Opinion – UK Local Authorities and Shared Services: Cost-Cutting – Myth or Reality? – John Gelmini

Metropolitan boroughs, London boroughs and non...

Metropolitan boroughs, London boroughs and non-metropolitan unitary authorities are shown (the remaining areas are shire counties) (Photo credit: Wikipedia)


 Dr Alf is right to worry about the risks of Local Authority shared services centres because the real problem of lack of local authority worker productivity (32%) and the number of local authorities, constabularies and fire commands is not being addressed.

Nor is the problem of too many local authority layers of Government being addressed,  nor the burgeoning problem of Adult Social Care, which now consumes 55% of county council, unitary authority, metropolitan borough council and London Borough Council budgets.

The steps needed are clear:

1) Abolish districts and boroughs and outsource all their functions to a rotating panel of providers

2) Reduce UK county councils, unitary authorities, metropolitan borough councils, London Borough Councils and City Councils to 15 (England, Wales, Scotland and Northern Ireland)

3) Reduce layers to five, and impose headcount restrictions to stop bogus grades re-emerging as happens now

4) Apply Lean EFQM to all services, recalculate headcount required fire all those surplus to requirements staring at the top with the 4000 or so council chief executives who are essentially not needed. In practical terms, this will mean firing 55% of all local authority workers

5) Reduce constabularies and fire commands to 15 and repeat the process but in the case of the police keeping the overall budget intact and using layering and procurement savings to fund cleverer detectives and more bobbies

6) Merge Adult Social Care into the NHS and get rid of Adult Social Care directorates in councils

7) Centralise all purchasing with a rotating panel of auditable providers changed once a year

8) Bring in random spot checking of all local authority workers bank accounts and in the case of senior officials, Chief Executives etc audit the accounts of their wives, girlfriends, partners, mistresses, children and relatives, forbid them from setting up foreign trusts

Catch and bring to justice two or three of the worst examples of corruption (there could well be many) and make sure that the sentences on conviction are draconian and that all monies are recovered in the full glare of publicity and with Dominic Littlewood the bald headed presenter given full scope to pontificate on the matter in a television programme

9) Bring in variable tax on foods, identify Adult Social Care recipients early, insist that people lose weight and stop smoking before they are given Adult Social Care or NHS operations.

Aggressively re-enable all Adult Social Care recipients so that only those truly in need of such help actually get it.

Apply gastric band and stomach stapling to the morbidly obese and prescribe Tai Chi for them once they are thinner

10) Merge all call centres and dispatching centres into CRM driven,web enabled shared services centres

11) Outsource whatever is left over

John Gelmini

A Hard Look Beyond the 13,000 Needless NHS Deaths – John Gelmini 1/2

NHS Iveco Blood Van

NHS Iveco Blood Van (Photo credit: kenjonbro)


I thank Dr Alf for re-blogging the article entitled “13,000 died needlessly at 14 worst NHS trusts“, published in the Telegraph. I am grateful for Dr Alf sharing my views  below and I shall state with a response to his open question, namely:

Should the UK have a referendum on the replacement of the NHS with a best practice healthcare system based on best practice in other countries?

A Hard Look Beyond the 13,000 Needless NHS Deaths – John Gelmini 

There is no need for a referendum on the NHS and if there was one the Government of the day would gerrymander the question so that the result was in favor of doing nothing or would ignore a vote for change by citing unsupportable costs.

The present system is much worse than the Daily Telegraph report suggests and it kills 120,000 people in botched operations and a further 70,000 through misdiagnosis by well-meaning family doctors.

Currently 20% of the entire NHS budget is spent on payoffs to whistle-blowers, lawyers, plaintiffs and vexatious and genuine litigants, gagging orders and tribunal awards.

Much of what is left is wasted on poor procurement practices, poor working practices and a continual failure to match nursing and medical resources to demand via MANPLAN software, flexible contracts and annualization.

The cost of the NHS to the nation is, however, much more than this but Civil Service Mandarins and government ministers of all political types ignore these costs and their implications which are profound and long-lasting:

1) We have the fattest woman in Western Europe and the 4th fattest men and we have both a diabetes and dementia epidemic which threatens the future viability of the NHS and the financial ability of County Councils Metropolitan Borough Councils, London Boroughs, City Councils and Unitary Authorities to exist at all.

This is down to the NHS’s failure to develop preventative healthcare strategies and the failure of successive Governments to bring in variable tax on foods, crack down on food manufacturers who put too much salt and sugar in food and their failure to regulate the poisons which go into our environment, food and drinking water

2) The UK medical profession is a cartel that operates as a law unto itself, and whether it is consultants at the top who deliberately create patient waiting lists and build up private patient lists or militant Trade Unionists fostering restrictive working practices by nurses, midwives and hospital staff the NHS is failing to improve standards to best in breed levels

3) Fit Notes and practices in GP’s surgeries are “malingerers and dole bludgeoners charters” that allow perfectly fit people to waste doctor’s time and extend their holidays, half terms and weekends.

About half the patients sitting in GP surgeries have no business being there and cause genuine patients to be missed for lack of time

4) 40% of the people in the UK are depressed and largely because of poor diet and drinking on an empty stomach which causes essential vitamins to be removed from the body, particularly Vitamin D.

Prozac, Seroxat and other drugs are prescribed for the resultant depression and the wizard Civil Servants and Government Ministers see the benefits in the form of VAT and drug and alcohol sales but fail to count the cost to the economy which is £100 billion gbp in lost days from work, lowered Corporation Tax take, lost productivity (we are now 16% behind the average for the G7) and the growing trade gap which has existed since 1982 and has been financed on smoke,mirrors and borrowed money

a) Scrap the present system forthwith, using France, Germany and Italy to create the dynamic model blueprint

b) Put Rife machines to German standards in all cancer wards

c) Variable tax on foods and new requirements on food manufacturers to stop adulterating it with chemicals, sugar, salt and poisons

d) Make people responsible for their own health and ensure that they eat properly and take vitamin supplements ,exercise and sleep properly

e) Pay doctors to keep people well rather than just treat the sick and manage patient lists

f) Merge the Adult Social Care and NHS budgets put surplus council workers involved in Adult Social Care to the sword

John Gelmini

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