In recent years my wife and I have had need of health services due to increasing age and working parts showing signs of wear, with a greater demand than for the whole of our working life. This has led to my changing my attitude for NHS reform and the need for change, but not in the present approach.
After a working life in Industry on research, manufacturing and management, one is immediately struck by the different way of life. In Industry you have to make things happen by careful planning, organising and management whereas in the Public Sector there is the Manana syndrome, events and computers run people.
Things happen naturally at a slow pace and if left that way events do not occur or are much later; action and decisions are postponed, there are endless meetings, minutes and memos or now emails as excuses for the non-events, with the associated lack of responsibility.
In successful business, there are weekly action meetings at a non- disruptive time, progress reviews without the blame game, decisions made and everyone leaves with a clear sense of purpose and what they need to do, with little need of excessive and time consuming paperwork.
Also people matter and so does stability, if the workers are singing it is a good production day. The Government are trying to effect major changes, but at the same time they are fighting and demoralising the workforce¸ enforcing change without adequate planning and consultation.
The impression is one of instant cost driven hatchet work without planning or forethought, regardless of the consequences; there are redundancies, wage freezes, changes to working agreements, particularly pensions and general uncertainty and often little sign of progress.
Change is necessary, not some half baked idealism, but well thought out, planned and organised programmes, which take these essential services forward in an affordable manner, using fully the public and private resources available to meet the ever increasing needs.
The NHS is a good example, in order to break the Consultant/ Doctor and Trade Union power grip, a new strata of management was brought in from outside the profession and services contracted out, leading to an uncontrollable and disorganised system for which no-one was responsible, including Ministers.
Any contact or visit to a hospital viewed with an industrial eye can see the problems, overworked doctors and nurses, thin on the ground, long waiting times and the lost matron discipline, cleaner groups pushing dirt and germs around, streams of people moving around clutching folders and general chaos.
In spite of all this there is still a high degree of clinical excellence and devotion to duty, this should not be exploited or abused but fully utilised, putting GP’s in charge will not solve anything but only introduce another layer of confusion. Shared responsibility and trust is essential and good communication, now easier than ever.
Normal health care needs to be separated from self inflicted and accident damage, which should be fully charged for on Insurance, with health care divided into the various levels and responsibilities fully defined, liased and integrated with well defined communications, including charities.
Cost for the ideal system should be evaluated and decisions made on what can be or must be afforded without post code lotteries and the necessary money found, if we cannot afford a healthy nation then we are lost.
This approach applies to all essential services, whether education, police, fire, local government, social care or general services, we have to establish what we need, the cost and how we can afford it without waste and in the best manner possible using all resources including charities, unpaid carers and volunteers.
Certain costs are relative things, particularly labour, where the money circulates internally, becoming important only when shortages occur or by undue wastage particularly by unemployment in skilled, qualified labour and youth potential and losses overseas. . Good Pension savings offer a key to meeting elderly costs and funds for capital investment, in addition to adequate pensions.
We need to make things happen in a well ordered manner and the sooner the better
Annuities, Public Sector, NHS, Teachers, Police, Local Government, Hutton, State Pensions, Transport, Comment
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