EFQM « Dr Alf's Blog

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

According to UK Health Minister, Jeremy Hunt, speaking on Question Time, at 10.35 pm, on Thursday 21st November, Dr Alf’s bewilderment at the failure to merge the NHS and Adult Social Care budgets will soon give way to euphoria and what Private Eye likes to call “trebles all round”.

Personally, I will believe it when I see it, and when the test applied by Australian Special Forces, for the recording of a North Vietnamese soldiers’ death, is applied to the serried ranks of Adult Social Care workers in Local Authorities, viz. the test being applied, once these functions are merged.

This means that I do not wish to see these workers transferred to the NHS for the numbers of people employed to remain the same–We need to see all these former local authority posts, from the Director of Adult Social Care downwards, eliminated and these workers put to the sword.

Why?

NHS and Local Authority productivity is running at just 32% or 70 working days per year out of a possible 220 working days (Source :ONS)

With restructuring, Lean /EFQM, and improved working practices around the D55A and D55B targets, earlier intervention, aggressive re-enablement, measures to tackle malingering and overeating, variable taxes on foods, measures to remove salt and sugar content from processed foods and other measures that I have identified in my work for a 3 star County Council in this area, services could be improved even with a 67% decrease in overall staff numbers, given the will to effect change.

That will is lacking because of a fear of pensioner power and the omnipotence of the medical profession and local authority Chief Executives within County Councils.

These barriers to progress need to be taken on and the number of County Councils and Unitary Authorities reduced to just 15 for the whole country or 14 if Alex Salmond wins his referendum which I predict he won’t.

Savings produced by these measures alone, would allow these old people to be looked after at home, and with better diet and re-enablement, there would be fewer of them needing to go to hospital to become bed blockers.

John Gelmini

Why Dozens of Local Authorities are Collapsing in the UK – John Gelmini (dralfoldman.com)
Record number of elderly forced to stay in hospital – Telegraph (dralfoldman.com)
Opinion – Betrayal of elderly on social care costs ex Telegraph – John Gelmini (dralfoldman.com)
Why UK Chancellor George Osborne will not be allowed to use the axe on the Public Sector – John Gelmini (dralfoldman.com)
UK Healthcare Reform: 25 Proposals Towards Real Effectiveness – John Gelmini (dralfoldman.com)
A Hard Look at How to Reform the UK’s NHS Effectively – John Gelmini (dralfoldman.com)
Opinion: Public health commissioning in the NHS 2014 to 2015 ex Publications GOV.UK – John Gelmini (dralfoldman.com)
Opinion: Jeremy Hunt accused of keeping parliament in dark over NHS plans ex Guardian – John Gelmini (dralfoldman.com)
Effective Reform of the NHS – John Gelmini (dralfoldman.com)
A Hard Look at the Implosion of UK Healthcare – John Gelmini (dralfoldman.com)

Dr Alf talks about spin and weasel words but having read the NHS document I am no clearer as to what has really changed or how the various outcomes are to be achieved.

The money talked about(just under £2 billion gbp) is being supplemented by Lottery money and Petroleum Revenue Tax but we are led to believe that what is stated in the document is the entire story.

UNLIMITED AND GROWING DEMAND

The NHS is demand led at the point of need and the public expect more and better delivery as their expectations of the medical profession rise every year.

Even with reform or replacement the UK healthcare system will fail because people expect to be able to down huge quantities of alcohol, smoke cigarettes, eat microwaved food, fish and chips, skip meals, take little or no exercise, take recreational drugs (in many cases), engage in bizarre and unusual sexual practices, go without sleep, live alone, become stressed and remain in good health.

If they become unhealthy through living like this and not heating and lighting their homes properly they expect the NHS to treat them and resolve their problems.

LACK OF PERSONAL RESPONSIBILITY FOR HEALTH AND WELL-BEING

People in the UK do not in the main take any responsibility for their health and the worst offenders and are malingerers cluttering up GP surgeries with non-existent ailments ,depression and problems that they should deal with themselves.

This has to change so that demand can be brought into line with what the NHS can actually deliver under present circumstances which is also unsatisfactory.

MORE OBVIOUS REMEDIES

After that we need to see:

–Food seen as medicine not as something to be treated as an unaffordable cost

–Hospital Consultants brought under control and made to work solely for the NHS rather than lining their pockets at the expense of paying patients in NHS beds or their private practices who are treated first in order to create long waiting lists

–GP contracts need to be renegotiated and malcontents sacked and replaced

–The BMA needs to be brought to heel or de-recognised as does the Royal College of Surgeons,the Royal College of Midwives and the NHS Trades Unions

–NHS Managers need to be reduced to just 4 layers and NHS Trusts need to be reduced to an optimum number ,say 15 for the whole country or 14 in the unlikely event that Alex Salmond gets an independent Scotland

–Merge the Adult Social Care and NHS budgets and remove duplication

–Create Kaiser Permanente Healthcare Apps

–Remove sugar,salt and harmful chemicals from food, the built environment, farming , power supply, aircraft fuel, plastics and mobile phones

–Variable taxes on foods

–Rife Machines in all cancer wards(as in Germany)

–Vitamin supplementation and other measures to boost immunity and testosterone rather than more drugs

–More Ayuvedic and Chinese medicine to stop minor ailments getting worse and act as a way to cure serious conditions without the need for commissioning expensive clinical procedures

–Use the ESD Toolkit as an aid to early intervention

–Make private medical insurance premiums fully tax deductible

–Greater use of nurse practitioners and Expert systems

COMMISSIONING

After demand and cost reduction, smart procurement, NHS radical reform, the outsourcing of non-core services and the inculcation of more personal responsibility in the minds of the public we will still have the genuinely ill, injured and afflicted who despite smaller numbers will need care and treatment.

For standard or simple treatments this should be done by GPs on-line and by telephone and in consultation with consultants for more expensive and complex ones.

STANDARDS

The NHS should be benchmarked against German, French and Italian healthcare with Lean /EFQM as the non negotiable standards.