the nhs disgrace

ILW

Cleaver wrote: »

You can fully understand people seeing these jobs, in the current climate, and getting annoyed by them. However, I think intelligent people realise that to run an organisation like the NHS you need a balance of clinical staff, support staff, administrative staff and managers to make the whole thing work. People will always want to debate the detail as to how this mix should be made up. If you simply want to provoke a reaction on an internet forum, or you're actually not actually bright enough to debate your point of view in a sensible way, then you might come on and say "Sack managers, employ more nurses. That'll work, innit?".

However, I think most people sense that the issue is more complex than this, so don't let it get to you too much. We shouldn't be banning people, even if their point of view seems quite extreme.

Sounds like all of our politicians.

Jonbvn

Cleaver wrote: »

You can fully understand people seeing these jobs, in the current climate, and getting annoyed by them.

I luurve to read the Gruniad non-job ads just before I do anything competitive;)

Here's a doozy:
http://jobs.guardian.co.uk/job/982753/womens-diversion-case-manager-prostitution-female/

This post provides an exciting opportunity to provide a specialist role within Lambeth’s System Change Pilot Programme as the lead Case Manager supporting women involved in street prostitution, substance misuse and the criminal justice system to receive support and diversion opportunities as part of the new Case Management Team (‘End2End’).

As the overall Case Manager for this client group you will ensure that women experience clear pathways and appropriate support from first point of contact with the criminal justice system and throughout the treatment journey and aftercare. You will also oversee the management and delivery of the ‘Support & Engagement Orders’ (April 2010) for women involved in street prostitution, coordinating referrals and monitoring outcomes.

PrivatisetheNHSnow

ninky wrote: »

i actually think a lot of the management techniques you are railing against are borrowed from the private sector.

many private sector companies have many levels of management and pay large amounts to managers.

do you really think you can run a large hospital or provide adequate healthcare without managers?

just because its borrowed from the private sector doesn't mean it will work. In the private sector there is: 1. a profit motive and 2. budgets which do not just go up every year and 3. people in management are often people that have worked at the lower levels - e.g. in an oil company the managers are usually engineers that have been promoted into management.

the NHS doesn't work because there's no profit motive, no budget discipline and the management appears to be people with little or no practical background in medicine or applied healthcare.

sure, labour's artificial targets are met by these managers, but look at the actual experience for patients:

Patients were routinely neglected or left “sobbing and humiliated” by staff at an NHS trust where at least 400 deaths have been linked to appalling care.

An independent inquiry found that managers at Mid Staffordshire NHS Foundation Trust stopped providing safe care because they were preoccupied with government targets and cutting costs.

Mr Burnham said it was a “longstanding anomaly” that the NHS did not have a robust way of regulating managers or banning them from working, as it does with doctors or nurses. “We must end the situation where a senior NHS manager who has failed in one job can simply move to another elsewhere,” he added. “This is not acceptable to the public and not conducive to promoting accountability and high professional standards.”

http://www.timesonline.co.uk/tol/life_and_style/health/article7039285.ece

sure these managers are great just look at their target performance - there's just the small matter that hundreds of patients unnecessarily died. the NHS is a joke - that story is exactly what blair and co said they would prevent happening again. if the managers have to stay, cut their pay to a level which reflects their ability - which is a lot lower than it is in those adverts

drc

My mum worked in the NHS for years. She despairs about how bureaucracy and meeting deadlines and targets have taken over from patient care and common sense.

princeofpounds

A lot of the problems you see in the NHS and in private business alike. Overpaid managers, complicated managerial responsibilities, management speak.

The main difference I have found is that whilst this sort of bureaucratic mushrooming can happen in any large organisation, private business experiences the cleansing fire of failure and recession which simply does not happen in the public sector in the same way.

So for example, my old company had a number of staff who built up the company 'university', a little-used and somewhat pathetic training resource. But when things turned difficult, they were cut within weeks. Nothing focuses the mind like a contraction in revenues.

But the response of the public sector to similar difficulties is quite the opposite, to throw cash at failure when private businesses lose cash for failure. Yes, they may get rid of the problem staff or process, but then they will design new oversight and new processes that typically require more and not less resources.

It's a bit like the staining you get on a monument or building facade - it requires an occasional sandblasting that removes the outer surface to get it clean, otherwise the dirt just builds up and up.

The 'edge' of private sector management is not a result of its specific internal skills, it's a result of the external business environment it is forced to face.

ninky_2

PrivatisetheNHSnow wrote: »

the NHS doesn't work because there's no profit motive, no budget discipline and the management appears to be people with little or no practical background in medicine or applied healthcare.

actually it does work. it works for millions of people every year. and for every tale of mrsa or misdiagnosis (and these things are happening in private hospitals too) there are thousands of people who are successfully treated or helped. the nhs has contact with 1.5 million patients every day.

we don't have to look very far back in history to a time when there wasn't an nhs. and it was clear what the results of that were. lower life expectancy and misery for many.

in addition it provides profit to many private drugs companies etc by buying medication that many couldn't afford otherwise.

if i get cancer i can expect to be treated. if i have a baby i know i will be able to have medical support.

but excuse me if i think that ill health is one thing that shouldn't be turned into a profit maximizing opportunity.

PrivatisetheNHSnow

princeofpounds wrote: »

Yes, they may get rid of the problem staff or process, but then they will design new oversight and new processes that typically require more and not less resources.

they don't even do that. it's just a game of musical chairs for council chief execs or nhs trust execs - one authority to another, with huge payoffs and golden hellos in between.

in other words, just like fatcats in big business, except the people in the public sector are even more incompetent, to the point of killing people like in Stafford NHS trust, and the taxpayer pays for their bonuses, redundancy package etc.

PrivatisetheNHSnow

ninky wrote: »

actually it does work. it works for millions of people every year. and for every tale of mrsa or misdiagnosis (and these things are happening in private hospitals too) there are thousands of people who are successfully treated or helped. the nhs has contact with 1.5 million patients every day.

what are you talking about? I was talking about managers, not clinical staff. read my post.

it's ridiculous to say it's all been huge success - sure there are have been improvements, but not enough to justify a tripling of the budget.

don't you think there a problem if a hospital trust gets top marks for targets, and people are dying there because managers have their eye off the ball?

ninky_2

PrivatisetheNHSnow wrote: »

what are you talking about? I was talking about managers, not clinical staff. read my post.

it's ridiculous to say it's all been huge success - sure there are have been improvements, but not enough to justify a tripling of the budget.

so what is your answer to this?

PrivatisetheNHSnow

ninky wrote: »

so what is your answer to this?

abandon all the stupid targets and initiatives from central government - reducing the need for managers in the first place. cut the number of managers and cut their pay. the reason we have these targets is just to make the labour party look good - as we know from stafford etc it has no connection to reality.

i know we obviously need some for estates, finance etc but there are too many overall.

what do people most complain about with the nhs - probably waiting lists too long, drugs unavailable. how are these solved by more managers? they're solved by more doctors and nurses and money spent on drugs. but labour aren't listening:

http://www.guardian.co.uk/society/2010/mar/25/nhs-management-numbers-frontline-staff

most of the new money for the nhs has gone on wages - everyone knows this,