issues?

Care homes- outside the NHS- and reveal the painful and to any one who has been involved in Social Care the desperate need for reform in that area.

The bigger issue now  is the economy and education.The travials of the NHS will pale into insignificance if we do not get the economy back upto speed.

1
 DancingOnRock 20 May 2020
In reply to The Lemming:

He’s not talking about the pandemic. He’s talking about what’s happening within the NHS on a day to day basis. 
 

The pandemic is extra-ordinary. 
 

Personally I think the NHS is seriously abused by a lot of people who are using it as a safety net and excuse to abuse their bodies in the mistaken belief that the NHS is a cure all solution. 
 

Record low A&E attendances. Seems years of telling people not to attend A&E or call 999 except in an emergency have been in vain and what we really needed were some good old fashioned fear of god scare tactics. 

4
In reply to DancingOnRock:

i find the drastic reduction in a and e visits very odd. my mother attended last year, and the place was rammed, not just the 'injured' but their whole bloody family was there to lend 'support' it was like a carnival atmosphere. it appears we have a large number of attention seeking citizens whose life, it would appear on the surface, revolves around the state paying them attention via what ever channels they can access. A severely dysfunctional section of society.

6
 joem 20 May 2020
In reply to Rob Exile Ward:

Clearly Unfair to say that the NHS has failed here, I think they've done incredibly well the failures you describe can be laid at the feet of the government and their funding and lockdown strategies. the NHS rose to the challenge, hospitals were not overrun people were not denied treatment. If the percuirment failed it was because it has  been badly set up by central government.    

5
 Luke90 20 May 2020
In reply to DancingOnRock:

> Record low A&E attendances. Seems years of telling people not to attend A&E or call 999 except in an emergency have been in vain and what we really needed were some good old fashioned fear of god scare tactics.

I take your point but I think it's important to also acknowledge:

  1. Large parts of this will be down to a genuine decrease in A&E-worthy events due to widespread changes in behaviour that we wouldn't expect from people under normal circumstances.
  2. Every medic I know is very concerned about the people who would normally have seen a medic but have chosen not to during the pandemic. Some of them will be seriously ill.
In reply to Rob Exile Ward:

You need to remember that procurement has been pulled back to the Department of Health and Social Care, to a company that is run by the minister themselves, in this case Hancock. You cannot blame the NHS for that clusterf*ck.

1
 EddInaBox 20 May 2020
In reply to Rob Exile Ward:

The management of the NHS as with any organisation cascades from the top, and unlike a business the framework it has to operate within is shaped by political policy.  If the operational structure is one of politically imposed internal markets to promote pseudo-competition for ideological reasons, with a single limited revenue source and no autonomy to develop external revenue streams like a true business would have, then I would suggest the natural outcome is that discrete management units are going to have to fight each other for as large a share as they can get without regard for the broader picture.  Directors and managers are therefore going to be appointed based on how successful they are at shafting everyone else (reflecting the example set by those at the top of the pyramid) and when a crisis like this comes along they are not the personality types who are naturally inclined to suddenly start cooperating.  I have my own view as to who is 100% responsible for this, your view seems to differ.

Post edited at 11:22
2
 marsbar 20 May 2020
In reply to Rob Exile Ward:

Perhaps the department of health is a catastrophe would be more suitable as a title.  

In reply to marsbar:

A very good point!

 The Lemming 20 May 2020
In reply to DancingOnRock:

>  He’s not talking about the pandemic. He’s talking about what’s happening within the NHS on a day to day basis. 

No he's not. And I think Rob Exile Ward can speak for himself, without you hypothesising what he said. The NHS can only work with the tools, resources and money given to it by the government. The NHS uses those limited resourcs to the best of their ability at every level. Its the government and electorate who have allowed the NHS to be where it is right now.

Nobody votes for a party who seeks tax rises. We have the government and NHS that we voted for at the Ballot Box over the last 30-40 years.

>  The pandemic is extra-ordinary. 

Can't say that I have noticed.

>  Personally I think the NHS is seriously abused by a lot of people who are using it as a safety net and excuse to abuse their bodies in the mistaken belief that the NHS is a cure all solution. 

No argument there. However I have a feeling that the NHS has evolved and will be less tolerant and sympathetic to habitual abusers of the system.

My two-pence view is to stop thinking about Budgets in little pockets/areas to be spent. This has to be looked at holistically not like a bean-counter. Making short term savings to survive till the next financial year only moves the problem onto other departments and resources. For example the ambulance service and Police have become the nations emergency mental health and social workers because budgets have been cut back in other little pockets/areas.

> Record low A&E attendances. Seems years of telling people not to attend A&E or call 999 except in an emergency have been in vain and what we really needed were some good old fashioned fear of god scare tactics. 

Scare tactics?

while at work I have witnessed the elderly crying before my eyes at the thought that they would have to go to hospital and be exposed to the virus. I have also witnessed their relatives in tears as they watch their relatives being packed into the back of a van, possibly never to be seen again for conditions that have no connection to the corona virus.

Since the unofficial lockdown has ended those record low attendances have come to an end. However this time around A&E departments no longer have the room or resources to deal with this rise in patients because that space and resources has been taken up by covid issues. You think schools and shops have it bad trying to work out how to put a gallon into a pint jug, spare a thought for hospitals having to do this on the fly.

Also the fekwits who use hospitals as Social Centres to meet their other service abusing friends have started to come back because they are bored and lost their tolerance and fear of the virus. And the drunken casualties have started to come out to play because they too are going stir-crazy.

I am a firm advocate of Drunk Tanks for those who think getting paralytic is a fun night out.

The NHS has not failed because its the NHS, the NHS has failed because of decades of government policy changing every time their is an ellection.

2
 baron 20 May 2020
In reply to summo:

> It runs out of money because it's under funded, less per capita than many other countries. In terms of results the nhs outcomes are high relative to spending. 

> The solution to the nhs's problems is more money through taxation, (clapping optional). 

Doesn’t the NHS have a relatively poor record at keeping people alive e.g survival from certain types of cancer?

That’s alive as in not dead, not alive as in lingering on when one might rather be dead.

8
 Luke90 20 May 2020
In reply to andrew breckill:

> my mother attended last year, and the place was rammed, not just the 'injured' but their whole bloody family was there to lend 'support' it was like a carnival atmosphere. it appears we have a large number of attention seeking citizens whose life, it would appear on the surface, revolves around the state paying them attention via what ever channels they can access. A severely dysfunctional section of society.

I feel like you've taken a huge "Daily Mail style" leap there, to reach the most sneering and patronising possible conclusion from a very minor and unsurprising observation.

I have also occasionally been in a busy A&E waiting room. Some people had their whole families there and were struggling to manage them. It doesn't strike me as very likely that those people were having a jolly day out and enjoying getting their validation from the state. Far more likely, it seems, that they were having a thoroughly miserable time and simply hadn't had chance to get anyone else to look after their kids.

Not to mention that they were probably well aware that the smug guy in the corner was judging them from his position of perceived superiority.

4
 Tringa 20 May 2020
In reply to Rob Exile Ward:

Have a look at this TED talk by Allyson Pollock - well worth listening to, IMO.

https://www.youtube.com/watch?v=Cz5dl9fhj7o&

Dave

 The Lemming 20 May 2020
In reply to Luke90:

>  Every medic I know is very concerned about the people who would normally have seen a medic but have chosen not to during the pandemic. Some of them will be seriously ill.

Like the little old dear I went to last week. She had been complaining about chest pains to neighbours but was too scared to call for help because of the virus. Sadly, she is no longer with us.

 baron 20 May 2020
In reply to The Lemming:

> >  Every medic I know is very concerned about the people who would normally have seen a medic but have chosen not to during the pandemic. Some of them will be seriously ill.

> Like the little old dear I went to last week. She had been complaining about chest pains to neighbours but was too scared to call for help because of the virus. Sadly, she is no longer with us.

I bet the neighbours are feeling good.

8
 The Lemming 20 May 2020
In reply to baron:

>  I bet the neighbours are feeling good.

What could they do?

You can't force a person to seek help.

1
In reply to andrew breckill:

' revolves around the state paying them attention via what ever channels they can access. A severely dysfunctional section of society.'

I think it's tragic. The NHS is the ONLY part of the state apparatus where everyone is consistently accorded equal status and respect. To those who are otherwise disenfranchised, routinely abused by other State institutions, or who generally regard society as something that doesn't work for them, it must be intoxicating; the one place they can 'exercise their rights.' Without, of course, any corresponding understanding of their obligations. 

Not dissimilar to Brexit, when quite a lot of disenchanted people voted for Brexit as a way of finally being noticed, even though it will cost them dearly.

6
 Ian W 20 May 2020
In reply to andrew breckill:

> i find the drastic reduction in a and e visits very odd. my mother attended last year, and the place was rammed, not just the 'injured' but their whole bloody family was there to lend 'support' it was like a carnival atmosphere. it appears we have a large number of attention seeking citizens whose life, it would appear on the surface, revolves around the state paying them attention via what ever channels they can access. A severely dysfunctional section of society.

Careful; that reads very much as if you were there to offer her support.......

 The Lemming 20 May 2020
In reply to Rob Exile Ward:

That was quick. OP to Brexit in one reply.

 baron 20 May 2020
In reply to The Lemming:

> >  I bet the neighbours are feeling good.

> What could they do?

> You can't force a person to seek help.

Never said you could but that doesn’t stop people feeling a sense of guilt as in ‘if only I’d called an ambulance’.

 DancingOnRock 20 May 2020
In reply to The Lemming:

Yes. Extra-ordinary times. 
 

And people scared that they may never see relatives again are the same people who expect the NHS to cure their sick relative and will be demanding answers when they can’t be cured. 
 

COVID has no cure, it’s here, there’s not a lot we can do about it. People are scared. 
 

Extra-ordinary times.

We need to adapt our way of thinking.
 

Unfortunately Boris was taken to mean we were looking for herd immunity when he said many of us will lose loved ones. When in reality he was just trying to prepare people. And the press seem to have forgotten that part of the message when they were trumpeting about government ‘u-turns’ and ‘herd immunity’. 

Post edited at 11:49
6
In reply to The Lemming:

''The NHS has not failed because its the NHS, the NHS has failed because of decades of government policy changing every time their is an ellection'

I don't think we are disagreeing as much as you made out in your original response. Thats why I am a serious advocate of finding a mechanism - not unlike the BBC - of running the NHS at arms length from government. 

Incidentally I have quite a lot to do with the NHS bureaucracy as a contractor, and day to day quite a lot of said contact is horrific. Meetings with hidden agendas, people exercising power without responsibility for the consequences, budgets that are ludicrously constrained at times but will run to meetings for 20 - 30 without clear agendas or any idea of costs. (I'm in favour of all admin staff wearing badges saying how much per hour their time is costing the tax payer. Start at £25 for a junior clerk and you won't be far wrong.)

 The Lemming 20 May 2020
In reply to DancingOnRock:

I completely agree with everything there.

 The Lemming 20 May 2020
In reply to Rob Exile Ward:

> I don't think we are disagreeing as much as you made out in your original response. Thats why I am a serious advocate of finding a mechanism - not unlike the BBC - of running the NHS at arms length from government.

That would be a great idea, if it was ever implemented.

 DancingOnRock 20 May 2020
In reply to Rob Exile Ward:

>Incidentally I have quite a lot to do with the NHS bureaucracy as a contractor, and day to day quite a lot of said contact is horrific. Meetings with hidden agendas, people exercising power without responsibility for the consequences, budgets that are ludicrously constrained at times but will run to meetings for 20 - 30 without clear agendas or any idea of costs. (I'm in favour of all admin staff wearing badges saying how much per hour their time is costing the tax payer. Start at £25 for a junior clerk and you won't be far wrong.)

Quite.

Although £25 isn’t an excessive wage, assuming they’re worth that and have training and skills. 

In reply to Luke90:

lol, it was not I in the corner but my mother, my take on it was from what she described, it may read as a daily mail attack on the peasants. I was not going for that though. I shall try to be more aware of how it may read.

1
 abr1966 20 May 2020
In reply to Rob Exile Ward:

'National' health service????

You are a few years out of date. We are a collection of Trusts operating a quasi business model constructed from countless changes of political ideology.

The mess is politically created. We have managers of many types....

I'm a clinical manager....as in I still see patients and do mostly clinical work. There are NHS managers who are employed as that with no clinical background....mostly in my experience generally ok. The worst in my view are ex clinical staff who go in to general management.

More money?? Of course we can spend more money.....I don't know where it all goes....I have had to make 'cost improvements every year....about 7.5 of my budget less than 3 years ago whilst an increase in referrals of around 70% in the same period.

We need to get rid of the falsely created market and also the farce of how the service is commissioned....by a whole raft of other people....in my experience with very little knowledge of what they are doing....but with an over confident opinion about it.

I could go on a lot but won't bother....armchair punditry with lots of ill informed opinion...

 colinakmc 20 May 2020
In reply to Rob Exile Ward:

I have sympathy with what OP says. Problem is that with a cronyist government whose behaviour demonstrates its hostility to anything aimed at the public good (but especially the NHS) it’s risky to suggest that. But working in social services I became aware of the tension between front line and commissioning functions, and also of the layers and layers of non-production in the nhs - much more so than in councils - and I’m sure there’s a case to answer that the NHS’s procurement has ossified so that it was unable to react quickly enough to the changes in supply & demand for PPE, for example.

Too much outsourcing, purchasing being handed to purchasing clerks without a tech background, and catastrophic politicisation. 

2
 wintertree 20 May 2020
In reply to DancingOnRock:

> Unfortunately Boris was taken to mean we were looking for herd immunity when he said many of us will lose loved ones. When in reality he was just trying to prepare people. And the press seem to have forgotten that part of the message when they were trumpeting about government ‘u-turns’ and ‘herd immunity’. 

I wonder what his senior advisor was taken to mean when he said “build up some degree of herd immunity”, which is what he said shortly before (Edit: it may have been shortly after) Boris’ comments.  Context and all that.  I believe another bit of context at the time his chief scientific advisor was discussing herd immunity is that Boris was taking about following or being guided by the science...

Post edited at 12:10
 marsbar 20 May 2020
In reply to andrew breckill:

One reason for a and e being less busy is the knock on effect from GPs being less busy.  This means that people aren't ending up at A and E because they can't get to see anyone at the doctors.  GPs are now working by phone which gets through the routine stuff much quicker than in person.  

 marsbar 20 May 2020
In reply to colinakmc:

I'm sure I read somewhere that responsibility for PPE for pandemics was taken away for the NHS and is the direct responsibility of Hancock.  

2
 Ian W 20 May 2020
In reply to DancingOnRock:

> >Incidentally I have quite a lot to do with the NHS bureaucracy as a contractor, and day to day quite a lot of said contact is horrific. Meetings with hidden agendas, people exercising power without responsibility for the consequences, budgets that are ludicrously constrained at times but will run to meetings for 20 - 30 without clear agendas or any idea of costs. (I'm in favour of all admin staff wearing badges saying how much per hour their time is costing the tax payer. Start at £25 for a junior clerk and you won't be far wrong.)

> Quite.

> Although £25 isn’t an excessive wage, assuming they’re worth that and have training and skills. 

For a junior clerk?? £25 / hr is approx £33k pa salary paid to said Clerk......assuming autoenrol pension, not defined benefit..........not exactly peanuts for  junior clerk when compared to nurses / teachers / everyone else....

 Ridge 20 May 2020
In reply to Luke90:

I agree for some people it is a case of not being able to find childcare, but I've been in A&E when f***wits and their equally f***witted family and friends are milling around causing mayhem. Plus the drunks,  and attention seekers diverting paramedics from dealing with serious cases.

In reply to baron:

> Doesn’t the NHS have a relatively poor record at keeping people alive e.g survival from certain types of cancer?

> That’s alive as in not dead, not alive as in lingering on when one might rather be dead.

Results relative to funding are good. Ie. They do very well despite being under funded, which is a credit to the staff, systems of work etc. 

European counterparts have better results, but are also better funded. You get what you pay for. 

 Ridge 20 May 2020
In reply to marsbar:

> GPs are now working by phone which gets through the routine stuff much quicker than in person.  

I had to get in touch with my GP by phone. I couldn't believe how quick and efficient it was. A GP phoned me about 25mins after I contacted the surgery, discussion on the phone, prescription sent electronically to the pharmacy, another quick call to the pharmacy to get a time to pick up my prescription and that was it.

Beats "Hello, I'm thinking of being ill a fortnight on Tuesday, can I have an appointment for then please?"

In reply to abr1966:

> The worst in my view are ex clinical staff who go in to general management.

I'm glad that you said that, as a clinician.  It's definitely my experience too.  When you say 'NHS manager' a very specific stereotype comes into my mind.  Someone who is motivated by status and org charts, is far more keen to tell other people what to do than to do anything themselves, and who is no position to give anyone dietary advice.

Like all stereotypes, it's often unfair.  But it very often isn't.    

 abr1966 20 May 2020
In reply to Dave Garnett:

Yep......ive met some really good managers but also some self serving idiots....most of whom have been ex clinical staff.....often with a poor reputation as clinicians. Keen to be promoted, gloss over the surface but put their next career move ahead of anything else. Sadly their line managers are from the same flock so nothing changes. On the ground I see a lot of team managers flogging themselves trying to maintain a quality service.....

 Ian W 20 May 2020
In reply to marsbar:

> I'm sure I read somewhere that responsibility for PPE for pandemics was taken away for the NHS and is the direct responsibility of Hancock.  

You did. Procurement of ppe is the responsibility of NHS Supply Chain Co-ordination Ltd, owned by the department of health;

https://www.ft.com/content/9680c20f-7b71-4f65-9bec-0e9554a8e0a7

distribution is run by https://www.sccl.nhs.uk/, under the control of the sec of state (Hancock). there was a thread on this a while back, based on hancock blaming the distribution arm, not the supply arm for the shortages, without realising that he personally had control of the organisation responsible for distribution........

but also read;

https://www.theguardian.com/world/2020/apr/22/revealed-private-firm-running-uk-ppe-stockpile-was-sold-in-middle-of-pandemic

which is a quite appalling situation.

 abr1966 20 May 2020
In reply to Ian W:

> For a junior clerk?? £25 / hr is approx £33k pa salary paid to said Clerk......assuming autoenrol pension, not defined benefit..........not exactly peanuts for  junior clerk when compared to nurses / teachers / everyone else....

These figures are made up....not real! Ive never heard of a 'junior clerk' im my time in the nhs. We have what is generally referred to as admin on band 2 or 3 grades mostly. Nothing like those figures.....subtract 10-15 grand to connect with reality...

In reply to abr1966:

> .....often with a poor reputation as clinicians. 

I stopped short of saying that, but that was my suspicion too!

 DancingOnRock 20 May 2020
In reply to Ian W:

Why are you comparing to nurses/teachers? 
 

They should be paid more, it doesn’t follow that everyone else should be paid less. 
 

If you want to attract people to a job you need to pay competitive wages. The NHS and Education system have pretty much a monopoly on Teachers and Nurses jobs. One of the setback of nationalised healthcare and education. 

6
 DancingOnRock 20 May 2020
In reply to wintertree:

I was talking about the u-turn. Just because the numbers necessary for ‘herd immunity’ were seen to be huge, didn’t mean that people were now suddenly safe for some miraculous reason. 

In reply to abr1966:

'Ive never heard of a 'junior clerk' im my time in the nhs. '

Well I've met quite a few though they aren't called that, obviously. 

And the £25 per hour is based on the rule of thumb that an employee used to cost about twice their salary, when you factored in things like recruitment costs, training, management time, holidays and sickness etc etc. Nowadays that will have gone up with pension contributions, additional H & S and HR obligations, etc etc. 

Your answer illustrates quite neatly why it would be good in lots of public sector organisations - not just the NHS - for staff - and managers - to clearly understand how much they actually cost the taxpayer.  

Post edited at 13:01
 Ridge 20 May 2020
In reply to Rob Exile Ward:

> Your answer illustrates quite neatly why it would be good in lots of public sector organisations - not just the NHS - for staff - and managers - to clearly understand how much they actually cost the taxpayer.  

Why not just have big posters with I PAY YOUR WAGES in a shouty font for a real morale booster?

Personally I think labels like:

"This light bulb was supplied and changed with pride for the NHS by ACME Facilities Management for £435.20"

"This shitty logo was provided by Joe Bloggs MP's girlfriend's PR company for £214,000"

"This isn't just any piece of bent aluminium sheet, this is a BAE Systems sheet of bent aluminium sheet @ £1,350"

Might better illustrate costs to the taxpayer.

In reply to Ridge:

Mine wasn't a very serious suggestion - it was just prompted by attending any number of meetings where I was paying for myself but any number of people were milling about who made absolutely no contribution.

I like your ideas though. 

1
 abr1966 20 May 2020
In reply to Rob Exile Ward:

> 'Ive never heard of a 'junior clerk' im my time in the nhs. '

> Your answer illustrates quite neatly why it would be good in lots of public sector organisations - not just the NHS - for staff - and managers - to clearly understand how much they actually cost the taxpayer.  

Well I can only speak from my experience but I know exactly what staff costs are....as opposed to what they are paid. A lot of budgets are managed at an operational level. We are held to account and are required to give assurance to our senior managers and finance department through the directorate structures that we work within. I know where every penny is spent....literally.

I take the general jist of what you are saying though.....its important to always be mindful that we are paid by the taxpayer. Some of my staff are sick of hearing me remind them.....

In reply to abr1966:

It really isn't a resentful thing, it's sometimes like encountering a different consciousness. People will have meetings to discuss expenditure when the meeting alone has cost more than the item under discussion.

I wonder who is costing the contact tracing app being trialled in the Isle of Wight? Anyone care to take a bet that however much we spend, it will never deliver?

1
 The Lemming 20 May 2020
In reply to Rob Exile Ward:

That's a given.

Anything commissioned by government is a fekup.

 tripehound 20 May 2020
In reply to Rob Exile Ward:

What a load of I'll informed rubbish. Time and time again the NHS has been proven to be one of the most efficient systems in the world. We pay less of our GDP than all but one European countries on health. The USA pays twice as much per capita than the uk on health, but the outcome for the poorest is abysmal. Child mortality rates for the poor in the U S are comparable to third world countries. 

The ONLY problem with the NHS is the level of funding especially over the last ten years. 

1
 DR 20 May 2020
In reply to Rob Exile Ward:

What Lemming said at 10:55. But also that the apparent dysfunction of the different facets of the NHS to which you refer are a result of the disastrous Andrew Lansley reforms. Ask anyone who works in the NHS...

 Al Randall 20 May 2020
In reply to Rob Exile Ward:

It's only in the last two of my 72 years that I have had recourse to attend hospital regularly.  A number of times for a broken ankle, badly abused by the Greek Health Authorities, to have corrective surgery then just as I had recovered from that surgery on my gall bladder. I absolutely agree that the NHS should receive more money and I would gladly pay more tax to give it to them but I did experience several serious mistakes and inefficiencies due to mismanagement and poor organisation that had nothing to do with either funding or staff shortages.

I think we need to be realistic in acknowledging both of these factors and perhaps be a little less emotional and political about the NHS. By all means give the more money but they should also be required to improve in many areas.

Al

 mondite 20 May 2020
In reply to Rob Exile Ward:

> I wonder who is costing the contact tracing app being trialled in the Isle of Wight? Anyone care to take a bet that however much we spend, it will never deliver?

Probability is it will fail. However associating that with the NHS seems, like many of your other examples, to be incorrect. NHSX seems more a central government unit.

 mondite 20 May 2020
In reply to Al Randall:

> I think we need to be realistic in acknowledging both of these factors and perhaps be a little less emotional and political about the NHS. By all means give the more money but they should also be required to improve in many areas.

The NHS has been under constant "improvement" for as long as I have been aware of politics although really picked up in the 2000s. The problem is most of the improvements havent been very good but have often been covered up by the repeated mantra claiming its impossible to change the NHS whilst making a dogs dinner of doing just that.

 Al Randall 20 May 2020
In reply to mondite:

I don't subscribe to the title of the OP but I do believe that there is huge amount of scope for improvement.

Al

 Planeandsimple 20 May 2020
In reply to Rob Exile Ward:

The fault of politicians of all stripes using the NHS as a football. Too much fear in reforming it for the better, too much political capital in using it to beat your opponents.

It's not world class. We need to stop pretending that there are only two models for health. We can run it differently without the inhumanity and exploitation of the US system. 

The fault lies at all levels from middle management upwards. There is no organisation so resistant to change I've had the misfortune of working with, even when the change was intended to save the lives of patients and staff. We should blame the politicians who've let this managerial attitude fester and undermining the efforts of those who are hands on. 

2
 mondite 20 May 2020
In reply to Al Randall:

> I don't subscribe to the title of the OP but I do believe that there is huge amount of scope for improvement.

I would start with not having every health secretary reorganise it to make their mark. 

Which is my point. It is complete and utter bollocks that the NHS is this unchanging organisation where it is impossible to question it. Every single politican in charge of it in recent years has launched change after change. Which is half the problem.

 Ian W 20 May 2020
In reply to abr1966:

> These figures are made up....not real! Ive never heard of a 'junior clerk' im my time in the nhs. We have what is generally referred to as admin on band 2 or 3 grades mostly. Nothing like those figures.....subtract 10-15 grand to connect with reality...

Glad to hear in one way that they are made up, but not glad that a made up figure was used to illustrate a real point. I'm aware of both low and high figures in NHS pay from first hand experience; both can be eyebrow raising......

 Planeandsimple 20 May 2020
In reply to abr1966:

> Yep......ive met some really good managers but also some self serving idiots....most of whom have been ex clinical staff.....often with a poor reputation as clinicians. Keen to be promoted, gloss over the surface but put their next career move ahead of anything else. Sadly their line managers are from the same flock so nothing changes. On the ground I see a lot of team managers flogging themselves trying to maintain a quality service.....

Well said. My experience was that ward to ward the difference was huge, some were fantastic, clean, helpful staff, had read the email about why we were working with them and were prepared for our arrival. Others were like bombsites with all the cheer and obstructive staff. 

None of these factors seemed to have any corellation to the seriousness of work on the wards and was simply a reflection of the leadership and crossing the corridor could be like night and day.

 Ian W 20 May 2020
In reply to DancingOnRock:

> Why are you comparing to nurses/teachers? 

because it shows how a nurse / teacher is undervalued compared to a junior clerk*. You have jumped to the wrong conclusion if you think that is a reason to simply race to the bottom by dropping the clerk's salary. The want a nurse to be a graduate level role; so pay for it. They want teaching to be a post-grad level career, so pay for it. I've no problem with any of that, as long as we dont pretend we can have those management aspirations for those careers (and no doubt others) without providing adequate funding. Which means higher taxes. Or no HS2, for example.

*although it now tuns out that the junior clerk figure was not real.

> They should be paid more, it doesn’t follow that everyone else should be paid less. 

See above.....answered both in 1.

> If you want to attract people to a job you need to pay competitive wages.

See above.....

> The NHS and Education system have pretty much a monopoly on Teachers and Nurses jobs. One of the benefits of nationalised healthcare and education is the ability to set standardised, realistic pay levels.

FTFY.

 Al Randall 20 May 2020
In reply to mondite:

> I would start with not having every health secretary reorganise it to make their mark. 

> Which is my point. It is complete and utter bollocks that the NHS is this unchanging organisation where it is impossible to question it. Every single politican in charge of it in recent years has launched change after change. Which is half the problem.

I'm not sure how you affect change if you are unwilling to embrace change.  You seem to be saying that there is nothing wrong with it.  I know several Doctors and Nurses would would agree that some fundamental changes are necessary.

Al

 mondite 20 May 2020
In reply to Al Randall:

> I'm not sure how you affect change if you are unwilling to embrace change.

The problem is the NHS has been embracing moronic change after moronic change for decades now.

> You seem to be saying that there is nothing wrong with it. 

No I am not. I am pointing out that the lie, which you seem to buy into, that the NHS is this unchanging structure is complete and utter rubbish. Every healthy secretary has been launching ideologically driven "reform" after "reform" normally not bothering to give the previous one time to bed in.

So please explain given how many changes have been made to the NHS in recent years why exactly you feel change hasnt happened?

 wintertree 20 May 2020
In reply to mondite:

> Every healthy secretary has been launching ideologically driven "reform" after "reform" normally not bothering to give the previous one time to bed in.

For a minute I thought we were taking about education...

In reply to Rob Exile Ward:

> attending any number of meetings where I was paying for myself but any number of people were milling about who made absolutely no contribution.

Ah, were there lots of government-mandated external management consultants in the meetings...?

Post edited at 17:48
 Al Randall 20 May 2020
In reply to mondite:

Apologies for jumping to the wrong conclusion but you have now done the same. What have I said that makes you conclude that I have "bought into a lie" or denied that there have not been changes? Indeed I specifically said I did not agree with the OP title.  Not sure I can be any clearer than that. I agree with you that there appear to have been lots of ineffective changes.  I was merely pointing out that with my very recent experiences with the NHS I witnessed, experienced and might also say suffered as a result of inefficiencies none of which could have been attributed to staff shortages or lack of funding. If you really, really want I could itemise them but I don't really want to go down that tack as overall I was quite satisfied and grateful for what they did.

Al

Post edited at 18:06
 SAF 20 May 2020
In reply to The Lemming:

I'd second lemmings excellent post. 

> Despite the government, the NHS did everything possible within its power of influence to prepare and cope with the pandemic.

I've been really impressed by the management in my NHS trust and the way they have handled a fast moving, novel situation. It's not been perfect, but they have problem solved like they have never had to before, and been very open with staff whilst doing it.

They've got the trust to a point where today the trusts second in command has announced that he has booked some annual leave next month and is encouraging other staff to do the same. 

If I'd been told 6 months ago that I would be working shifts with soldiers, I would never have believed them, but it has worked seamlessly, and been a good laugh as well.

There have been moments of information overload at all levels, but that can only be expected given the circumstances.

It has been a success not a catastrophe so far!

Post edited at 18:58
 DancingOnRock 20 May 2020
In reply to Ian W:

>FTFY

No you didn’t. You’ve just imposed your own set of arbitrary wage limits. How comes everything else runs off capitalist principles apart from the one thing that should - our labour. Everyone should be free to move around and work for the highest bidder. Not have their income fixed by some socialist notion of ‘fairness’. 
 

Who decides what is fair for a nurse to be paid? Why isn’t it linked to what a ‘junior clerk’ earns? 
 

3
 The Lemming 20 May 2020
In reply to DancingOnRock:

>  Who decides what is fair for a nurse to be paid? Why isn’t it linked to what a ‘junior clerk’ earns? 

Laws were put in place to stop Dickensian factory owners paying thruppence an hour. Sadly with a minimum wage law, we have a race to the bottom to put as many people on minimum wages as possible.

And if that is too expensive then the same Dickensian factory owners can invent Zero Hour contracts to lower wage bills, frighten the shit out of poorly paid employees and increase profits at a human cost.

And then how about taking your factories to countries that aren't encumbered by such silly notions where the Dickensian factory owners can go back to paying thruppence an hour or even less because those people with the watermelon smiles need the pittance to survive.

Shall I continue?

Thatcher is dead. Long live Thatcher.

Post edited at 19:27
1
 Ian W 20 May 2020
In reply to DancingOnRock:

> >FTFY

> No you didn’t. You’ve just imposed your own set of arbitrary wage limits. How comes everything else runs off capitalist principles apart from the one thing that should - our labour. Everyone should be free to move around and work for the highest bidder. Not have their income fixed by some socialist notion of ‘fairness’. 

> Who decides what is fair for a nurse to be paid? Why isn’t it linked to what a ‘junior clerk’ earns? 


Who the hell set any wage limits? To quote Stichtplate, do you ever read anything before replying to it? Pay / condition levels should be set in such a way that individuals are attracted to that career that can  contribute positively, and move the profession forwards. Better healthcare outcomes in this case. If, as has been done, the employer believes this should be a degree level profession, then they are competing against other careers that would employ graduates. Whilst all careers are different, and attract varying levels of pay, there are ranges / expectations fit into.

You also have spuriously introduced a perceived notion of "socialist" fairness into this.

It isnt linked to a junior clerk because it is / should be linked to a level that will attract the right people into the profession.

 DancingOnRock 20 May 2020
In reply to The Lemming:

You lost me. You’re saying that’s the fair way to do things? 

 DancingOnRock 20 May 2020
In reply to Ian W:

Exactly. 
 

The wage limits are set by Stitchplate or rather whoever is in charge of setting them. In a government owned monopoly its the government. 

Post edited at 19:46
In reply to The Lemming:

'And if that is too expensive then the same Dickensian factory owners can invent Zero Hour contracts to lower wage bills, frighten the shit out of poorly paid employees and increase profits at a human cost.'

That's not, in fact, how it is. There's a decreasing number of truly unskilled jobs, because if a job IS unskilled then it becomes cheaper to outsource to a lower cost economy or employ robots. 

When you are talking about skilled jobs most employers AREN'T in a 'race to the bottom' - they need a motivated and stable workforce, and they have to compete for the good employees. The difference in productivity between a motivated workforce and a demotivated one is the difference between profit and loss. I've seen it with my own eyes on a number of occasions - Tarmac, IBM, some local authorities, Boddington pubs. They changed from profit to loss - and vice versa - practically at the flick of a switch. And the switch was staff motivation. You can't supervise every employee to make sure that every decision they take every minute of the day is the right one - you have to assume that they will do their best. And being fair is the only way to ensure that. You can't frighten a sought after employee to be their creative best, to solve every problem that they encounter the absolute best way they can.  You can only motivate them to do so.

As a public sector employee whose employer will never go bust, you may find that hard to understand. But in the private sector, the interests of employer and employee are much more closely aligned. The absolute, irreversible  trend is that in future we will need fewer employees but higher skilled and better paid ones, who will always be in a sellers market; they in turn will require more service industries and leisure industries, the success of which also depend upon motivated employees with initiative, enthusiasm and skin in the game.   

  

2
 The Lemming 20 May 2020
In reply to Rob Exile Ward:

Fair comment. Now to go off at a tangent. If the workforce becomes more skilled and educated and there are less and less unskilled jobs, what happens to people with a poor education?

An example could be that an individual could not keep up with the target driven education system and got left behind. Or the individual that will never have the mental capacity to be able to achieve high academic grades.

 Martin Hore 20 May 2020
In reply to Rob Exile Ward:

> Your answer illustrates quite neatly why it would be good in lots of public sector organisations - not just the NHS - for staff - and managers - to clearly understand how much they actually cost the taxpayer.  

I think it might be better if the rest of us taxpayers more clearly understood how much we need to pay in tax if we want good quality public services, and be prepared to vote accordingly.

Martin

 Planeandsimple 20 May 2020
In reply to Rob Exile Ward:

> 'And if that is too expensive then the same Dickensian factory owners can invent Zero Hour contracts to lower wage bills, frighten the shit out of poorly paid employees and increase profits at a human cost.'

> That's not, in fact, how it is. There's a decreasing number of truly unskilled jobs, because if a job IS unskilled then it becomes cheaper to outsource to a lower cost economy or employ robots. 

> When you are talking about skilled jobs most employers AREN'T in a 'race to the bottom' - they need a motivated and stable workforce, and they have to compete for the good employees. The difference in productivity between a motivated workforce and a demotivated one is the difference between profit and loss. I've seen it with my own eyes on a number of occasions - Tarmac, IBM, some local authorities, Boddington pubs. They changed from profit to loss - and vice versa - practically at the flick of a switch. And the switch was staff motivation. You can't supervise every employee to make sure that every decision they take every minute of the day is the right one - you have to assume that they will do their best. And being fair is the only way to ensure that. You can't frighten a sought after employee to be their creative best, to solve every problem that they encounter the absolute best way they can.  You can only motivate them to do so.

> As a public sector employee whose employer will never go bust, you may find that hard to understand. But in the private sector, the interests of employer and employee are much more closely aligned. The absolute, irreversible  trend is that in future we will need fewer employees but higher skilled and better paid ones, who will always be in a sellers market; they in turn will require more service industries and leisure industries, the success of which also depend upon motivated employees with initiative, enthusiasm and skin in the game.   

Oh my god REW for once we agree. Often we hit opposite sides however I fully agree with you here. Creativity, free and radical thinking require true investment from individuals the tech sector is particularly good at this and in my experience the NHS lacks it. Agile, responsive and striving for team goals. Value of NHS staff is key, but why can they not be valued in a modern way, companies like Facebook and Google have dedicated operators who, from PHD to porter are valued. Surely better leadership is the way to foster better team ethos and achieve greater things. For the good of us all. 

 jethro kiernan 21 May 2020
In reply to Planeandsimple:

I think your view of the tech industry is a little niave, yes management and developers May get big perks and climbing walls in the office but your ignoring the moderator farms that are full of demoralised staff.
https://www.google.co.uk/amp/s/www.cnbc.com/amp/2019/02/25/facebook-pays-content-moderators-a-fraction-of-median-salary-report.html

Or what about the divide nets they had to instal in Foxconn factories in China.
 

trying to create false markets in the NHS with aspirations to be more like apparently dynamic sectors is the root of some of the problem, using the tech industry which has a model of surfing a wave of bullshit and investor money to crush any opposition in a hope that no competition might mean profit is hardly the business model for the nhs.

In reply to Rob Exile Ward:

> (I'm in favour of all admin staff wearing badges saying how much per hour their time is costing the tax payer. Start at £25 for a junior clerk and you won't be far wrong.)

A typical clerk in the NHS appears to be band 3, that's about £10 an hour, of course they cost more than that when you take in to account, NI, Pension and holidays etc, so let's say £15. More importantly, those clerks are not sat in meetings all day, they are dealing with the public or doing 101 admin jobs that are required to keep the service running.

 tripehound 21 May 2020
In reply to Rob Exile Ward:

Yet again the NHS is let down by government ineptitude. Dithering on contract tracing.

https://www.bbc.co.uk/news/uk-52748564

No doubt RE will blame the NHS.

1
In reply to The New NickB:

It wasn't a terribly serious suggestion but interesting that you are only adding 50% to the salary for additional costs of employment, when the 'received wisdom' (I know, I know) is more like the 100% I quoted. 

 The Lemming 21 May 2020
In reply to tripehound:

> Yet again the COUNRTY is let down by government ineptitude. Dithering on contract tracing.

Fixed that for you

L KriszLukash 21 May 2020
In reply to Rob Exile Ward:

Healthcare needs to be local, decentralised and patient-centric.

The NHS is the opposite of all of that. Still a lot better than no free healthcare though.

1
In reply to tripehound:

It seems odd and disappointing that with all the money we spend on health, whether through the 'NHS' directly (whatever that is) or associated bodies such as PHE, relevant LA departments and so on, we have not been able to put in place a key component of getting this under control and suppressing it. I don't 'blame the NHS', I blame successive ministers, but the senior management in those bodies have some explaining to do as well. 

In reply to jethro kiernan:

'trying to create false markets in the NHS with aspirations to be more like apparently dynamic sectors is the root of some of the problem, '

I did a masters degree in health service management in the 90s, and I was genuinely amazed at how poor the standard of management teaching was.  It was all about discipline, hierarchies, hiring and firing, setting targets and firing people who didn't meet them... it was pure Victoriana. 

 The Lemming 21 May 2020
In reply to Rob Exile Ward:

I think the phrase "Systemic Bullying Culture" is what you are politely avoiding, when referring to the NHS and its management system.

In reply to Rob Exile Ward:

Received wisdom? What are you including? Whilst still a good way off.

In reply to The New NickB:

It's not an exact science! But as well as obvious costs such as NI and pension costs, there are costs of recruitment, a proportion of management , admin and HR  costs, cover for holidays and sickness, induction and ongoing training...

In reply to The Lemming:

Yes you're right - and it was really depressing seeing the lecturers genuinely espouse that sort of stuff because a) they thought it was what happened in the private sector, and b) it's what they knew the government - Margaret Thatcher - liked to see. Fear in the workplace.

In reply to Rob Exile Ward:

> It's not an exact science! But as well as obvious costs such as NI and pension costs, there are costs of recruitment, a proportion of management , admin and HR  costs, cover for holidays and sickness, induction and ongoing training...

Funnily enough, I based my assumption on real costs for those things in a public sector organisation.

Pan Ron 21 May 2020
In reply to Rob Exile Ward:

I have near-zero experience with the NHS, but am automatically wary of anyone proclaiming, red-top-style, that something is a "catastrophe". 

Likewise, the claim that all blame lies elsewhere and higher up the food-chain, while "hard-working people at the coal-face" are automatically accorded a free-ride on responsibility. 

From extensive experience in the public sector, I can categorically state that those at the bottom of the organisational chart can be as big a detriment to an organisation as the people at the top, and at the very least exhibit the same human fallibility as senior managers.

1
 The Lemming 21 May 2020
In reply to The New NickB:

> Funnily enough, I based my assumption on real costs for those things in a public sector organisation.


Why are you two arguing over somehing as insignificant as a clerk and their hypothetical pay?

Want to rant about something really obscene?

I'm an EMT1 and I work very closely with a Paramedic and I have done this for 10 years and I'm on Band 4. No great shakes as I do a bit of admin, not much but I do other stuff as well such as wiping vomit off the vehicle floor and the odd bit of "One Potato, two Potato".

However with the NHS's drive to keep down costs and keep the workforce in their place and not cause waves many of my new colleagues who train to become an EMT 1 are kept on a Band 3 pay grade for a year until they complete their training. And I say this loosely as they are capable of doing the job, its just another way to keep the wage bill down while threatening the new staff that if they don't play nicely then they won't move to Band 4 in a year's time. There are plenty of Smoke and Mirrors to say that its about training but they are doing the same job but under paid for a year.

You think that's bad?

Then spare a thought for new Paramedics who go onto the road. They do the same job as a Paramedic with many years under their belt but they have to wait two years before they are paid the same. That's two more years of Smoke and Mirrors to save on wages and get new staff to tow the Party Line.

Now that is disgusting and an insult to staff, under the guise of Training.

Post edited at 11:09
 Ridge 21 May 2020
In reply to Rob Exile Ward:

> I did a masters degree in health service management in the 90s, and I was genuinely amazed at how poor the standard of management teaching was.  It was all about discipline, hierarchies, hiring and firing, setting targets and firing people who didn't meet them... it was pure Victoriana. 

I think the standard of management, (and leadership, which IMHO is a completely different thing), in the UK is generally very poor.

In some cases people  generally seem to be 'promoted' to manager (in my case a few years ago very reluctantly) because the pay and conditions are better, but with absolutely no evaluation if they're suitable other than the standard interview and no support or training.

In the worst companies cronyism and nepotism is how managers are selected, or even worse they employ people who are desperate to be 'in charge', regardless of suitability.

 jethro kiernan 21 May 2020
In reply to Ridge:

I agree,I’ve mentioned this on unrelated threads previously, British management culture is rubbish, I’ve experienced management and been involved in management myself both in the UK and the Continent and we just don’t do it well, I haven't worked in the public sector but nothing you describe is unusual in certain sectors of industry.

To much “efficiency “ is usually unhealthy as it makes people fearful and encourages ass covering and massaging KPI’s rather than meaningful progress, What you then have are the KPI managers who can play the system to hit the figures but quite often leave chaos behind.

Just spend some time on LinkedIn Comments and “inspirational” posts to get a measure of the herd like behaviour  of British Managment

Post edited at 11:49
 neilh 21 May 2020
In reply to Ridge:

Its an organisation with is it 1 million or 1.2 million employees.

Try managing that lot to ennure everyone is happy and that it runs smoothly all the time.There are so many different organsiations with in it all competing/vying for money, resources and time.

And you never hear about the good parts that run and are managed well.

 krikoman 21 May 2020
In reply to Rob Exile Ward:

> We really should be on top of this stuff by now, we really should. Hapless Hancock has a lot to answer for, and so do his predecessors.

We should be on top of Track and Trace, but we're not, and it doesn't look like we will be in the near future!!

How come we don't just borrow Korean's, change the language and probably the network setting and off we go!

We've had nearly 8 f*cking weeks to realise we were eventually going to need some form of this, and look where we are. I don't think you can blame the NHS for this, likewise most of the other shit you seem to lay at their door.

 Offwidth 22 May 2020
In reply to neilh:

It's really not one big organisation. Since the Landsley reforms it's mainly been many competing organisations of various sizes (a good few private and non public sector non profits) bidding to local commissioners for contracts, all monitored with a broken quality system and with lots of interference from DHSC. We even had an NHS hospital taken over by a private company (with disastrous results). The negativity some here have towards NHS management is plain dumb, it's no better or worse than anywhere, but too many organisations have slipped into manage-up bully-down cultures given the incredible financial pressures (especially where trusts carry historic PFIs). Outside the NHS, Public  Health has been near destroyed by putting it into cash strapped councils and there is still no coherent link to Social Care (although a few cities are experimenting to improve this). Most of the problems track back to UK government underfunding compared per capita to most other European countries.

Where Al says coal face improvements can often be made, I think he is right but missing the cause will nearly always be local big picture issues. The more an organisation struggles and strains management away from focussing on best practice, the more good people will leave and the more dispirited those who remain will become and the more support from new inexperienced staff or agency staff will be needed. Worst case you end up with Mid Staffs.

https://en.wikipedia.org/wiki/Stafford_Hospital_scandal

Those with a serious interest in improving NHS management (from the biggest political issues to the small sharing of good practice)  should subscribe to Roy Lilley's blog as he is wise, pragmatic and funny.

https://ihm.org.uk/roy-lilley-nhsmanagers/

Post edited at 09:18
In reply to Offwidth:

I've been familiar with Lilley since 1995. Why he isn't higher profile has always been a bit of a mystery to me. 

 neilh 22 May 2020
In reply to Rob Exile Ward:

Probably because it is sometimes easier to comentate rather than actually do.People who want to get their hands dirty so to speak and get on with doing a job are different to those who sit from the outside and throw recommendations .

Happens across most sectors and life in my experiecne. Its a question of if it is that simple why did you not do it.

He has , no disrespect, probaly not got the bottle to take on a bigger role. Nothing wrong with that, if that is what ticks your interest.

In reply to neilh:

IIRC he did have high profile management posts in the 90s when he was a 'do-er'; I can iagine how you would get worn out though, even/especially after Tony Blair became PM with his touching belief in silver bullets like IT and PFI.

 mondite 22 May 2020
In reply to krikoman:

> How come we don't just borrow Korean's, change the language and probably the network setting and off we go!

Because they arent really using an app.

 neilh 22 May 2020
In reply to Rob Exile Ward:

25 years ago then. Way past his best.

In reply to neilh:

Good job you weren't around in 1940!

 neilh 22 May 2020
In reply to Rob Exile Ward:

Well in 1945 we must remember that alot of  Drs and Consultants fought tooth and nail against the formation of the NHS. As a result they were allowed to continue treating patients privately.Often forgotten about.

Post 1945 this along with the continuance of the private sector in education were 2 fundamental strategic issues that have shaped social life etc in the UK.

Anyway its a bit off subject.

In reply to neilh:

I was thinking more in terms of writing off some bloke because he was in his 60s. Churchill was 70 when he took over, and seemed to have rather more energy, creativity, team building skills and ability to make things happen than anyone in this current shower.

 krikoman 22 May 2020
In reply to mondite:

> > How come we don't just borrow Korean's, change the language and probably the network setting and off we go!

> Because they arent really using an app.


Are you sure, because they seem to think they are!

 mondite 22 May 2020
In reply to krikoman:

> Are you sure, because they seem to think they are!

Not if you actually pay attention they dont. Their primary tracing is lots of people and then high level phone tracking and spending information.

 krikoman 22 May 2020
In reply to mondite:

> Not if you actually pay attention they dont. Their primary tracing is lots of people and then high level phone tracking and spending information.

I might be wrong but.....

https://www.independent.co.uk/life-style/love-sex/coronavirus-tracking-app-cheating-partners-married-south-korea-affair-a9514996.html

Apple and Google already have apps for this, so why don't we use theirs?

Or have I not been paying attention there either?


This topic has been archived, and won't accept reply postings.