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News and Comment from Roy Lilley
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How are you going to vote? For 20 years, I was a Tory Councillor and a 'political appointment' when I took on the Chairmanship of a first-wave NHS Trust. All that was over twenty years ago. The monochrome days of John Major and the Euro-Fruit-Cakes finished me off. I voted Labour in the elections that saw Tony Blair swept into Downing Street. I stayed up all night watching the telly. I thought things could only get better...
Now, I have given up with politics. My preoccupation is the NHS and no one has a health policy that looks remotely like it's going to work.
World-wide, health systems have the same problems; too many patients and not enough money. It is the most difficult question all politicians are facing. What's the answer? Bigger hospitals, smaller hospitals? More treatment in hospital, or more out of hospital? Can hospitals integrate and become system leaders or are we looking for a local-led service? Stripped down, bigged up? Federations, chains, bigger is better, or closer to home. Do we mimic Finland, Spain, Netherlands or should we have confidence in what we are doing? No one has any new ideas.
Labour's Andy Burnham has just seen his health policy trashed by the other Milly-Brother. We await his replacement and a new big idea from Labour. I Googled 'Lib-Dem health policy' and got this advert for the Tories.
The truth is, pretty well any system is sustainable if we want it to be. That's code for 'pay for it'. Getting more, for no more, getting better for less, efficiency, effectiveness, productivity; it all points in the same direction... consolidation and money. No politician will say; 'we need more to look after more of you, for longer'.
The alternative is to do less. Rationing.
Thanks to the HSJ, yesterday, we were able to read the full horrors of what LaLite is planning next. The story appeared first in the �walled Times and later on PA. The HSJ (bless 'em) spelled it out for all of us:
"NICE has rejected government proposals that would see an assessment of the benefits a patient may have on society being taken into account when deciding whether to pay for new drugs. The advisory body dismissed plans by ministers that would see patients who contribute to the economy being given priority."
Shocked by that? I was stunned. Read it again; it is a step away from saying; if you are old or don't have a job, don't expect to be looked after.
"Under the government's proposals drugs that help older people live longer would be seen as having a "negative" social value because elderly patients take more from society than they can put back."
The head of NICE, the indefatigable Sir Andrew Dillon, told the DH and 'ministers' to shove their idea where the sun-don't-shine, as should all men and women of goodwill and conscience. The DH is populated by kids with lap-tops led by someone called Una O'Brien boss of strategy. Some boss, some strategy. I guess this 'strategy' is hers? I hope she never gets old. Given how the NHS is struggling and Tory health policy is unravelling I don't think there could have been a dafter, more stupid, idiotic, foolish, unwise, imprudent, irresponsible, thoughtless, irrational, crazy, ridiculous, silly 'strategy' for LaLite to put his name to. I have to say I am surprised at No-Man Lamb. They all deserve each other. Ignoring medical ethics, the EU Convention (Article 2) on Human Rights, 'the Right to Life', equity, fairness, logic, integrity, morals, scruples, principles and values LaLite might have a point... Uncle Fred might have had a 'good-innings' and would like a quiet exit but that's his choice not the decision of a spiky haired kid in the DH, a bozo strategist or a closet red-neck Secretary of State who has abandoned any thought of re-election. What were you doing in June 1983? It was election time. On June 7, two days before polling day, Neil Kinnock was on his way to a Labour rally in Bridgend, Glamorgan. During the journey he scribbled the notes for what is widely regarded as one of his best campaigning speeches. He warned his audience "... not to be young, I warn you not to fall ill, I warn you not to get old." The implication; cradle to grave, the NHS would fail under the Tories. He was Cassandra.
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Contact Roy - please use this e-address
[email protected]
Know something I don't - email me in confidence.
Leaving the NHS, changing jobs - you don't have to say goodbye to us! You can update your Email Address from the link you'll find right at the bottom of the page, and we'll keep mailing.
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Medicine for Managers
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Dr Paul Lambden
This is what I'm hearing;
if you know different,
tell me here
>> CSUs in Cheshire and Manchester and Mersey are merging. Do these organisations really have a future? >> Does anyone know what Una O'Brien does? Do we need her? There are 5 topic headings she is responsible for all inward facing; why does the DH need a 'permanent secretary'. What does it cost? Does the role make the NHS any safer, better? >> There are a few of us who can remember the Griffith's report - a reader sent this to me. It's from RG's Audit Commission Lecture 1991; speaking of management... "the introduction of an effective management process. I did not intend that the result should be yet another profession in the NHS, to work in parallel with the other professions." Ouch!>> I'm hearing the Flat-Earthers at the CQC are advertising a role for 'internal staff engagement' at �70k. Isn't that what we used to call good management?
>> Dentist friends tell me the Flat-Earthers have been trying to fine surgeries (4,000 of them at �4k each) for failing to nominate a 'registered manager'. Many of them say they have tried and got the evidence. Just thinking; �4k x 4,000 =�16m... the budget for registering dentists.
---------------Today's Larfwith
Martin Shovel
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