Hoppy

Anybody see last night's documentary on NHS inefficiency (9pm BBC2, by Sir Gerry Robinson)? Very insightful. In a few short metings, he cut waiting times for kids from eight to two weeks Does he work miracles, or simply apply common sense?

It seems that hospitals are run by the Consultants with a ridiculously old-fashioned hierarchical (and selfish) system. Half the threatres are sitting empty, and nobody works Friday afternoons. Schedules for ops bear no relation to the time needed (or not, as in some cases). Managers have almost no influence. One consultant took the law into his own hands, introduced his own system within his highly motivated and dedicated team and got though twice as many ops per day!!!

I was personally struck by this fact by a recent spell in hospital - I was bewildered by the complete lack of communication and coordination. I thought I was just unlucky Ended up paying private for some excellent care.

Did anybody else feel an overwhelming urge to give (almost) every Consultant a massive kick up the ****? They are all very well rewarded and do brilliant work. But In private industry, they would not last five minutes.

I'm angry, and due for a hip op next week (if it's not cancelled again). Only been waiting ten months...

Richard.

mart360

Change is what most people in any industry fear,

Ive been in a few company's that were dinosaurs, we were brought in to change them, but when they saw the size of the problems they had, following our reviews and audits, they baulked. they made us all redundant and went back to what they used to do......last i heard they were looking for a buyer!!

I heard once that a suggestion was made to run theatres U.S style, with the surgeon going from theatre to theatre carrying out the same / similar ops over and over again.

Again our dinosaurs baulked and nothing happened.

No one said it would be easy, but throwing money at problems dosen't solve it, it justs gets spent on kudos projects...

get some real troubleshhoters in, empower them, scrap targets, and strip the pen pushers..

The only reason, they have targets, as its a way of showing that something isn't happening.. if its run correctly, they dont need targets, they have results!!

Mart

Matteeboy

I found it shocking - Consultants are paid massive salaries yet seem obstructive, lazy (in some cases) and downright grumpy.

Four and a half day week actually working less than half that day for probably over £100k a year.

Hmmmm....

jasey

Privatise it.

Problem solved in 5 years.

If the NHS where a country it would be the 36th biggest in the world - or something like that !!

speedking

Looking forward to tonights second episode. Very reminiscent of John Harvey Jones, the troubleshooter.

Consultants blame nurses, nurses blame anaesthetists, anaesthetists blame managers, managers blame consultants, ...

Mind you, I wouldn't like to be operated on by a consultant being paid on a piecework basis. It's well known that when you reach a target it just gets made harder, timescale shortened, budget slashed, staff reassigned.

powerman1

Just recovering from a broken wrist and i have to confess that from arriving at hospital everything seemed pretty good and the operation the next day was credit to the surgeon but from there on things seemed to go a bit downhill...no one gave me any info on physio and what the best way to excercise the joints etc and the ward i was in only got a quick sweep once in five days When i went back to have the pins etc removed 5 weeks later according to the consultant i should have already have been recieving Physio.
http://i6.photobucket.com/albums/y23...1/DSC01237.jpg

mart360

bet you cant wait for a good ****:


mart

powerman1

Id take you up on your offer but the wife wont agree,..thanks anyway

kingofturds

iTrader: (1)

What do you do if you break both wrists

powerman1

SCREAM

porkerboy

Absolute rubbish mate.

Consultants work very very hard - especially surgeons and other specialities that provide 24 hour on call cover.

£100k - for medical school, at least 10 years post graduate training and more exams/qualifications than you can through a stick at, is not unreasonable - in fact they are underpayed.

Matteeboy

Porkerboy - Perhaps I should have added "the program portrayed Consultants as..."

It's obviously shock tactics to get viewers in and I'm mature enough to make my own mind up (I think medical consultants are the only profession qualified to call themselves "consultants" in this day and age where anyone uses and abuses the term) but it didn't portray them in a great light.

Take it you're in the profession?
I know lots of medics from Bristol Uni.

_Meridian_

iTrader: (1)

The whole point of the problem is that the consultants ARE privatised. The system relies on them, but the NHS has no power over them because if it tried then they'd all leave to go private completely, rather than the 30% private or so that they currently do. When the NHS was set up they were the principle obstacle, and were basically bought off (they were told that they could keep their private work) - look up "I have stuffed their mouths with gold".

So how exactly would privatising the rest of the service help?


M

GC8

Negotiating the consultants deal with the BMA held up the creation of the NHS by two years!

Varboy

underpaid by the NHS maybe, but they can certainly make up for it elsewhere through private work

Varboy

one problem that the NHS suffer from is that the government (who is ever in power) are continuously changing the goalposts depending on political flavour of the month, so as soon as the staff get used to one set of targets and goals, they are changed before acomplishment.

Like many large organisations, efforts are often siloed with no helicopter view to ascertain what effects one initiative will have on another 'part' of the organisation.

The way to cure the ills of the NHS (IMO) would be to remove goverment control, but is that ever going to happen???

Deep Singh

Thank god for some sanity.

James Neill

iTrader: (1)

Thought it was a great programme. It was made so obvious what the problems are. It beggars belief how so much money has been spent tinkering with things round the edges over the last few years without addressing fundamental problems/challenges that are obvious to all.

I know we love to debate who is at fault. But that hardly improves things. So who do you think needs to play a part in the solution and what might the solution look like?

I do think part of the answer is in privatisation. But the challenge will be how the government demonstrates appropriate oversight on those providers so that we (the public) are comfortable with the balance struck between profits for providers and duty of care to patients.

Hoppy

Not sure privatisation is essential. More a reversal from management down to management up would be a big start. Those on the shop floor always know best. The skill is getting them to tell you. Asking them is a good starter

I could waffle about this for ages, but in my company (4,000 employees) the whole enterprise is broken down into small manageable units.

When I was a middle-manager, I had about 25 people under me, and absolute control. All great people BTW, which helps. If anybody had a good idea, it would get discussed the same day and implemented within the week. Everybody got a huge buzz and success rolled on.

I was called to account in regular formal meetings, and bollocked by finance for over-spending, but since the bottom line was up WGAF (If it wasn't, I'd have been in deep poo, though.) Success is a wonderful motivator; disappointment and frustration is a downward spiral.

That NHS Chief Exec chappie on the TV prog is the least inspirational manager I seen in a long time. He has no charisma, is terrified of confrontation, and most of his hospital staff don't even know who he is. What does he do? With due respect to the guy, who the hell appointed him

Richard.

Midlife......

iTrader: (2)

OK

I'm a Full time 5 days a week NHS Consultant running a service for the population between the scottish borders (scotland) and the border with Lancashire......my total budget is probably £150K for a half a million people.

I get paid probably £40K less than the GP's in my area.

Which private company would like to take over and make a profit ??

Midlife.....

As Porker boy says....it took 12 years plus to train me to do my job, I do no private work as I'm innundated with my NHS patients

jasey

Well throwing money at it hasn't helped.

The "market" would sort it out.

oh - and as an added benefit all the chav scum would die

scoobynutta555

Privatise the whole thing and make people take out medical insurance. 3rd largest employer in the world, give me a break!

Watched the programme last night, all that fannying around for the simplist of solutions. The whole system is cockeyed, it gets even worse with PFI.

Matteeboy

Last nights program made me cringe!

Why is it with anything government related, so much time and money is just thrown away?

The Chief Exec is the epitome of a government worker - All talk, no action, hidden away in his little room.

The Consultants were put in a much more positive light apart from that gimp that said "some of us have five or six degrees but are being managed by people with three O levels" - WTF?!! Some (and a very small "some") and I say this very carefully, medics do seem to think they are the cleverest people in the World.

jasey

Pretty much every consultant I've ever met seems to be in a "I can get my head further up my **** than anyone else" competition.

I spent 7 years socializing with the ****** !

You do get the odd nice one though

MattW

Does seem a lottery, my youngest was seen last week by the ENT consultant (glue ear) who advised grommets. We agreed and she went on waiting list. Had a call Monday night and they were done yesterday.

TelBoy

The past two evenings' programmes have demonstrated more clearly what's wrong with the NHS than any 500-post thread on Scoobynet ever can. If you haven't seen either of them, i urge you to tune in for tonight's final episode.

The NHS is in a parlous state. Management, such as it is, is woeful. Dire, in fact.

Anybody who is prepared to say that Labour have done a good job with the NHS is fooling themselves, and that's being kind. Education isn't good enough for Ministers, the NHS isn't either. The whole thing either needs to be abandoned completely or tackled by people with the resourses and empowerment necessary to make REAL changes to what has to be one of the biggest embarrassments for this or any other post-war UK government.

David Lock

An interesting programme. The CEO came out in a very poor light IMHO. Didn't even bother to wander around and make himself known to staff. Talk about Ivory Towers!

And what do you do about a consultant who is out-of-date and uses GA for operations when the ops could be done with modern locals which are safer and take half the time. Answer: send him on a refresher course or put him out to grass.

And all that wasted empty theatre space..... I bet there are plenty of competent EC surgeons who would be prepared to fill in the gaps at unsocial hours if need be.

It struck me that smaller hospital units might actually be easier to run efficiently and be more accountable. dl

Matteeboy

Did I hear Gerry R say the NHS is the third biggest employer IN THE WORLD?!!!

Or did I hear it wrong?

Good thing about the program is that it not only shows what the NHS is like,it also gives sound business "advise" - Gerry Robinson seems to be a rare leader who doesn't feel the need to shout and patronise - His patience and positivity are amazing.

Agreed though - Labours big selling points were Health and Education, both of which are buggered beyond belief.
Yet an awful lot of people are making big bucks out of the **** ups.

Seems wrong to me.

scoobynutta555

Yes, third highest employer in the world, it really does beggar belief. The amount of waste must be unreal, billions and billions of money must be spent on wasteful multi layers of management within each hospital.

Seems that more and more money is being spent on wage increases and unneeded management than at the sharp end.

I can see no argument against privatisation and compulsory individual insurance. Might as well bin social security while you're at it for people on the dole above a certain time too. You'd probably be able to make a 15% flat rate tax with all the savings. Not that any of the opposition parties have the ***** to be radical thinkers these days, so expect no change from whoever is in next.

Matteeboy

Surely they could ditch/reduce NI payments (which are massive!) and then us public could use that for insurance?

I think only privatised hospitals competing for "customers" money could work now.
I'm sure a vast amount of money wasting waffle would suddenly disappear.