Thursday, December 25, 2014
The Ghost of Christmas Past
Tuesday, December 16, 2014
Them and Us
Wednesday, November 19, 2014
In Defence of the NHS, part 2
Since hospital I need certain medical equipment to enable me to live a normal life. A specialist nurse advised me, and supplied an initial stock of the equipment, together with the details necessary for re-ordering. When the re-order was necessary my preferred supplier advised that the local GP reception had reduced the order by 75%, had refused to deal with them again, and made no arrangement to inform me! Once again, on enquiry I discovered that notwithstanding my changing need my GP surgery will deal with only one supplier and is dismissive of the others.
There are certain implications in all this. the most charitable is that their preference is for economic reasons. Since the surgery do not pay the supplier directly (the bills are paid by the NHS centrally) the economies, if any, have to be procedural. Dealing with only one supplier provides for less confusion among staff, fewer destinations for prescriptions etc., easier training and control and a stable system. They also may be better able to assist patients with queries about the supplier and to smooth the path to hitch-free supply.
Contrast this with an alternative scenario. How much disruption to the GP's system would the presence of a competitor supplier cause? True there would be the possibility of the wrong document being sent to the wrong supplier, but with electronic mail and the innovation of the Electronic Prescription Service (EPS) this is negated. A little more training of staff may be necessary, but only concerning document recognition. An alternative supplier may be cheaper for the NHS, surely a consideration, and if they are found unreliable in their dealing with patients or GPs they can always be replaced; is that the rub?
When I was in commerce one of my responsibilities as a manager was to deliver value for money. Our agents (other companies) were always under review, and they knew what was expected of them. If my company were not receiving the revenue expected, or the service agreed, meetings were arranged to thrash out any difficulties (on either side) and if matters continued to be less than satisfactory the agent was replaced. Why should that not happen in the NHS? I have no evidence to suggest that it doesn't other than the aggressive stance taken by the surgery and their operation of an apparent monopoly.Do they serve the best interests of the patient who ultimately pay their salary, the GP who directly employs them and has a tight budget to run, and the NHS which constantly tries to fit quarts of expenditure into pint pots of income? I'd like to think so but it should be transparent - it is MY NHS after all.
Competition is healthy for any business so long as it is fair, it forces prices down and service levels up. If a company is found wanting in any area the competition will eventually eliminate the laggard or force it to change. Monopolies on the other hand are incestuous, inflated, anti-improvement, and generally loss-making. Without profit there can be no new investment, no expansion to attract more staff, and probably no development. The company stagnates, becoming out-dated and fossilised, benefiting no-one. So the employees suffer, the patients too and the GPs and ultimately the NHS. Sound familiar? And all for the want of diversity.
Sunday, October 05, 2014
A great day out
Sunday, September 28, 2014
Politics
Saturday, August 02, 2014
Family Ties
Tuesday, July 29, 2014
In Defence of the NHS
In nearly 72 years I have been incredibly lucky to never have been in hospital. Negative stories about the NHS are legion, but I have long suspected that those stories are about either unfortunate individuals on the receiving end of poor decisions or care; or about the leviathan bureaucracy that accompanies the institution. In mid July I had the opportunity to experience at first hand the UK's flagship institution, second only to the monarchy.
I had an appointment for an intimate procedure which would include at least one night's stay. All of the staff I encountered, from the off-duty nurse who directed me to the right area, to the Registrar who oversaw my procedure, were friendly, helpful, approachable and professional.
The ward to which I was assigned had just 6 beds, but was only a “bay” of about 5 similar bays which made up men's surgical. The whole unit is staffed by about 20 people from staff nurses to domestics, overseen by a Sister. They work incredibly hard. Our staff nurse was busy and on her feet from 8am for 12 hours (with breaks) and I not once detected impatience, irritation or anything other than a smile and a willingness to help. Sometimes one had to wait due to a more urgent need elsewhere, but the pleasant disposition never faltered. The night staff were just as attentive and caring, even performing routine tasks by torchlight to avoid disturbing sleeping patients.
One patient required surgery and was collected, in his bed, around 10 pm, destined for theatre. Some two hours later they wheeled him back, quietly, talking in hushed tones (not quite a whisper), and shielding a light from the rest of the ward. The ward staff had tasks to perform before they could leave him to sleep, and they went about their business as quietly as possible.
The food was adequate in quantity, not a serving that one might get at home, but bearing in mind the sedentary nature of one's stay it was enough. I certainly didn't feel hungry after eating. The variety on offer for each meal was reasonably extensive without being confusing, and there was always the chance of something extra for later on offer too.
The secret, it seems to me, was that each ward had its own housekeeper whose job it was to oversee ward organisation, meal arrangements and cleaning regimes. There seemed also to be a spare room so that at intervals each ward would be moved in rotation enabling deep cleaning to be carried out. All in all, I was almost sorry to leave after three days, so welcoming and relaxing were the staff. I have nothing but praise for the dedication, hard work, caring attitudes, and reassurance I found on this my first foray into this arcane world.
Then there was the local GP's receptionist. On being discharged from hospital I was provided with certain equipment, which I needed, and was instructed in its use. I was also advised to ring up the supplier of that equipment to arrange future supplies, which I did at the earliest opportunity.
Two or three days later I had a phone call early morning from the receptionist complaining that I had used the wrong supplier as her system didn't recognise mine and in future, if I wanted to use the surgery I had better use her designated supplier, whom she failed to identify!
I think the difference in these two episodes can best be categorised by professional versus rank amateur. I'm willing to believe that Ms receptionist is good at her job vis a vis the doctors, but she has no people skills at all. Worse, she seems to believe that but for her no one understands the NHS, which would collapse under its own inefficiency if she weren't there to save it. People like that (and I am told that many doctors' receptionists are like it) get the NHS a bad name and the service, both to the public who pay them, and the surgeries who directly employ them would vastly benefit from some retraining or dismissal. These people are effectively the shop window of the NHS, the customer service representatives, and attitudes need to, and must, change. Many surgery receptionists deal with elderly and vulnerable people, and all of them deal with the sick with conditions ranging from relatively trivial to life-threatening. Many patients get confused when unwell and some are, alas, confused due to age or infirmity. To be faced with a harridan such as I encountered (and have formally complained about) is unhelpful, rude, arrogant and unnecessary. Save the NHS, get rid of the attitudes and those who exhibit them, and let's have a truly caring, helpful and world-class service.