It will now take a miracle for the voters to forgive the Tories. Our strike-addled NHS has imploded, with another 2,837 excess deaths in the most recent week. Some 20 per cent more people are dying than normal; there have only been eight worse weeks since 2010 and all of those were during the first two waves of Covid.
Yet the Government’s lack of empathy is shocking, its refusal to admit that we are in a major emergency baffling. What is the plan? Why aren’t hospitals being put into special measures, or a supremo brought in to tackle the crisis? Do we even have a functional Government, or is it merely a Potemkin construct run by people who pretend to be in charge and enjoy the trappings of office, such as the chauffeur-driven cars and grace and favour residences, but are terrified of actually governing?
The NHS is an organisation of 1.3 million people. There is no set of levers, no reins or set of instructions, to manage 1.3 million people. It’s simply not something that anyone knows how to do. Beyond human ken and all that.
Supremos and Ministers and all that – men behind curtains. The NHS, by and large, runs itself. And when it doesn’t, it also doesn’t run itself.
Simply too large to be managed by anyone at all from the centre.
So the fix is to have the right person making the decisions, or different people running hospitals under special measures? Fantastic, that means we’re accepting that some number of that 1.3 million whose job it was to do those things have failed and we can be rid of them. Right?
There is no set of levers, no reins or set of instructions, to manage 1.3 million people.
The Chinese military might disagree with you there.
Being once a lazy bureaucrat, I naturally feel that the people to run things are the customers.
But I don’t think anyone is talking about privatising health care.
Just imagine being CEO of just one of the Trusts in the NHS. That’s a big job. Thousands of staff, ranging from consultants to nuclear physicists to cleaners. Acres of crumbling 19thc buildings with grotty 70s prefabs attached plus some shiny 21st century stuff that costs the Earth to run on poorly negotiated PFI contracts. Sometimes you have been forced to take over another poorly performing trust. You are dealing with everything from an ingrowing toenail to CAT scanners and LINAC machines. All the systems are a mess and still based on paper. Every central IT scheme has collapsed leaving evidence of costly failure behind it. At one local hospital, they ask you to check in on a machine that is attached to a queuing system that had to be switched off because it displayed data that patients preferred not to be publicised, such as “Peter Ward please come to the lab for your bowel scan”, for the entire waiting room to read….
Just think of the range of skills required to address that range of problems. There are currently 219 such trusts. I am not sure that there are 200 people in the world capable of that job. And you also have to deal with about 30 other NHS organisations to make a decision of any great size.
Diogenes,
“Just think of the range of skills required to address that range of problems. There are currently 219 such trusts. I am not sure that there are 200 people in the world capable of that job. And you also have to deal with about 30 other NHS organisations to make a decision of any great size.”
And the problem there is that all that stuff is imposed. If this was privatised, you’d have a hospital manager deciding on the IT. Probably buying in a package that worked. I mean, Nuffield manages this. Specsavers manages this. My dental practice manages this. Booking with Specsavers is clicking a few form things. Going to A&E is like something Soviet.
My personal NHS story was from many years ago recommending satnavs for district nurses. They missed appointments because of getting lost, traffic. Some of the nurses had bought their own TomToms. And when I said it, the people were all “well, that means raising a report, getting it on the approved product list, then finding a supplier and…”. They couldn’t even go to someone senior at the Trust to approve it. Plus the “managers” were useless. I’d have put a senior nurse who seemed clued up in charge, let her run the district nurse service with a budget and some outcomes.
The biggest part of the problem is that when we joined the EU our politicians didn’t have to do anything so we replaced all the competent ones, and they were few, with people that get good publicity and say the right things. They were actors playing politicians. Now that the wheel of state is back in the politicians hands we discover that none of them can drive it. Sure they take turns spinning the wheel but none of them can steer a course and we are still voting in actors.
Dio – Johnson Matthey, pretty much bottom of the heap by market cap in the FTSE 100, has 14,000 or so employees. Top of the pile, AstraZeneca, 76,000. The local NHS Trust, two hospitals, about 5,500. Another, not that far away, 3,500. That Trust serves a population of around 535,000.
I’m not sure what you’re getting at, unless it’s a problem of under-specialisation, Trusts being all things to all men.
More’s the pity. It’s the only thing that has a hope in hell of fixing the “envy of the world.”
“Yet the Government’s lack of empathy is shocking . . .”
Unlike the sincere, glowing concern from the striking nurses and ambulance drivers abandoning the patients for their pay dispute.
Ducky
My knowledge might be out of date but Johnson Matthey does catalysts and platinum, plus some green funnies that are going nowhere. Your average NHS Trust does: surgery, rehab, ICU, out patient services, A&E, various forms of radiography and, sometimes, radio therapy and management of radioactive isotopes, a pharmacy, anaesthesiology and management of explosive gases, a large property portfolio with its attached crowd of deranged local activists, an academy, nurses and doctors in hundreds of different disciplines with different requirements and on top of the normal day job you have continual interference from other NHS bodies and the fools and dolts in Government. It’s a little more complicated than a platinum business or one that develops and sells drugs
And you are judged by targets that are invented on a whim by some idiot promising something in Parliament rather than something that might be relevant or useful
Who’s looking into that excess death rate? Why no enquiry. Is the NHS failing to fix us to that extent? I don’t think this is through neglect, people have been neglected for years and failing to go sick early. No way you can explain the increase in deaths-at-home through this. The NHS is killing us by action, not inaction.
“a supremo brought in to tackle the crisis”: ah, the Führerprinzip.
As for the excess deaths: the causes are presumably (i) Long Lockdown, (ii) Long Vaxx, (iii) Strikes.
I guess that (ii) dominates but governments won’t release the data you’d need to be sure of that. Which is just one of the reasons to assume that (ii) is indeed the big deal.
Dio – then you are noting the relative complexity of what’s offered/provided on each site, compared to those firms that are far more specialised. The management role for comparison would be below the CEO, at the department/function level, cardio, paediatrics or whatever.
‘Do we even have a functional Government, or is it merely a Potemkin construct run by people who pretend to be in charge and enjoy the trappings of office, such as the chauffeur-driven cars and grace and favour residences, but are terrified of actually governing?’
Yes
interesting to speculate what causes these extra deaths. Personally I suspect it is neither the lack of or availability of money, but rather it is simply because the NHS.