NHS fines

This is an idea floated by the head of the NHS - the one who's just suspended surgery at the Leeds G I children's heart unit.

It seems ridiculous to me to take away from a cash-strapped hospital the taxpayers' money that they need to improve standards. I don't think this is government policy yet - but it's a daft enough idea to get there eventually.

Why don't they just send in "turn-around" teams like they've done with some schools - with good results.

Bring back Matrons!

Viv 8)

There is no doubt in my mind that somebody would profit from fining the nhs. Im sure they will have to pay a fortune in consultancy before hand and then theres the administration costs.

They just need to help the stuggling hospital departments, not hinder them!

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donnellysdogs said:

So agree.. Why cant government allicate the supposed 'fine' money back to hosp to bring them up to standards?

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Why would they do that when there's poor politicians going without their second homes ;(

shouldn't be fining the hospitals, they should be fining the managers in charge of those hospitals out of their own pockets...

things will only improve if there's a personal hazard to the people in charge of these trusts for getting things wrong...

that is shocking - agree with paul_c - fine the managers - they're obviously not doing their job to a right standard!

Don't ***** about, sack bad managers !

Some of the suggestions from the government think-tanks (an oxymoron, if you ask me) are a subliminal message to the private health care (non) providers for when the whole NHS is sold off.

Goodbye NHS -- welcome US-style health care (or not, as the case may be)

donnellysdogs said:

One paper this weekend is reporting that Nhs hospitals face having fines for bad standards.

My question is.... Why fine the hospitals?

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The reason why the hospital is fined is out of the misguided belief that by restricting the supply of money, the management of the hospital will rectify errors in an attempt to get the funding restored. This is a fundamental error in target driven management systems which underestimate the ingenuity of the managers to manipulate the systems. Corporate hangers on are better adapated to survive management systems than workers in any 'sink, float or swim' culture.

Around 1987 the NHS had a budget of around £7 billion but found that it had to approach the Government in January and ask for some more money because they had run out and didn't have enough left to manage until the end of the financial year in April. The Government stumped up the cash and told them, "don't let this sorry state of affairs happen again". The following year it did. The NHS asked for more money in or around February and the Government reacted by asking the question, "Again? Don't you guys budget?" to which the NHS replied, "Budget? Sorry, don't understand what you are getting at. We spend the money as and when we need it." Ever since then Government has been attempting to work out ways of getting the NHS to manage itself. It started in the 1990s with the 'Internal Market' and has now descended into the same target driven management system that has destroyed much of the financial services sector. The budget is now around the £110 billion mark and the NHS employs 1,700,000 people. Of this 1.7 million, there are 39,780 general practitioners, 370,327 nurses, 18,687 ambulance staff and 105,711 hospital and community health service (HCHS) medical and dental staff. To save you adding it all up, that's just short of 535,000 leaving the question, what do the other 1,165,000 people do? It doesn't include all cleaning staff or porters who tend to be contracted in through private contracts thesedays.

Managing any organisation, at a distance, is bad. Well managed companies have managers who are known and seen on the shop floor. The theory of management by targets works on the basis that people will do what is necessary to achieve the targets, that is, do what is in their best interests rather than the organisation's best interest. The theory holds that on balance, the organisation benefits from having people working in their own best interests.

Except the theory is wrong. Financial services are in a bad way precisely because this is wrong.

toots8298 said:

that is shocking - agree with paul_c - fine the managers - they're obviously not doing their job to a right standard!

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Except that in many cases the managers are given targets which are not desireable but against which they are measured. If you set a target for survival rates on heart operations, all that happens is that hospital doesn't do the riskier heart operations and concentrates on the safer heart operations. If you need to cut waiting lists, introduce a pre waiting list waiting list. It's the culture that is wrong and changing it is like wrist wrestling an octopus. It's the 3rd or 4th largest employer in the world and yet still has a shortage of medical professionals. Sacrificing a few bad managers won't do it. It needs to be completely changed.

You should be running the NHS.

Yorksman said:

1,165,000 people

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to change light bulbs?

Can I suggest, Yorksman, that you forward your last two posts directly to a Minister of Health (contact email addresses available at parliament.uk (or is it .gov?). I can't remember the names of any of the Health Ministers just at the moment, I'm afraid.

I think you've just quoted figures that may never have been put in front of the politicians in quite that form! :lol:

Viv 8)

The worrying thing about those figures is that they are quoted on the NHS Choices website with some pride! They also like to point out: "Only the Chinese People’s Liberation Army, the Wal-Mart supermarket chain and the Indian Railways directly employ more people." It's pointless pointing it out to anyone in charge because they all think its a good thing.

http://www.nhs.uk/NHSEngland/thenhs/abo ... rview.aspx

Yorksman said:

The worrying thing about those figures is that they are quoted on the NHS Choices website with some pride! They also like to point out: "Only the Chinese People’s Liberation Army, the Wal-Mart supermarket chain and the Indian Railways directly employ more people." It's pointless pointing it out to anyone in charge because they all think its a good thing.

http://www.nhs.uk/NHSEngland/thenhs/abo ... rview.aspx

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In fairness Yorksman the NHS does have to employ a lot of admin and secretarial staff which would make up a large amount of the "remaining numbers".

But of course In truth though the NHS is dangerously understaffed at present, I heard recently that a consultant at a large hospital found to his dismay that he was the only doctor on call over the recent back holiday. I doubt if there is a hospital ward in this country that is not understaffed, it is a very real problem that will inevitably end disastrously for some I fear.

I could rant on about there being far too many managers many of whom have been employed for all the wrong reasons but whats the point when ministers cant see past their four year term in office, they worry more about being re elected than running the country efficiently in the long term.

The current wave of spin about those on benefits is creating a real problem for those genuine claimants who are all being labelled by the current Tory government as lazy idle befit fraudsters. Ironic really so soon after the MP's expenses scandal dont you think? ~~~~Pot and kettle mean anything Mr Osborne?

So Cameron fiddles while Britain burns :?

I agree that fining publicly owned bodies is nonsensical, I suppose it creates a headache for the financial managers if they suddenly have to find money out of their budget to pay a fine, maybe this is the incentive they need! Although it's not the finance managers whose performance is being criticised is it, its usually the clinical staff who are at fault.

Sid Bonkers said:

I heard recently that a consultant at a large hospital found to his dismay that he was the only doctor on call over the recent back holiday. I doubt if there is a hospital ward in this country that is not understaffed, it is a very real problem that will inevitably end disastrously for some I fear.

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Mrs Yorks will start her 8pm til 8am shift in the haematology labs this evening. She has to run three separate labs, single handed. A&E, emergency surgery and maternity are all told that the labs provide a 24 hour service. What they are not told is that there is only one person there.

Many years ago all the Labs in Pathology, haematology, biochemistry, histology, microbiology etc had lab staff, seniors, and managers. They were all in the labs, in white coats, working at the lab benches, even the senior chief, head of all the Labs in the Pathology.

One day someone thought it a good idea that the senior chief and the individual lab managers were moved out of the labs into separate office well away from the laboratories. They immediately protected themselves with a ring of secretaries and personal assistants. So, the overall productivity went down and the staff numbers went up. Furthermore, because they were now separate from the labs, they needed some sort of interface so they used the seniors who now spend 50% of their time in meetings, resulting in even less productivity. They are so remote that Mrs Yorks refused the senior chief entry to the labs because she didn't know who he was, despite him having been in position for 6 months. Comments by the managers like, 'oh this is new, what does it do?' meets replies like, 'you should know, you ordered it'. More worryingly is the fact that they are also expected to be fully familiar with the operational procedures and be expected to step in and use it, but they can't. They rely on stand ins, locums, at £500 a day.

Has anything at all been achieved by this? Well not much. Most of the hospital management don't even know that the labs are there. When the new hospital was planned, all the plans had been signed sealed and delivered and Bovis Homes, who had never built a hospital, got the contract. Someone in the Path Lab saw the plans and asked, where are the Path Labs? No one had included them in the plans. Well, not to matter, they hadn't even included a laundery. It gets worse, much worse but as all the staff are reminded, whistle blowing is a sackable offence. To quote my mate's sister who is a personal admin to a consultant, 'no one seems to do anything'. I can well believe her.

donnellysdogs said:

I also have a sister in law off sick.. (paid nhs).. With depression .. And yet she can still go to wimbledon, olympics, and safari holiday....off sick paid for 1 year. Now she run out of paid sick she is hoing back to work.

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That used to be common in the public sector. 'I'll take a years sick and then push for early retirement'. The inconvenience to the employer, school, hospital etc. was that they had to do without a member of staff, pay their sick pay and pay for a stand in, usually at a much higher rate. After one year, it was easier to offer early retirement on the grounds of ill health. The employee got 7 to 10 years enhanced pension years service and the employer got rid of the problem, which was moved from their budget and onto the government's budget.

After about 25 years of this, government started to twig to what was going on and are now attempting to stop it. It was common 20 years ago to see NHS jobs advertised as 'with generous sick pay'.

An interesting and excellent subject donnellysdogs with some excellent, and well
thought out composed replies.

"We" can see the problems our country is faced with, the causes, the eventual
fair minded solutions, so too, the politicians however, as we all are aware, the
Government is not governing for the good of our country and or us, its citizens.

The politicians of the UK make plans, argue over points, sip their cups of tea,
come to a stage of overall agreement, implement their finely tuned decisions,
many of which tend to lean to their own advantage and are based on point
scoring aimed at the opposition. NOT, for the good of the country.

Until that immoral and down right wrong attitude is eradicated, we're all stuck with
the mess this country finds itself in at present.

I never ever thought I'd say this but, what this country needs in my view, is an
out and out non-violent rebellion telling the Government to heed the overall view of
the population regarding rational changes this country requires.
Such a rebellion would shake parliament and the politicians to the very roots of their
foundations with shock and hopefully, fear.

Oh, and I agree with viviennem...bring back the Matrons.


Thank you for such an interesting thread.
weewillie.