A Hard Look at the Cancer of the UK NHS – John Gelmini


NHS BMW RRV (Photo credit: kenjonbro)

The exchanges in the House of Commons were unedifying because the NHS has been unfit for purpose for years, possibly as far back as the 1970s in the days of Jim Callaghan.

Under Margaret Thatcher, attempts were made to reform the NHS via competitive tendering, PFI and money following patients with a purchaser provider split to drive down costs but even under her the number of managers in the NHS grew by 189%.

In addition, the problem of NHS consultants deliberately creating waiting lists to build up their private practices was not addressed effectively and the drug companies were free to overcharge the NHS with the NHS’s procurement practices remaining in the dark ages.

Subsequent attempts were made to reduce the explosion in the numbers of managers but most of them came back in Lazarus like fashion as interims and consultants on even more money than before so there was no real reduction in overall numbers.

After Margaret Thatcher’s removal from office, following a decision at a Bilderberg meeting made in 1991 when Kenneth Clarke a member of that organisation’s steering committee delivered the coup de grace, the new “heir apparent” to the Prime Ministership became Tony Blair. Under him, various reforms were tried but once again the civil servants and his Ministers were outflanked by the BMA, the consultants, COHSE and the mendacious NHS managers whose numbers increased by a further 225%.

In previous posts, I have mentioned the Gordon Brown/Wanless Review which sought to solve the problems within the NHS via targets and a further £7 billion gbp. All that money was consumed in higher wages and higher NI contributions and productivity, already very low, fell by a further 5%. On top of that 20% of the entire NHS budget goes to lawyers,  payoffs to sacked employees,  gagging orders and insurance.

Under the previous Labour Government, there were many PPP/PFI deals which were totally one-sided and benefited the private sector contractors. Some of these were so badly negotiated that one would have to conclude that there was either widespread incompetence on the part of civil servants and the NHS,  or perhaps even another worse explanation.

We are now under the Cameron/Jeremy Hunt regime; David Cameron having failed to back Andrew Lansley and having failed to renegotiate the disastrous out of hours contract which the BMA achieved at the expense of everyone in the country – this time due to the incompetence of civil servants, many of whom Sir Jeremy Heywood (the Head of the Civil Service) has publicly branded as lazy.

The revamped Cameron reforms of the NHS designed to produce £20 billion in efficiency savings by 2015 will not do so because, once again, the NHS Chiefs and managers are gaming the system.

Between May 2010, when the Coalition came to power, and September 2012, 2,200 NHS staff were re-employed by the NHS following redundancy – a new form of “revolving door”, in which as one wag put it, “You go to someone’s leaving do, then a few weeks later they’re back.”

Since 2011, 1341 NHS employees have received redundancy payments of more than £100,000 gbp; among them 438 who received £150,000gbp or more, and 173 who received in excess of £200,0000 gbp. Examples of those who left only to come back for more include Sir Neil McKay, who left with £1 million gbp having been CEO of Midlands and East Strategic Health Authority and Derek Smith from Hammersmith Hospitals NHS Trust who left with a 6 figure payoff only to reappear at Leicester NHS Trust for 6 months at £205,000 gbp.

The system clearly needs to be reformed under the principle “When they are gone they are gone” and the people undertaking transformative interim work should be from outside the NHS so that real reform and real progress is actually made.

John Gelmini

Enhanced by Zemanta

A Hard Look at the Politics of the UK’s NHS – John Gelmini

Second Life: National Health Service (UK):

Second Life: National Health Service (UK): (Photo credit: rosefirerising)

To be fair the decline of the NHS started under Gordon Brown with the inception of the Wanless Review which injected £7 billion gbp into the NHS, none of which produced any productivity improvement and any benefit that might have ensued was eaten up by increased wages and NI contributions.

The rot continued under David Cameron when instead of backing the Lansley Reforms he started a process of “listening to the healthcare professionals”.

This “listening process” was to yield to pressure from Sir David Nicholson the disgraced NHS Chief who allowed the terrible events in Staffordshire and needless deaths elsewhere to occur on his watch.
The satirical magazine Private Eye ran a story before Andrew Lansley’s removal as Health Secretary demonstrating how Sir David Nicholson was deliberately undermining the reforms particularly to the “commissioning ” processes.

Instead of backing his Minister David Cameron sacked him and replaced Lansley with the more telegenic Jeremy Hunt and then continued to have complete faith in Sir David Nicholson a man who should have been dismissed for incompetence and bungling without any compensation and personally surcharged.

The NHS does need complete reform starting with the removal of all but 4 layers of management and continuing through to the merger of the Adult Social Care and NHS budgets.

It does not need to be privatised but does need hard commercial focus in procurement particularly in the area of purchasing drugs which are up to 2000% too expensive (See article in the Independent).

Some things like printing, cleaning, parking, the typing of patient notes,grounds maintenance,IT and administration can be outsourced and strategically in-sourced and hospital consultants cannot be allowed to create waiting lists to build their private practices.

This last objective can be achieved through the use and application of “expert systems” to enable more specialist work to be done at lower cost and with fewer people.

The NHS needs to focus more on stopping people from getting ill in the first place so measures here would include:
–Variable taxes on foods
–Teaching people how to cook
–Encouraging people not to drink on an empty stomach
–Promoting exercise and vitamin supplementation
–Reintroduce Vitamin B17 into our diet
–Opt out of Alimentarius Commission directives on food and supplements
–Forcing the NHS and civil servants to see food as part of a person,s treatment
–Refusing operations to those people who are smokers or morbidly obese until they stop smoking or reduce their weight
–Paying doctors for keeping people well not the size of their patient lists
–Teaching people a Stoic philosophy ,Zen,meditation and NLP so that they are better able to cope with the vicissitudes of life
–Tax breaks for PMI policies
–Promoting traditional marriage in the tax system and discouraging bizarre and unusual lifestyles which produce dangerous health outcomes and lead to greater mortality at an earlier age Note:In this regard traditional marriage leads to the longest and most healthy lives,stable cohabitees live the next longest along with spinsters and single men especially if they are out of work die the fastest.
–Stopping any further moves to make divorce or cohabitee breakup easier ,cheaper or faster and sacking /retiring early those judges in the Family Court Division who want to bring in American style “No fault divorce”
–Using work scheduling software in hospitals to roster nurses and doctors to meet peaks and troughs in demand
–Weeding out malingerers in GP surgeries
–Making people more responsible for their own health
–Removing, as far as possible salt, sugar, additives and harmful chemicals from food, drinking water, air and the environment
–Banning the use of amalgum containing mercury for dental fillings
–Planting more broad leaved trees around roads,motorways and industrial areas
–Putting air cleaning FICA plants in offices and factories
–Stop building any houses within 1 kilometer of an electricity pylon or sub station(banned in Russia because it causes cancer)


Enhanced by Zemanta