We are the change makers says Blair

Give him his due, he has changed things. Changed this once proud country into a backstreet /forums/images/graemlins/frown.gif deli, oops, should that be Delhi?
 
So how do you think the economy is going compared to France or Germany or Japan? I'll try not to mention the growth rates of the world's biggest democracy because we don't stand a hope in hell of matching those.
 
But we're paying a heavy price for it. Our so-called economic strength is being paid for by the government by insane IT contracts and endless departments of pen pushers.

WIth so many people employed by the government or dependent on benefits something is going to give sooner or later.
 
As somebody who's currently feeding off the tax-and-spend merrygoround, I agree that something's got to give. You'll see a lot of stories coming up about NHS and education cuts based around cutting the "bad" bits out of the over-expansion of the sectors (e.g employing a 1000 new staff over the last couple of years then cutting 200 of the old staff).

That's be nothing compared to the blood-letting in the NHS once the last few months of the waiting lists are chopped out - there's a lot of over-capacity in place and being bought to clear the backlog by 2008. Funnily enough I suspect there might a resignation after the end of waiting lists and before the cutting-back has to kick in (assuming the NHS is still the most high-profile reform). April 2008 anyone?
 
And actually a lot of what has changed is the way in which things are measured eg Waiting lists. Not now from referral by the GP but from the first appointment with the consultant ... really cut the waiting list that one .. but did sod all to help those in need of treatment!
 
No, referral time to first appointment with consultant is measured too and has been massively forced down (albeit only close to a still disgraceful 13 weeks maximum).

At last, though, there is going to be an end-to-end waiting time measured to include all the multiple consultant appointments and tests done along the way. Nobody knows yet how long the end-to-end times currently are and there's a lot of medical concern that operations will be forced too soon when a "wait-and-see" approach might be better.
 
erm, this "NHS success" is total and utter tripe.

The target of 48hours maximum has been reached by (for example) our local doctor not permitting any appointments to be made further ahead than 48 hours - reaching the target at a stroke. Similar massaging/cheating also accounts for other "huge successes" which by simple emprical observation are not based on reality.
 
Sorry to prick your balloon but a lot of the successes are actually real and real patients are getting real treatments way sooner than before, and hopelessly archaic working practice are having to be swept away to make it happen.

However, I've got to roll over on the target of seeing GPs within 48 hours. GPs have worked enormously hard(er) to see patients sooner but the measurement is often done by the same person calling up each practice each month, saying "Hello, how are you etc. etc." then asking when their next available appointment is. Not exactly mystery shopping and leads to entirely understandable general cynicism.
 
erm the actual experience of several doctor friends in practice plus my sister who is a nurse plus brother in law (NHS doctor) is quite different with increased feelings of impotence and ineffectiveness due to much higher levels of bureaucracy and lower effectiveness in primary patient care. Seemingly at variance with statistics but have heard stories of statistic manipulation ie triple time etc in dec so the waiting list can be lowered at the "measuring time" but the real lists are even worse for the rest of the year.
 
sorry, but don't see where the waiting lists are actually being cut except for the shuffling around of patients from one list to another. In reality I think it's a load of bollocks. SWMBO who works in a major hospital is amazed by these claims. It's all a case of manipulation, or done by mirrors.
 
Balloon pricking

um, it was you with the inflated balloon of success.

Whatever the archaic practices of which you speak - they also included home visits, the ability to get hold of a doctor at weekends, pregnant mothers being kept in hospital for a week rather than being bullied out the day after giving birth as today, and lots more, and all with much lower taxes.

Blair is mendacious or naive in the extreme in his target of making public sector services attractive to those who could afford to use the private sector. They aren't "better than they ever were" - they're worse. Lots of nurses don't do any nursing any more, and plenty of consultants are paid full-time salaries for a part-time job, so they can still offer an operation next week if you go private.
 
Sorry again, but although there is "gaming" and manipulation done at all levels these patients are not getting magically treated and the stats are continuously followed. Individual patients are tracked to find out how they got from one list to another, or were late being treated, or why they haven't been sent to the hospital along the road who can treat them far quicker.

Again and again this has exposed daft logistical problems which would have been solved in the private sector many years ago.

The NHS has been run for the benefit of well-meaning staff for way too long and there's a lot of kicking and screaming going on - in my experience from doctors far more than nurses who've tended to have the best ideas on how to get things working properly. Doctors are great to go drinking with and great once a patient is put in front of them, but they couldn't manage a branch of MacDonalds, or comprehend how it actually runs. That's not what they're for.

I really must get back to counting things or I'll never get home this evening.
 
"Doctors are great to go drinking with and great once a patient is put in front of them, but they couldn't manage a branch of MacDonalds, or comprehend how it actually runs. That's not what they're for."

Then how come all the doctors I know are moaning about how much less time they've got available for patient care due to the demands of bureacracy?
 
Exactly my point, some doctors dive into management so they don't lose control and many of them struggle with it, particularly delegating the simplest tasks.

I would agree, though, that there is far more paperwork about than needed, some historic but a lot introduced in the last few years, often for good reasons but ineptly designed and often over-complicated.
 
My point was that the time doctors in non primary areas is non discretionary ... Ie they are forced to do it. Your words and anecdotal experience have a vast (and expensive) credibility gap
 
Not what they\'re for

But doctors *do* have to be able to have some of the skills needed to run a macdonalds. The macdonalds guy can't give fabulous attentive service to one customer but leave the others waiting an hour. But this is exactly what the doctors are allowed to do regardles of the structure or managemnet or reporting regime.

The mantra "free at the point of delivery" is hollow: if macdonald's products or services were completelty free and essentially limitless - why wouldn't the first person just make lots of requests, ordering stacks of food or perhaps even eating the stuff on the spot and then trying something else, perhaps asking to see a dietician, or asking to taste/try various things, and discussing each option in great detail. Most tho not all doctors are happy to do this - effectively sqaundering the very product at their disposal - their time.

Some sort of charge should be made. How about a quid a minute, minimum ten quid, refund if you're on benefits.
 
I've used anecdotes because I don't think anybody would be convinced by statistics. I've spent the last few months immersed in NHS numbers and discussions on what should be counted, where the flaws are etc. The received wisdom is so entrenched that anything positive is not believed whether personal experience or numbers.

If you want numbers then look at the Dept. of Health websites (or if you want slightly less massaging then look up local hospitals and strategic health authorities' sites) - compare a quarterly board report from a couple of years ago to today, and you'll see that an "unachievable" 18 month wait is now an unachievable 6 month wait, and so on and so on

The naysayers are getting a bit like Comical Ali who will keep denying that anything is happening until it's "suddenly" all over.
 
You're a management consultant and you should know that "walking the floor" will tell you a million times more things than immersion in stats etc.
 
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