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The resources to improve health

Thu, 01/21/2010 - 01:04 — Hugo_Minney

Buying votes - of course that could never happen hereIn the run-up to the general election, all the political parties trying to win your vote using the NHS card. They make all these wild promises, but what is going on behind the scenes?

Labour -- Gordon Brown's health team is promising something for everyone:  the public can have whatever they want – if they drink themselves nearly to death the NHS will put them right; speaking of rights, they will have the right to be waited on hand and foot. The NHS will find £20 billion worth of savings. And any manager who cuts services will be named and shamed.
Conservatives -- David Cameron promises a better NHS. His health team is busy flirting with private companies, to great effect (Andrew Lansley’s electioneering pot is £20,000 richer!). The United States experience of private healthcare is that 40% of all spend goes on administration. This means; 40% less money available for patient care -- how can they maintain standards of patient care if the money is being used up on administration?
Liberal Democrats -- lots of worthy talk, very little sign of realism and implementation – but then they don’t think they will actually have to do anything.
BNP – apart from wanting to paint everyone white and sterilise anyone who isn’t a member of the party, I haven’t read anything interesting yet.
But what do we gain from all of this navel gazing?
It's as well to be prepared. If an incoming government is going to do what's necessary, that is, empower the people and organisations who can have the most impact, then those very same people need to be ready with ideas of what to do and plans to do it.
If, on the other hand, an incoming government plans to continue the current policy of promising everything and funding nothing, then we -- the people who can make a difference -- need to reconcile ourselves and continue doing the best we can.
I've worked a long time understanding health in UK - on the outside looking in (selling into the health service and NHS); I worked at a national level developing and supporting policy; I've worked regionally, implementing policy and strategy; I've worked in NHS organisations; and I work in a GP practice at the moment. The biggest difference that can be made is where the patient first touches the health service. Most of the time, nine times out of 10, that's with the GP.
The right resources in the right hands
GPs make the first decision following a diagnosis: they can make the biggest difference to the quality of service the patient receives (by referring to the best pathways), and the amount of resources (cost) that a patient consumes (by using appropriate healthcare close to the patient's home). It really does make sense to empower the GPs and support them to care for their patients.
So how can primary care trusts engage with their GPs?
The first thing to do is to listen; understand the concerns they raise; understand their ability to implement (or inability); and understand whether they are looking for more money for themselves, or more money to support their patients.
It's important not to get precious. If someone comes up with a good idea for a service, that doesn't mean that you'd steal the idea and give it to your PCT provider arm. NHS as preferred provider was old-fashioned before Andy Burnham said it – competition has created some inefficiencies, but it has also created an enormous amount of good.
Making it happen
Minney.org Ltd works with many health and social care service providers and commissioners: we promote engagement, we are realistic about the provider's ability to implement the good ideas they come forward with, and we support Commissioners to get the best for their population. It would be pleased to talk to you about what we can do for you. Contact me on the contact details below.

 

Comments

Thu, 01/21/2010 - 01:10 — Hugo_Minney

Letter to my MP

Dear Dr Blackman-Woods

 
One of the principles that makes Britain as great as it is – in spite of the sad situation that we are rich enough to try to kill ourselves, is our national health service (NHS).  Free at the point of use – one of very few in the world.
 
Standards keep improving, but mainly through the use of competition.  I’m pleased to say I played my part in killing the South Yorkshire ISTC (Independent Sector Treatment Centre) before it left the drawing board, as a totally unnecessary waste of £20million.  But I did notice something very important – the possibility of a new ISTC made local hospitals buck up their customer service and clinical quality.  Even if the £20million had been spent, it would have been money well spent for the improvement it caused – improvement which probably no amount of money would have achieved.
 
So Andy Burnham is ready to throw all of this away, to rewrite the remit of the NHS Co-Operation and Competition committee?  Great Yarmouth PCT has acted, letting out services ONLY to NHS providers, excluding the numerous private and charitable organisations that have stepped in where NHS has failed. 
 
Parliament must act to reign in this out-of-control executive.  You answer to me (along with 100,000 others) I’m delighted to say, and you are both active and responsive.  But the Prime Minister and Cabinet office appear not to answer to you.  What is to be done?
 
Please  make these views known.  Please save the hundreds, perhaps thousands, of small organisations that ensure that care given to patients is current and excellent, and that staff have a sense of belonging.  The monolith that is NHS provider is failing (actually the monolith that are PCTs aren’t so good either, but that’s another story) and the bright lights of excellence have only come about because of competition.  I would be very sad to go backwards.
 
Sincerely
 
Hugo
 
Dr Hugo Minney
Minney.org
28 Edlingham Rd, Durham DH1 5YS
Minney.org is a limited company registered in England number 6287126. VAT Registration Number 916 0444 43
Mobile:  07786 961837
 
email:    hugo@minney.org
 
see:       http://www.minney.org
 

 

Thu, 01/21/2010 - 01:06 — Hugo_Minney

Spend too much on H1N1 vaccine

Dear Dr Blackman-Woods

You can tell I’ve been reading British Medical Journal at lunch time.

Could the UK government, along with the other governments of Europe, take similar action on the vendors of swine flu vaccines as we seem so happy to take with Microsoft? 

We were sold, to put it bluntly, a pup.  The vaccine has limited efficacy and unknown side-effects.  The risk of pandemic was never what they said it was.  Blair’s ’45 minutes to launch of weapons of mass destruction’ dossier on Saddam Hussein was like de Saint-Exupery’s “the little prince” compared to the marketing we swallowed as a government, we as a population had to put up with.

If we can fabricate a fine against Microsoft for being good at marketing a safe product (the problems with Internet Explorer are with its version 6 – this is an out-of-date product and since up-to-date versions are free there is no reason why people can’t upgrade to a more secure version), surely we can levy a fine against drugs companies who market vaccines of unknown safety.  No-one was the victim in Microsoft’s case, except a bunch competitive businesses who don’t understand Microsoft’s model (see below).  Many of us are victims in this pharmacological situation – those who get side effects from the vaccine, those who worry they might, those denied treatment because the UK government spent so much on this vaccine instead of something else . . .

Tell me it is possible to make a case and that the politicians are willing to do so.  Tell me that Labour politicians are ready to rub Andrew Lansley’s nose in the donation he accepted from Care UK.

Hugo

Microsoft’s model
Microsoft gives away a lot of free products, to give you an idea of what is possible.  For example:
Microsoft Paint – I found I could edit photos, so I bought Adobe Photoshop Elements to do it better
Drawing tools in MS Word – I needed better so I bought Microsoft Visio
Speech recognition – it worked so I bought Dragon Naturally Speaking
MS Excel – I needed accounts so I bought Microsoft Accounting, and statistics so I obtained Minitab (as a consultant they provide me with a license free, but I would have been happy to pay)
MS Word for web pages – I bought Macromedia Dreamweaver many years ago, and since it moved to Adobe and prices rose I bought MS Expressions
MS Movie Maker – it’s only good enough to get an idea of what is possible, so I bought Adobe Premiere Elements
EndNote, Act!, PerfectDisk, Acronis TrueImage, Abbyy Finereader Sprint: all products I bought because I saw what was possible with Microsoft cut-down versions, and decided I needed something better and could justify the price.
Dr Hugo Minney
Minney.org
28 Edlingham Rd, Durham DH1 5YS
Minney.org is a limited company registered in England number 6287126. VAT Registration Number 916 0444 43
Mobile:  07786 961837

email:    hugo@minney.org

see:       http://www.minney.org
 

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Sat, 02/27/2010 - 23:39 — Hugo_Minney

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Fri, 02/19/2010 - 15:08 — Hugo_Minney

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