Posts Tagged ‘infrastructure’

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?

Advertisements

 

Not a pothole in Shawforth

Over the past couple of years there has been substantive damage to our road networks across the county of Lancashire, and in Shawforth, attributable to the weather we have had. Which has been undoubtedly bad.  In the March edition of “Lancashire Vision: The newspaper for the residents of Lancashire”, Lancashire County Council (LCC) proudly boast of “New Investment”, which will see the investment of £81 million pounds in maintaining the road networks, lighting, and bridges in the county. This equates to approximately £5000 per mile of road per year; not taking into account the lights and bridges. Great, we will soon see our potholes disappearing…?

What the article in “Lancashire Vision” does not expand on is how LCC propose to address the issue of pothole repairs in the county and in what time frame. Obviously a quick fix would address the issue in the short term but would not be cost effective. To replace lengths of effected road would be more costly in the first instance, would take longer, but would last longer. As there appears to be no attempt to address the potholes in the far reaches of Lancashire, including Shawforth I guess, by the time LCC find us on the map, there will only be enough coppers in the tin for a quick fix anyway. It is not as though maintaining our roads to a reasonable standard will greatly affect the infrastructure to encourage economic growth in Lancashire; let alone boost the local economy in Bacup!

Although now twelve months old; an article, entitled “Why is snow so bad for potholes?”(http://bbc.in/gottQH), makes the suggestion that with current local authority budgets [January 2010] to address the backlog of pothole repairs in England could take approximately thirteen years, (Annual Local Authority Road Maintenance Survey, 2009). So whilst I selfishly wait for LCC to find Shawforth and start the long over due repairs to the roads, I will admire their efforts in encouraging economic growth in the rest of the county.