Archive for the ‘Society’ Category

skeletal-debate

Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community.

Aneurin Bevin

The ability to provide safe, cost effective health and social care, across the National Health Service (NHS) England, and other recognised agencies, is continually being driven further into an abyss.  Contribution to this situation is seen through numerous factors: the change in societal expectations of what treatments should be available on the NHS; the historic failing of successive governments to create mechanisms within general taxation, and additional charging to facilitate the continuing demands on these services; poor leadership by the Department of Health-a direct result of short-termism and political ideology-cascading down to hospital management teams.  The private funding initiative (PFI) projects that have been demonstrated have a phenomenally catastrophic impact on patient care.  Outsourcing of services to the private sector which are integral to patient care, for example portering, and domestic services.  And more recently a drive, initiated through a shared myopia of government, and hospital managers, to blindly follow a culture of “more for less”, to name but a few.

Making savings ad infinitum with the objective of maintaining the same standards, is detrimental to an organisations ability to be efficient and sustainable.  Savings are a tool used by accountants to achieve short-term gains.  Whilst “Lean” working is a viable proposition in health care “lean” is not anorexic.  The long term effects of short term savings are to drive down standards, to force errors through the cutting of corners, and to cost the organisation dearly in the future.  “Speculate, you can’t accumulate, if you don’t”: true leaders in the NHS will see the value in this proverbial saying.

Hospitals are finding themselves in such financial dire straits, that with no apparent means of raising capital for investment, in the very basic infrastructure to make them viable propositions, under any  other circumstance they would be bankrupt.  It is possible to put a plug in the bath, even if it is a round(ish) plug in a square hole; and to at least turn the flow of the, money, taps down so they are running at a steady flow and not gushing.  But this requires long term policies, more freedom from government control, and leadership: not crisis managers.

It is time for hospitals to look at becoming shrewd financial investors; to speculate wisely.  If £25million in the red, to continue saving will only drive debt.  Speculate and invest to drive productivity over the long term, bringing the debt down.  If it is a system allegedly good enough for the government to implement, then why not Hospitals?

Managers do not inspire doctors or clinical staff but good leaders do. NHS needs good clinical leaders.

Dr Umesh Prabhu

It is true, managers do not inspire doctors or clinical staff; it is also true that the NHS needs good leaders. 

However, even good leaders will fail to inspire the diversity of professional groups within healthcare, even though they share common objectives. Professionals, who with their own opinion toward hierarchical importance within the organisation, are but a barrier to progress.

Recognition needs to be given to the real and present danger within health care. One [danger] so great that the power it wealds will lead to the conclusion of the self fulfilling prophecy, based on the negative implications, of a failing NHS. This danger to healthcare, and leadership within healthcare, is the short-termism afforded to financial savings imposed by accountants, on the behest of others.

What is required, is for NHS Trust boards to be represented by members of all parties with intrinsic and extrinsic vested interested in the provision of healthcare, each with parity of voice. 

NHS Trusts must be empowered to raise funds: but not held captive by the shackles seen imposed through Private Funding Initiatives (PFI); to facilitate long-term investment. There is real truth in the addage, “speculate to accumulate”.

NHS Foundation Trust Hospitals are in a position whereby they no longer have the facility, ability, to progress.

Dear Mr Hunt

Let us not beat about the bush.

Your attempt to save the National Health Service (NHS) £1 billion over three years, by way of capping agency spending bills, to re-invest in frontline patient care, is nothing but bravado in the face of a public who knows no better; and intimidation of hard working professionals who have to tread daily through sludge of government induced bureaucracy in order to deliver high levels of patient care.  To implement this aggressive policy at a time of year when individuals are at their most vulnerable clearly demonstrates the disdain this government has toward public sector workers.

Jeremy, the ignorance to the true potential of damage to health care demonstrated through your action is incomprehensible.  It is evident that there is already considerable loss of income across the NHS through the inability of hospitals to meet, in a timely manner, contracts with commissioning trusts.  On-the-day cancellations attributable in part to the inability of NHS hospitals to staff substantive vacancies with permanent staff; and a reluctance to employ short term agency staff, compound loss of income with the addition of  fines imposed by the commissioning trusts for failing to meet standards.  The perceived cost to prevent the cancellations, through the employment of short term agency, is an additional expenditure of small significance in the grand scheme of overall patient experience and outcome.

It must be asked Jeremy whether National Health Service Professionals (NHSP) ltd, an agency for healthcare professions set up by the Secretary of State for Health Alan Milburn in 2001; which was still owned in whole (all though not centrally funded) by the Secretary of State for Health in 2011, is included in your harsh opinion of, “agencies ripping off the NHS“?  In the very own words of NHSP:

We typically recruit more than 1,000 flexible workers every month, making NHS Professionals the largest recruiter in the NHS. http://www.nhsprofessionals.nhs.uk/nhsp/Pages/default.aspx

Is NHSP Ltd going to flourish through your anti-competitive attack on the private companies supplying agency staff?

Based purely on empirical data there is sufficient, substantive, evidence to be able to be explicit in saying the ratio of permanent staff (doctors, nurses, Operating Department Practitioners (ODP)) in post, on any one day, is far greater than that of agency.

Jeremy, if you are serious about making substantive savings in the NHS, remove the barriers of the internal market implemented by Thatcher post the Griffith Report.  Healthcare in silo’s creates financial waste.  Put some meat back on the carcass of a health care system made too lean by the blind followings of an inappropriate management system.

Regards

Richard

 

141f3438758a52b854f3e2219e2c8f1bFollowing the atrocities of Friday 13th November, witnessed on the streets of Paris, during which, through coordinated suicide attacks and shootings, one hundred and twenty-nine innocent victims lost their lives, there has been a collective outcry on social media to “Pray for Paris”.  Praying will not bring back loved ones: will not lead to justice, what justice is there to be had?  However praying may very well be the only path to solace people know to take.

There have been two particular comments which have appeared on social media, that have stood out for me, which  could have much further reaching influence; and which can direct us toward the path to peace.

The first, “When the power of love is greater than the love of power, the world will know peace.”  Whilst there is religion, countries will know no peace.  Religion is the politicisation of  faith and with politics the love of power will always prevail.  Rabbi Jonathan Sacks, Baron Sacks, makes a suggestion in his book, “Not in Gods Name: confronting religious violence”, that the God of Abraham was a God without faith: that Judaism, Christianity and Islam compartmentalized faith through interpretations of the word of God by man.  Compartmentalization creates a “them and us” situation, that in turn leads to the power struggles, the dehumanization of the believers of one faith by others, and the violence allegedly perpetrated in the name of God.  Lose religion, keep faith in humanity, nurture peace.  God is faith in humanity: not religion.

The second has come from the Dialama,

“We cannot solve this problem only through prayers,” the spiritual leader said. “I am a Buddhist and I believe in praying. But humans have created this problem, and now we are asking God to solve it. It is illogical. God would say, solve it yourself because you created it in the first place.” http://www.rawstory.com/2015/11/dalai-lama-stop-praying-for-paris-humans-created-this-problem-and-humans-must-solve-it/

We can solve it, we must stand side by side in solidarity and say, “NO MORE!”

We need strength to have that faith in our neighbour as he has in us.

Silos444pxThe Labour Party are as guilty as both the Conservative and Libdem parties when it comes the privatisation of healthcare in the UK.

Privatisation of healthcare, without doubt began with Margaret Thatcher’s creation of the “internal market” in the mid 1980’s, using recommendations made by Sir Ernest Griffiths, in his earlier report “NHS Management Enquiry”, 1983. The report implied that healthcare should be run in line with the practices incorporated within supermarkets; Griffiths’ background was director and deputy chairman of Sainsbury.

Within the microcosm of healthcare provision [hospitals], the effect of the internal market was to create silos: separate within the whole. Unfortunately, because systems within the existing NHS ethos were not not geared up to facilitate Thatcher’s ideology; moreover, non-NHS managers could not comprehend why their management systems could not, on the whole, work within healthcare, the NHS continued to flounder like a supertanker embedded on a sandbank.

The silo effect of healthcare provision has continued through successive Governments, Labour and Conservative alike. Therefore it is unreasonable for Labour to continue to argue against the privatisation of healthcare when they themselves have done nothing to prevent progression of the privatisation of health care.

Cameron, Clegg and Milliband, all in it together.

 

skeletal-debateIt is ironic that despite all the negative press given to the abuse of controlled substances, illegal or not, figures produced by the Office of National Statistics (ONS) suggest drug poisoning involving both illegal and legal drugs is on the increase.

Misuse of illicit drugs is not a new phenomena, we just have to listen to the tales from those who were present at Woodstock and the “Summer of Love”. The question that needs asking in relation to that era is, were the drugs cleaner in those days? How many celebrities from the music world have appeared to defy death through substance abuse. In fact, how many bankers, stockbrokers, and barristers partake in illegal drug use ( as reported in the press) and manage to lead relatively normal lives? Is it always the base drug which kills or the additives used to make it go further, and make the drug dealers richer.

Referencing data from the ONS (acknowledging their disclaimers), whilst drug related deaths in the UK are on rise in both male and female populations, the deaths represent an insignificant percentage on a whole. Though the loss of life is not insignificant.

Unlike the change in law to make not wearing of seat belts illegal, changing the law and misuse of drugs act will not, I believe, save lives.

It is long over due that society must take a step back, draw a deep breath, and ask where the heck are we going?
And for the time being we have to accept that people are not averse to risk taking. Children and adults today have enough information and sources of reference to make informed decisions; we should accept that is life.

skeletal-debateI really do not know what all the fuss is about…

Edward Snowden has confirmed what many of us already believed happens on a daily basis; by bringing PRISM to the forefront of media.

A self-confessed believer in conspiracy theories, I have embraced the digital age including mobile technology, and every risk associated with using it. Every day I run the risk of having my social media accounts hacked, virus’ covertly inserted my hard-drive and worst of all my wife finding out I have more than two email accounts.

We are already aware of the personal information that Google and Yahoo collect on users to target advertising; why not extrapolate this example to Governments. The activity of Google and Yahoo in my eyes is just as intolerable as alleged actions of the National Security Agency (NSA) in the United States, or the Government Communications Headquarters the United Kingdom (UK). But it is the price we must pay for advancing technologies: someone somewhere will find the technology to get what they want, when they want.

How do the allegations put forward by Snowden differ from intercepted letters, written by soldiers fighting on the front, were censured; or the interception of wireless transmissions? Okay, instead of discriminating against the few it is alleged Government agencies are indiscriminating against the many.

“Even if you are not doing anything wrong you are being watched and recorded”, suggests Snowden. Go to the garage and fill up, your car registration will be scanned and checked, to see if you have tax and insurance. Use your super-market loyalty card and they will know more about your shopping interests then you. My journey to work is 21 miles and I wouldn’t be surprised if the entire journey could be tracked. All this information can easily be manipulated to benefit the end users purpose.

Yes Snowden could have done something wrong, in as much as being in breach of the terms of his contract of employment. Whether this his actions are morally or ethically acceptable is not for me to say. But I suspect when the dust has settled there will be a T-shirt, a book and then a film.

For what else is there for us to do if we don’t like what we have heard about the alleged actions of these Government agencies? Quit the world-wide web…?