5th February 2015

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Health-Chat with Roy Lilley 

Dr Sarah Wollaston MP Chair Health Select Committee

11th March - King's Fund 5.30.  Details here.

End of the line
News and Comment from Roy Lilley

I've done the joke but in case you missed it; A Martian lands and says 'We'd like to copy your NHS, take me to the leader....' The little green man gives up and goes home. No one has any idea who the leader is.


The DH used to be in charge. The Carbuncle tries to make out it is in charge. Monitor can't figure out how much to charge, the CQC charge around like a bull in a china shop and the TDA... forget them.


I thought about the joke as I was reading about the Public Accounts Committee latest NHS bash. Margaret Hodge, the chair, says her biggest worry (really?) is NHS finances and points out; the proportion of NHS trusts and foundation trusts in deficit increased from 10% in 2012-13 to 26% in 2013-14. Her calculations are probably behind the curve; I reckon if the NHS had to balance its books tonight 2/3rds couldn't do it.


We are in a Kafka world.

  • There is not enough money in the system and Trusts are punished if they overspend.
  • They have to overspend to get staffing levels up to new 'safe' standards.
  • As there are not enough staff in the system they have to go to agencies to buy-in the same staff they once employed in the NHS, now at twice the price.
  • Many Docs and nurses don't want to work in the system because being an agency staffer creates flexibility and freedom not found in the consolidated ranks who are pressured, shoved around and the butt of everyone's ire.

Hospitals can't find enough staff and the CQC spend a fortune (that could be used on patient care), turn up with 80 people (who could be working in the NHS providing care) and say; 'You don't have enough staff, therefore this place is dangerous and we want new leadership'.


New leaders are found who hire more staff and overspend. Monitor (who spend a fortune that could be spent on patient care) turn up with an army (who should be working in the NHS) and say you have overspent and we want new leadership.


New leaders are found who balance the books by cutting the staffing levels and the CQC turn up and say; 'You don't have enough staff, we want new leadership'. The old leader gets the sack and .... around we go again.


If someone was I charge, would this happen? Would we continue to play this mad game of pass the parcel of responsibility? I don't think so.


The Carbuncle has to find efficiency, Monitor has to find a way to spread cash around the system and the CQC has to find fault. The DH has to find ways of pretending this isn't happening. None of them has to find a system wide solution. They exist to make life difficult for each other so they can say they are doing their bit.


I was thinking about all this when I bumped into Jane. I know her Mum; runs a scout group. I met Jane on the train into London. She lives in my neck of the woods but works in a London hospital because she gets paid more. She is a nurse; followed her Mum into a profession she loved.   Her Gran was a nurse, too.


'How you doing?'


I'm leaving...


A story of pressure, travel, anxiety, worry, exhaustion and rush unravelled.


'There is not enough money, they are cutting everything they can... not enough staff on the wards... unless the CQC turn up... then agency people come in and the managers come on the wards... give out the tea. I hate it. They all run around like headless chickens.  No one is in charge. There's no time to do anything properly.'


'What are you going to do?'


'I've got a job at the Meadows'.


...a huge shopping centre. Jane, will earn more, with family friendly hours and a discount on food and clothes. M&S is her new employer.


I looked at the pale, exhausted youngster in front of me. Her blue eyes welled; 'I don't want to but... we want to get our own place and start a family... and... I don't know how I'm going to tell Mum...' Her voice tailed off and she sunk into her brown scarf and puffa-jacket.


The train pulled into Waterloo. The end of the line.  


'What is the point of a select committee' come and join me in conversation with Dr Sarah Wollaston MP, chair of the Health Select Committee.

 Kings Fund 11th March - details here. 


  Contact Roy - please use this e-address


Know something I don't - email me in confidence.

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Dr Sarah Wollaston MP
Chair Health Select Committee
In conversation with
Roy Lilley
11th March - Kings Fund
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