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The NHS MUST be reformed after COVID-19 so that front line and clinical staff are valued as they should be whilst universal health provision for all remains something our Country can afford

April 13, 2020 2 comments

It is at the pinnacle of a National Crisis and not after the event itself that the most pertinent questions should be answered about how supply chains and service provision can be improved to ensure that the national response to the same thing happening again is future-proofed.

So much effort within, on behalf of and supporting the NHS and it’s staff is being expended during the COVID-19 Lockdown, that many people including the Media and our MPs too are failing to allow room to think about the lessons that should already have been learned.

From the responses to appropriate comments and questions on social media, that much is sure.

It is now essential for the Government to ensure that the future of our universal healthcare service for all is safe and that we can all be confident that in a time of a future medical crisis like there is with COVID-19 now – should a pandemic or similar be repeated – the Country will find it much easier to cope.

NHS Staff are doing the best that they can with the resources and the support that is available.

But the time it has taken to put resources like ventilators and PPE in place, the need for the recall of retired and specialist staff who had let their registrations lapse and the suggested need for the whole country to acquiesce to a Lockdown in order to ‘Protect the NHS’ speaks volumes about the problems that already existed within the NHS before the Coronovirus Pandemic began.

We must all ensure the Government is compelled to both consider and act upon these supply and resorting issues immediately and appropriately when the COVID-19 Crisis is over and done.

If the real and underlying condition of the NHS is not considered in this way now, the lack of political will to deal with real problems unless they are under the media spotlight will ensure that nothing like the change that has been necessary for a very long time will ever get done.

Don’t be deceived into thinking that the money and resources that are being thrown at our hospitals now without limit will make a difference to the Nurses, Doctors and health workers in the long term. It won’t.

The NHS has institutional and cultural problems that cannot simply fixed by providing the Health Service with more money at a rate that is neither sustainable or at a cost that the Country can actually afford.

What the NHS needs is complete bottom to top reform.

Comprehensive reform is the only way that real value can be given to frontline clinical staff and their support – both in terms of what they earn, the responsibility and influence that they have and the support they have from the Government and the Public Sector.

Money will never work as a genuine solution to the problems that the NHS has, even if it looks that way, because more money will simply maintain the service in the state and condition that it currently is. And the NHS is not a happy place to work.

What we have learned and are now likely to accept is the people who do frontline jobs in services such as the NHS, healthcare, waste collection, transport and working in supermarkets too all have roles which are just as important to our lives and existence as any celebrity, football player, company CEO, journalist or politician – if not more.

Everyone has a big part to play in making the wheels of the Country turn. Not even bankers are the untouchable gods that they would like us to believe.

WE ARE ALL THE SAME. WE ARE NOT AND SHOULD NEVER BE DEFINED BY WEALTH, JOB, INCOME OR ANYTHING ELSE THAT MAY APPEAR TO MAKE US LOOK DIFFERENT TO ANYONE ELSE.

The Government must now take steps to ensure that REAL value is attributed to NHS Staff not only financially, but in the public policy and measures that the Government can take to support ALL people who are currently underpaid in relation to what it costs to live.

One of the most ridiculous things that I have read in recent days was that an advert had gone out from one particular Health Trust to employ a diversity officer at about twice the wage of a frontline NHS Nurse. This kind of stupidity in the management of political correctness applied in the workplace represents everything that is wrong with the NHS today. It has to stop.

This is part of a massive problem that the Government can and should be tackling head on.

Things that the Government should do include:

  • Placing a ban on the use of agency and contract staff to fill frontline NHS roles to be enacted within 18 months
  • Placing a ban on the outsourcing of management work to contractors, freelancers and consultants to be enacted within 12 months
  • Management of all operational functions to be placed back in the hands of experienced clinical staff
  • Rescind the European Working Time Directive and replace it with legislation that allows each individual to work the hours they choose to, providing their doing so will not put others at risk and that they can only work hours above those they are contracted to do so as a personal, non-coerced choice.
  • The creation of a parallel extended vocational route (a genuine apprenticeship or time served route) to degree qualification as a Nurse for non-academically inclined candidates
  • The cancellation of tuition fees for Nursing, Medical and other NHS-related undergraduate degrees for academic candidates
  • GPs, Drs and Consultants who leave the NHS after receiving a UK education and on-the-job training with the NHS to be required to undertake 10 years service in their post-trained NHS role after the completion of training before they can ‘go private’
  • That any employee transferring from a commercial sector role be required to undertake a minimum of 6 months clinical operations experience before being able to take up their new NHS role, unless they have gained worked within the NHS as a full-time NHS employee within the preceding 5 years.
  • That no Public Sector employee should receive bonuses for carrying out the function that they were employed to undertake.
  • All purchasing to be carried out for the whole network by a centralised service with ordering only carried out at local level
  • The NHS ‘internal supply chain’ to be managed and operated by the NHS and not contracted out to external suppliers
  • The cancellation of all existing PFI arrangements
  • Removing the ‘right to sue’ from anyone who has not directly paid for NHS care in the event of something ‘going wrong’. (Directly to include those receiving private treatment on a private healthcare policy)
  • Set up a specialist NHS Adjudication Service to make judgement on any negligence claims from patients who have directly paid for treatment
  • Setting a basic standard of living level, ensuring that the providers of essential services such as utilities are either in public hands or run on a strictly not-for-profit basis and resetting the property market to ensure that standard housing is affordable to all.
  • Remove the ability of Unions to call strikes or any kind of industrial action
  • Set in law the requirement that the CEO of any health trust cannot earn more than 10 times the wage of the lowest paid member of staff in the trust – including any enhancements that come with the role.
  • Pensions to be brought in line with general requirements
  • The changes made by Gordon Brown to Pension Funds in 1997 to be reversed

One of the most important requirements of successful change for the NHS and equipping our Hospitals to be prepared for all future events is the acknowledgment that the NHS does not stand alone.

A significant number of people work professionally within the NHS and its supply chain. But by its very nature as a public service, the NHS and the people who staff it are effected by Public Policy right across the board.

It is therefore essential that the Government no longer treat the NHS like it sits in an isolated bubble – just as people outside of it understand Westminster and everything political to operate..

What the Government does for or to the NHS will have an effect on other public services and industry, just like what it does for them will affect the NHS too.

Some of the changes that need to be made are specifically related to the management processes within the NHS. But not all of them, as there are many more.

Identifying and implementing policy for the NHS and its staff that overlaps with other areas of life is beyond essential.

Without it, the next time we need the NHS just as we do with the fight against COVID-19 today, it will have long-since been placed in critical care.

 

 

 

 

 

The Government is forcing us to fear life as if it were the same thing as death

March 21, 2020 1 comment

img_5361Friday was a very dark day for this Country.

Journalists, activists and supporters cheered on Boris Johnson as he effectively closed down life for any other purpose than to facilitate work that cannot be carried out from home, or for making what has become a futile attempt in recent days for many of us as we attempt to service basic human needs.

Meanwhile, the Chancellor succeeded in convincing the party faithful that a half-hearted attempt at addressing the financial problems people now face would be beneficial to everyone. In fact it prioritises only the needs of some without coming anywhere close to answering the real questions for them or anyone else.

Many others were simply bypassed by the big words of this written-on-a-fag-packet strategy altogether, when what could and more importantly should have been a working plan to treat everyone the same and as an equitable cause was simply not considered at all.

What many of us are missing as we watch the endless streams of news and what has quickly become the media-driven 24hr Coronavirus Show, is that these Politicians are not in charge of what they are doing, nor are they successfully meeting their real obligations to the people who elected them and put them in office in any thought-through way.

Whilst they would like us to believe otherwise, the Politicians making the decisions today are human beings who like most people outside of Westminster are actually very afraid.

The problem with this form of leadership is that fear is no leader when what is called for to genuinely help others is the ability for them to be strong.

Our leaders are not leading. They are being led by fear themselves, and that fear is leading them to make decisions that have already or soon will become an overkill that really hurts a lot more people across this Country than it could ever really help.

The Government and the people advising them are more afraid of getting a few very specific things with healthcare wrong, when they should be a lot more afraid of not getting everything else about this Crisis right.

There are some cold and harsh realities that we all must face about the Coronavirus itself and what the reaction of the Politicians, the State and the so-called specialists working alongside them is going to do.

None of them are particularly nice.

Key in peoples minds will be the tragedy unfolding in a very personal way for the people who have and will continue to die. It’s horrible, but the media focusing on individual cases non-stop as they are doing is making the whole experience for everyone else unnecessarily much worse.

Next will be the toll that dealing non-stop with Coronavirus in our hospitals will be and what the exposure to that will mean for the longer term mental health of those who were already working on or have volunteered to join the front line. This is the job that they have trained and committed to doing and keeping this in the forefront of wider perspective is what will keep the wheels turning.

However, the one reality that we should all wake up to, be most concerned with and understand today is the one that nobody is talking about. The one that unlike Coronavirus does not have the capacity to go away. The one where the Government is prioritising the fight to prevent the most vulnerable in society from possibly dying prematurely at what is the disproportionate cost of denying everyone else the ability to have and maintain any kind of normal life.

Yes, we are hearing horror stories from Italy and from other places around the World about infection rates and the related number of deaths.

But we have no guarantee that the potential for any of that to happen here will be mitigated by shutting down the country just to facilitate what could be a delay.

What none of the medical people, specialists and experts can tell or rather guarantee any of us, is how long Coronoavirus will be here and how long social distancing will remain their only solution in what will surely be an ongoing and what will soon feel like a permanent process of temporary delay after temporary delay.

Indeed, on the basis of what they are telling us, the duration of this social lockdown will actually need to go on for as long as it will take to exhaust the spread of the virus throughout the entire population, or alternatively to create a vaccine, test it, produce it and then vaccinate everyone, or which ever will be possible to achieve first place without any further or unseen delay.

None of this advice being given is based upon real numerical facts. Even if it was, that advice would be or is subjective, is based only on the management of critical health care and does not take into consideration any of the wide-ranging impacts, consequences and knock-on effects for people, businesses and society as a whole that an unmitigated focus on being able to provide ventilators at the time that everyone might need them has already began to cause.

We already know that our leaders are thinking the time their policy of social distancing will take to keep the need on any day for these resources, managed by the pathway of time, is likely to run into many months. As such, it could easily become a period of years.

Meanwhile, the Country is set to fall apart on nothing more the basis that because Coronavirus is new and has a name, it is somehow more important and therefore must be treated differently than the significant number of deaths we have in this country each and every day or every winter when the figures for deaths from existing conditions such as seasonal flu alone are typically already much worse.

The reality that we all must face once we have been conditioned to it and matured is that this life ends for every one of us in some way, some day.

This whole crisis and the decisions that Politicians, Advisors and government officers are taking right now are already affecting and are about to take over our lives both today and for the future.

They will do so based only on the premise that we should listen to somebody with a title without question, whilst they are themselves motivated by fear of something even they don’t fully understand, and are taking little more than a guess about how only the things they are responsible for in isolation might turn out.

What is more, the number of people that this unproven and best process of guesswork might save from an early death is likely to turn out significantly smaller than all the hype being peddled by our irresponsible media would suggest.

The consequences of shutting down this Country, the economy and all of our lives simply as a strategy so the NHS can cope will inadvertently kill, destroy lives and create a level of hardship for a number of people that will go way beyond – if not actually totally eclipse the number that this fear-driven escapade on the part of people driven by their fragile egos will ever save.

Yet the deaths, the suicides, the life-long mental health issues, poverty, hardship, the destruction of relationships, safeguarding issues and many other forms of malaise and negative knock on effects for individuals and families that the choices the Johnson Government is going to create by shutting down businesses, our lives, our incomes and our ability to pay the debts that they have done nothing to keep at bay, will never get mentioned or championed by these same Politicians in any way.

Yes, Coronavirus kills. But death is an inevitable end to this life and other diseases, conditions and factors will always kill more.

The fear of our Politicians and the stupidy and self-serving nature of the media that leads them has turned a drama into a crisis, simply because they have been able to give the fear that they thrive on a name and through their words and actions have given it the power of being like a flip side celebrity cause.

The misery that their ineptitude, ignorance and incompetence will cause to many more than will ever die from Coronavirus is an uncomfortable subject that the establishment will wilfully fail to recognise when any individual brings a story of real life misery to their door that might uncover the horrid truth about how those in power operate whilst exposing their many flaws.

The real fear for us should not be Coronavirus.

Our real fear should be our politicians and the people advising them because they are out of their depth.

Through the actions of shutting down our lives and making us dependent upon everything they say and do, we are together and collectively being coerced into behaving and therefore believing that it has become normal to fear living in the same way that we are conditioned to fear death.

Leaders who are afraid of their own shadow will not easily relinquish the control which their fears have motivated them to take at a time when they were trusted because they believe they will continue to keep them safe.

In the weeks to come and as the inequity and self-serving nature of their thinking becomes more apparent and as it becomes clear how their inept plans are going to turn out for everyone, people are going to realise just how over the top the dysfunction of this wholly avoidable shutdown of our lives really is.

As things like the parts run out to keep the lorries and ambulances running that they are telling us will keep us all safe whilst everyone is shut down, and the flawed concept of social distancing remains the only political parable that exists, people are going to realise just how draconian and out of touch with the hard-hitting realities of the wider and wholly avoidable Crisis they are creating alongside Coronavirus that our current Government and the thinking of the MPs around them really is.

None of us really wants anyone else to suffer.

We certainly don’t want anyone to prematurely lose their life.

But the reality is that we are all being forced to sacrifice our lives and peace of mind for little more than a cause that has value because it has been a name and therefore a face.

The response of the Government and the specialists to Coronavirus is going to damage and destroy much more for us, our Country and our future indirectly than it is ever directly going to save.

The only genuine protection for the NHS is meaningful reform

November 9, 2019 Leave a comment

red-herringFive weeks until the General Election and there’s so many red herrings around, you could be fooled into thinking our MPs are trying to sell us a smokery.

The biggest pool of them all surrounds the Labour-led debate over privatisation of the NHS – a topic which is a continual source of dishonesty for the Labour Party, the Conservatives – now the SNP too, and very much a political ball.

The issue was in many ways fuelled by the recent Channel 4 Dispatches Documentary about big pharma and the USA’s probable attempt at assault on the way that the NHS buys drugs as part of a post-Brexit Trade Deal with them.

However, what Labour’s push of ‘we are the only Party who believes in the NHS’ fails to so spectacularly address is the real level of the problems that exist within our National Health Service, how those problems became manifest and have to be addressed, and how fire hosing money at this Public Service might keep the wheels turning, but in the long term it will not save the NHS and in fact could be making all of  the problems significantly worse.

The principle of the NHS is a very good one. We should ALL continue to have access to free healthcare at the point of access. But we cannot continue onwards thinking that its existence can be assured in the future simply on the basis of how much We spend.

Privatisation in its most literal sense is – on the face of it – a very big part of the problem of cost attribution within the NHS today. So for Labour to even suggest that they can stop privatisation when it is already present, is either disingenuous on their part, or demonstrative of their ignorance of how the service actually works.

Many of the problems with cost have come about because of deals that the Blair and Brown Labour Governments constructed under the guise of PFI. Others have snowballed because of the cultural steer towards the use of private contractors or consultants to undertake backroom management functions and the excessive use of temporary staffing agencies that were never required before all good sense in employment laws and conditions was excessively overstepped and the door was opened to unbridled levels of profit making which has gone on for so long now that it is simply the way rather than individual choice.

Fixing this problem so that the NHS once again becomes sustainable isn’t easy. And with politicians who don’t even understand how it all works, real or meaningful reform is not  even currently on the agenda, let alone being a political choice.

The MPs that we have had, their Parties and the People who lead them have no incentive to really get to grips with what is really going on. Their lack of knowledge and understanding is self evident each and every time they are interviewed – which during an Election Campaign is pretty much every time that we turn the radio or TV on.

Until this changes, none of the problems that we as People within this Country face will be dealt with.

Yet we don’t even have the option of Political Parties or Candidates on 12th December who even have an idea of what is really going on.

 

image thanks to unknown

NHS and the predicted £30 Billion deficit: It’s time for change, but change is about much more than simply saving money

A NHS sign is seen in the grounds of St Thomas' Hospital in London

You can’t really help but admire the audacity of Sir David Nicholson, the outgoing head of the NHS, for his latest attempt to sidestep and cover the tracks of his questionable tenure by shining a light on what could become a £30 Billion deficit within the NHS.

His failure to fall on his sword over the Stafford Hospital outrage was beyond what many will agree as being in good taste and was compounded yet further by his indignant refusal to accept any form of responsibility, despite being the Executive Officer at the very top of the tree and arguably placed within the one position where there simply is nowhere to run or hide when it comes to carrying the can for mismanagement on what appears to have been an unprecedented scale.

The most regrettable facet of this latest twist is that the lack of respect which Nicholson holds with people now will surely deflect attention away from the cold reality of his message, which in a perhaps more capable set of hands would have not only been brought to public attention much sooner, but effectively acted upon too.

Many of us already realise and understand just how serious the problems throughout the NHS actually are. In local politics, where we closely scrutinize the real-world impact of ward and department closures; the centralisation of services, and the amalgamation of GP’s practices into so called ‘community hospitals’, there has been little doubt for us all of the real purpose of such changes for a considerable time.

Cost aside, the principles upon which the National Health Service were created and the application of universal care are still however very much valid even today.

But it is the continued compromise of those very principles at their heart which has led to the seemingly insurmountable financial and management problems that we face today.

These were principles that were intended to prioritise the care of the end-user; not the interests of managers, union leaders and politicians, who have all had something to gain at various points by moving those priorities elsewhere; often at everyone else’s cost.

Any commercially run business or ethical organisation is created and run to efficiently provide a particular product or service to its customers. It is not created or subsequently evolved to disable itself by prioritising the working conditions of its workforce and certainly not run for the benefit of harvesting statistics as part of some politically expedient mind warp which is simply designed to spread the message that things are running far better than they actually are.

Tragically, this is pretty much in a nutshell what the NHS represents today and evidence would suggest that people are dying needlessly as a result of it.

It’s not as if health professionals are oblivious to the realities of the situation either. Talking to a career nurse only a few weeks ago who freely admitted that she had been a lifelong socialist and Labour Voter, even I have to admit to my surprise when she clearly told me ‘Adam, I love the idea of socialism and what it stands for; but in my experience, it simply doesn’t work’.

Herein lies the greatest problem with the NHS; Its culture.

The culture within the NHS is the base issue which much be faced, understood and addressed if the Organisation as we have known it and the services that it provides are to be saved and our society is to be protected from the arrival of either tiered health provision across the board or UK-wide service which is only made available to those who can pay as they use.

Right now, we are all witnessing the preferred method of dealing – or I should say – avoiding reform throughout the NHS, NGO’s and the tiers of Government, which presents itself in the form of privatisation. Privatisation of any Government funded service has arguably become nothing more than avoidance of the need for reform at its worst because services are never the same when profit is the master. Furthermore, recreating public-run services once they are lost will be a whole lot harder than the reform which most Politicians already seem to see as impossible.

The only way we will keep and maintain the NHS as we have known and appreciated it in terms of what it offers the public will be the result of transformation and change which must begin with Government and work its way right the way through.

The NHS is strangled by the culture of workers’ rights, tiers of managers who barely understand what practical patient care is, Europe and the rise of the blame culture, where practitioners are increasingly forced to consider the bureaucratic pathways to treatment first, before addressing the urgencies and acuteness of clinical need. Ironically, such delays may of course be little hindrance to treatment for the people who will be looking for an opportunity to sue them either.

Government must act now to change and support the whole working culture of the NHS and put patient care back at the forefront of everything they do, rather than putting everyone else and the profit hungry ambulance chasers first.

It’s not an easy job by any means and most of us do appreciate that. But Governments get elected to take responsibility for big problems just like these; not so they can talk up the delivery of results when what they seem to be doing is looking for the easiest way out of problems they just aren’t responsible enough to face.

The patients of today and tomorrow don’t care about statistics or the money that providing treatment costs.

What they do care about is trusting that they can rely on getting medical help when they need it; where they need it and without worrying whether or not they qualify for it. Every day, the number of people who simply don’t have that trust are growing rapidly, and each new day is a sorrier one than the day before.

If Government keeps treating the problems in the NHS as if they all revolve around money, the cost of running the service will probably lead to its end.

It’s time for change throughout the NHS. But real change is about much more than simply saving money.

image thanks to http://www.channel4.com

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