NHS Crisis, What Crisis ?

Yesterday I was lucky (maybe not) to attend the NHS Confederation Conference at the Echo Arena in Liverpool. What a shindig, what a back slapping, aren't we doing well, right royal knees up it seemed to be. And guess what, it's not just an NHS awayday, it's on for three whole days !!!

Everyone who thinks they're anyone in the NHS appeared to be there. The Key note speakers included such big knobs and big wigs as :

• Health Secretary, Jeremy Hunt; 
• NHS CEO, Sir David Nicholson,
• Shadow Health Secretary, Andy Burnham
• Former Director General of MI5, Baroness Manningham-Buller DCB

I was astonished at the number of NHS people at the event, considering all the bad stuff going on in the NHS I was amazed at what appeared to be a 3 brass monkeys approach of see no evil, hear no evil, speak no evil. It was also very apparent that they thought the NHS was some corporate business not a public service.

  

There were some novel subjects you could go and listen to in the breakout workshops including :

• 'Bringing people with us: a new approach to public engagement in the NHS'
• 'How meaningful public-patient engagement can improve decision making'
• 'From rhetoric to reality: how to make integrated care happen where you are'
• 'Help! I need somebody...Putting patient's at the centre of care'
• 'Empowering patient's with transparent information'
• Money, money, money: how much is the public willing to pay for healthcare?'

Now forgive me for thinking the NHS has swallowed the whole 'corporate speak' dictionary but in the current scheme of things couldn't they do better than some of that lot really ?

The simple fact that these subjects were being addressed shows the abysmal state our NHS is in. That they have to hold a workshop at a major conference to discuss putting the patient, Yes, the patient at the centre of care says it all. It does beg the question where is the patient now? At the bottom of the list I suspect! The one about 'meaningful public-patient engagement improving decision making' is astonishing, has the penny now dropped that if they talk to the patient, yes they'll get the truth but they might actually look like a caring organisation? 

Walking around the exhibition was an eye opener. Now forgive me, my memories not what it was, but didn't the Government as part of it's NHS reforms promise us a slimmer, less bureacratic NHS with few managers, lead by the doctors ? Thought so ! Well as you'd expect, there were some of the larger NHS Foundation Trusts exhibiting along with a number of the new Commissioning Support Units. All well and good, these are virtually the frontline organisations, however, also exhibiting were this lot :

• Care Quality Commission
• eWIN – NHS Workforce Information Portal
• Foundation Trust Network
• General Medical Council
• Health & Social Care Information Centre
• Health Education England
• Monitor
• National Health Executive
• National Institute for Health and Care Excellence (NICE)
• NHS Benchmarking Network
• NHS Clinical Commissioners (NHSCC)
• NHS Confederation
• NHS England
• NHS Improving Quality
• NHS Jobs
• NHS Leadership Academy
• NHS Library & Knowledge Services
• NHS ProCure21+
• NHS Professionals
• NHS Shared Business Services
• NHS Trust Development Authority
• NIHR Clinical Research Network
• Public Health England
• Tell Us Once

All are public sector bodies either affilliated to or actually part of the NHS. Now I suspect the vast majority of the public have never heard of half of this lot, who knows who the 'NHS Benchmarking Network' or the 'NHS Library & Knowledge Services' are ?

 

These are all public sector bodies few of whom deal with providing 'Front-line' NHS services. How much do they all cost ? I thought we were supposed to be streamlining? And as a side thought, how much did this conference cost both in facilities, hotels and people time?

This neatly takes me back to the breakout workshop discussions and the amazingly titled : 

 Money, money, money: how much is the public willing to pay for healthcare?

First thought would be, why don't you ask us ? Instead of engaging in either navel gazing or blue sky thinking or whatever debate internally you carry out, just come and talk to us. 

As a member of the public, my answer would be that we're happy to pay whatever it takes, but on the following provisos :

1. Facilities are clean and safe.
2. Clinical staff treat the patients (note, 'patients' not 'customers') as if they were members of their own family.
3. The reduction of waste in the NHS continues.
4. GP contracts are re-looked at and made more realistic. They should be forced to offer an out-of-hours service. You should also be able to see a GP within 2 days.
5. If my children or my parents are seriously ill a doctor will come out to them.
6. Waiting times in A&E should be no more than 2 hours for the adult population but 1 hour for children or OAP's.
7. The layers of management is reduced and the frontline is increased. At the moment evertime a job needs doing, a 'manager' is appointed to "look into it" instead of simply employing people to actually do the job in the first place. This is how you end up with one poor sod trying to clean the floor and 5 tiers of managers trying to explain why the job isn't being done and producing reams of paper reports to try to justify their pointless jobs.
8. I accept that private is not perfect, in some circumstances it can be a better than public but there's room for both. The NHS is superb at the serious stuff like Oncology, major heart surgery, transplant, accident and emergency etc. Private is exceptional at routine, the NHS has been contracting out routine ops for years, this should continue.
9. Be more local !! The NHS suffers from the folly of successive governments in subscribing to the gigantism of Super Hospitals. In the past, small surgeries and cottage hospitals required fewer, if any managers and served the local communities. Remote, inaccessible Super Hospitals and surgery consortia spawn complex systems in an attempt at management, these suck in vast numbers of managers and administrators. We want local services for local people.
10. The NHS and DoH need talk to the public more. Better advertise consultations and allow broader membership of steering groups. Engage with us, don't dictate to us !!!

Attending the NHS Confederation Conference, you'd be under the impression that the NHS is a smooth running, crisis free, corporate business. Patient's seem to come a long way down the list of priorities though. 

At the end of the day the NHS and the politicians need to understand it's a SERVICE to the whole country whatever your circumstances, it is not a BUSINESS which is only there to make a profit. And the majority of the population want it to stay that way.