Wednesday, 20 October 2010

This is where I came in.

One benefit which might follow from increasing the retirement age by 10 years or so, might be that the accumulated wisdom of the years might be listened to. It is of course well known that once people have retired, their opinion is not worth a bucket of spit. That's why the retired diplomats who advised against starting a war in Iraq were ignored. What did they know about modern American weapons and diplomacy! Old fuddy-duddies.

We're seeing it at present in the NHS. What goes round, comes round.

Shortly after I was appointed as a NHS consultant in 1973, Mrs Thatcher had the bright idea of asking an American expert on Health Care for his advice, and she then instituted the first of the many NHS Reforms which have cost the country so much money for so little benefit.

I remember one suggested reform was to fund hospital departments according to the number of patients they could attract. The more successful departments would then be able to afford more staff and they would see more patients, while the less successful ones would lose staff and would gradually dwindle away to nothing. It did not seem to occur to the managers that there was not an endless supply of experienced doctors and nurses just standing around waiting to be employed by the successful departments, and that the expensively trained doctors and nurses who were made redundant from the less successful departments would either go abroad or be re-employed in the more successful departments. It would take a lot of managers and administrators to make sure the system worked well though, so the plan was approved.

The money would follow the patients, who would choose where they wished to go. Market forces. Marvellous. In the South-West they appointed a senior manager from the airline industry to reorganize the NHS on these commercial lines. It was just a matter of putting people in the operating theatre at the scheduled 'take-off' time and giving the customers what they want. I think it took him about a year to learn it ain't that simple. (It took the military invaders in Iraq slightly longer to discover they should have listened to the old buffers).

Now, some 25 years later, I read in the Telegraph (October 18th) that Martha Lane Fox, the internet entrepreneur, is planning an 'information revolution' in the NHS. Patients will be able to compare doctors across Britain, and will be able to study survival rates in different hospitals. The article says "It is hoped this will help drive up hospital standards as patients choose not to use the services of poor doctors, who will then lose funding".

It isn't April 1st, is it?

The Telegraph does have a good sense of humour (sometimes).

Their final 'leader' in the same issue (A Christian Family) said We appreciate Homer Simpson for his sophisticated understanding of the power of prayer, demonstrated when he lifted up a plate of cookies with this appeal: "Lord, if you want me to eat them, give me no sign"

And may the Lord deliver the NHS from young internet entrepreneurs.


  1. I am worried about our small cottage hospital here on the island after the CUTZ are put in place. We used to have a wonderful surgeon (Mr Kapoor) who could do everything from resetting arms to removing lumps and bumps....but when he retired, he was not replaced :-(

    So we basically have a unit with beds in it and if you are brave enough to have your baby here, you get well looked after by the midwifery team. Sometimes doctors and misters come over from the mainland to see us here and keep the facilities from being entirely mothballed.

    But if you break your arm, you need to drive to the mainland, up to Paisley and go to the Proper Hospital there. Not exactly convenient to have a big stretch of water between you and the white-coated people...

    What lies ahead for us here now?

    Ali x

  2. It could be a lot worse. It could be the USA. becoming sick here is a dodgy business, even with health care. A friend of mine on the island lost his job and his health care just in time to become really sick. In order to help him recieve treatment, we have to fund raise. He regularly misses treatment because he/we can't raise enough money to cope.

  3. Legend - that's awful! It's wonderful that you fund-raise, but it's stories like that that make me appreciate our NHS: it might be worse than it was, but it's still better than a lot of other places...

    Hope your friend gets better soon.

    Ali x