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View Full Version : How would you change the Health Service Stellios, Mr O'Leary, Mr Branson?


Primary Care
28th Feb 2006, 09:38
Visit your local hospital, health centre or Trust HQ, and you see a lot of bums on seats, pertaining to be involved in "strategy" (whatever that is), or other area's which, in some peoples opinion, do not add to the quality of care we give to our patients.

The Government has now opened up health care provision in these area's to various parties, which may include groups of doctors, foundation trusts, commercial companies, or YOU Mr Branson, Stellios or Mr O'Leary.

How would you improve effiency, whilst maintaining (or improving) quality, gentleman.

(I take it you occasionally browse these pages.)

Mac the Knife
28th Feb 2006, 09:53
Kill 90% of the managers and social workers. One good clerk can do the work of 20 incompetents.

Pay the nurses a decent wage and let them concentrate on clinical patient care and not on filling in endless meaningless forms.

Select doctors in the basis of empathy and common sense instead of on how-many-A-levels-and-what-grades. Stop training so many people who will never practice or practice only part-time.

Stop forcing clinicians to do "publish-or-perish" research and focus on improving their practical training and skills. Create proper research jobs for those with a liking and aptitude for it.

Maintain financial discipline, but stop the rat-race of "what is the cheapest way we can get away with treating our patients".

Get rid of the attitude that we're all potential Shipmans who need constant surveillance.

Re-create Hospital pride.



Reopen the doctors mess bars....

Kalium Chloride
28th Feb 2006, 10:07
How would an airline boss run a hospital?


Perhaps he would apply well-known airline practices such as...let me see...accepting bookings from more patients than there are beds, in the hope that 10% might automatically get better on the day.

Which would, of course, leave a few patients short of a bed and the managers making rubbish excuses about it being down to 'policy'.

So...no change, really. ;)

ORAC
28th Feb 2006, 10:27
Hmmm,

Beds and operating theatres available on a first come first served basis. No compensation for cancellation. Hospitals closed if they don´t get as much traffic as expected.

Errrr, as said previously, no real change then.... :uhoh:

Grainger
28th Feb 2006, 11:05
I can see it now: EasyOperation - book your appendectomy online. Discount if you book early, but taxes and credit card charges are extra. No hospital meals - if you want a cup of tea, get it yourself.

Or the Ryan-Op: we'll take your appendix out for only £2 - well, whatever we can get at somewhere near your appendix anyway. :eek:

Most scary of all - Virgin Hospital Branson dressed as a nurse !! :eek: :eek:

acbus1
28th Feb 2006, 11:15
Turn the industry into a dog-eat-dog competitive venture.

When oh when oh when oh flippin when will it dawn on the human race that State run things just descend into inefficiency, apathy, decadence and waste whilst costs spiral out of control?

Competition is what made us into the species we are today.

Without competition, nothing evolves upwards, it either stagnates or regresses.


Gawd, it's sooooooo simple and obvious!!!!!!!! :mad: :mad: :mad:


I feel ever so slightly strongly about this, can you tell.

Mainly cos I want lower taxation and Public Services which work!

slim_slag
28th Feb 2006, 11:35
Reopen the doctors mess bars....

My memories of the messes were places you could relax at 2am after being up since 7.30am the previous day, to be ready for that 2.05am call which would keep you up until time to do the bloods and put in another day. Junior doctors don't do any bloody work nowadays, they are too precious for that, and anyway they are boring gits, so would never use the messes anyway. It's all changed. I think you once said you know the mess with all the porno pictures carved into the wall, now that was the place! Last time I was there it was full of leather sofas, bit too posh.

Llademos
28th Feb 2006, 13:51
Of course, if a hospital was run by the BAA, it would have two beds but lots of shops to spend money in while you waited for one of the beds to become free ... :)

Grainger
28th Feb 2006, 14:08
Hey acbus - competition, huh ? I can see it now:

"Buy two operations, get one free !"

"Gall bladder playing up ? - just call 0870 OPS-R-US"

"Are you paying too much for your antidepressants ?"

"Hey doc - I want you to me Prozac me happy"

Seriously, I'm not sure it's as simple as that when you're dealing with a captive audience. Just look at the state of the privatised railways, water companies and gas / electricity suppliers. :yuk:

Jerricho
28th Feb 2006, 14:23
......and Air Traffic Control.

effortless
28th Feb 2006, 14:28
Turn the industry into a dog-eat-dog competitive venture.
When oh when oh when oh flippin when will it dawn on the human race that State run things just descend into inefficiency, apathy, decadence and waste whilst costs spiral out of control?
Competition is what made us into the species we are today.
Without competition, nothing evolves upwards, it either stagnates or regresses.
Gawd, it's sooooooo simple and obvious!!!!!!!! :mad: :mad: :mad:
I feel ever so slightly strongly about this, can you tell.
Mainly cos I want lower taxation and Public Services which work!

Move to the states then son. Then you can have thirty percent of every dollar spent on medicine go into insurance coffers. Get chronically ill and see how long your insurance lasts with a two thousand dollar a month prescription. Competition is a shite way to run a health service. I don't say that we shouldn't have to pay at first contact like in ireland. That would cut down on the time wasters.

I pay less tax than I have ever done. But then I am a high earner and things like VAT, council tax etc. are a small part of my outgoing. I am in favour of higher income tax especially for people like me. This should be combined with lower regresive taxes, like the above, which affect those on lower pay and fixed incomes. My mother is in her eighties and on a small pension. She pays more of her income in tax than I do. I pay more of my income in tax than Micheal Heseltine does. Is this just? Income tax is at least honest. If I haven't earnt I won't have to pay it. All these other taxes are liable whether you have earned money or not.

The worst thing that has happened top the NHS was the internal market. The second was the Thatcher injection of managers. I know where of I speak since I am one of those dreadfull breed of outside "consultants". I am paid to enable organisations such as health authorities to distance themselves from their responsibilities. A little bit of magic thought up by NHS business managers.

I have loads more to say but i will spare you all.

slim_slag
28th Feb 2006, 14:51
The worst thing that has happened top the NHS was the internal market. The second was the Thatcher injection of managers. Were you around in the NHS before the introduction of these changes? There really was no control over spending by doctors. Thatcher asked the famous question 'How much does a hip replacement cost' and nobody knew. Nobody knew how much the tests cost that everybody carried out and didn't tell you anything important anyway. Now I'm not saying the current system is good, but the system before certainly wasn't. Thatcher took on some very big names in the medical community and beat them, wasn't pretty at the time, but it had to be done.

Primary Care
28th Feb 2006, 14:52
Thanks for the comments so far.

I'd rather reserve any judgemental response, as I'd prefer for contributors to "say it as it is."

I take on board what your saying about privatising the NHS, and I know people do care about keeping it free at the point of entry, but in a way, every decision we make, does involve spending your money. (I try to imagine the patient entering the system with a wad of cash in his back pocket).

I'm really interested in how we can spend that money more efficiently, without compromising quality.

Mac the Knife
28th Feb 2006, 16:07
Ah, slim - I see you've been there too...:ok:

My memories of the messes were places you could relax at 2am after being up since 7.30am the previous day, to be ready for that 2.05am call which would keep you up until time to do the bloods and put in another day.

Do they still have Christmas pantos I wonder? Therein lie some tales! Probably banned now because of innuendo, bad language and PC concerns.

And as for privatising the NHS...

I can't operate on lots of my public patients because we're short of beds, theatre time, nurses and instruments.

I can't operate on lots of my private patients because they can't afford the fees for beds, theatre time, nurses and instruments.

There's a moral in that somewhere I suppose....

Shropshire Lad
28th Feb 2006, 18:53
Privatisation of the health service would be its death knell - I would rather 100% of my tax spend in this area went on health rather than a significant proportion into shareholders pockets - and I mean health not just treating sickness.
On another point (and I will declare myself as an NHS Manager) as we are at a point now where there are significantly fewer managers in the NHS - why is the NHS the only large organisation that the public seem to think can be run without management. Saw a study recently that showed crudely a comparison with private sector organisations and the NHS which showed that on a like for like basis the NHS had significantly fewer managers to run similar size organisations.
Best way to improve the NHS - stop reorganising the structures and let everyone get on with their jobs! (10 years NHS service - 8 reorganisations!)

acbus1
1st Mar 2006, 06:15
Hmm......My post has been misconstrued.

I put forward a case for competition.

That's not necessarily the same thing as privatisation.

And I certainly wasn't suggesting the insurance driven, uncivilised mess of the USA.

:hmm:

Primary Care
1st Mar 2006, 07:59
Thanks for the replies so far.

I think it can be taken as read that competition (or you may interpret it as privatisation), is just around the corner. The legislation is certainly in place.

I guess part of my question is what would you keep, and what would you discard? Remember the overarching principle is to improve efficiency, without compromising quality.

I ask Mr Branson, Stellios and O'Leary, as some would say, that they have achieved this,to some extenct, in the airline industry.

GreenWings
1st Mar 2006, 08:35
I am paid to enable organisations such as health authorities to distance themselves from their responsibilities. A little bit of magic thought up by NHS business managers.
I have loads more to say but i will spare you all.

No, no. Please elaborate!!

GW

effortless
1st Mar 2006, 13:37
Ah well perhaps it was a bit unfair on NHS managers since it is what all large organisations do. Never do safety inspections in-house. If you do and summat goes awry you are liable since you did the inspection. If you hire an "expert" to do it and summat goes wrong you can say "Well look we hired experts to assess the risks and audit our practices." The consultant isn't liable since he can say "Well it was alright when I looked at it.

This is cost effective as all you have to do is pay lip service to anything but the most fundemental routine good practice.