Sunday, 7 October 2007

We're loving it.

"enhancing the client’s reputation by positioning them as open, engaging, listening and responding."

Readers of the right-wing blogs might come away with the idea that there is widespread dissatisfaction with our current political leader. Readers of medical blogs might think that the millions of pounds of taxpayers money have been wasted. This is far from the truth.

Take Opinion Leader Research for example. This company has been running the Citizens' Juries for NuLabour. OLR thinks taxpayers money has been well spent. Why does this matter? It matters because if OLR thinks it then you think it too - that is their job. They proudly claim: "Opinion Leader influences". Why do they think the money has been well spent? It has been well spent because a large amount of it has gone to them. The tag-line "enhancing the client’s reputation by positioning them as open, engaging, listening and responding." is also from their website. It tells us clearly what our money has bought. It hasn't told us anything about public opinion; it has been used to give the impression that this government cares about public opinion and thus enhances its reputation.

As an extension of the democratic process the Citizens' Juries are profoundly undemocratic. OLR gets to pick the participants and gets to chose the questions. The participants are only told selected aspects of the argument and, in the atmosphere generated during the "consultation" can be manipulated by skilled moderators (or social influencers as OLR prefers to call them). There seems to be no rigorous audit of the selection or voting process.

OLR conducted the "Your Health, Your Care, Your Say" Citizens' Jury for Patricia Hewitt in 2005. Never heard of it? Pulse magazine said:

"The Government has fixed its flagship listening exercise on the future of primary care to ensure it backs pre-stated plans for dual registration, walk-in centres and an increase in private providers."

Sounds familiar? This seems to have been a dry run for the current Darzi review and had only 89 participants.
Pulse later did a FOI Act inquiry on the event. Its conclusions were:

"The finding supports accusations by GPs and academics (Pulse, 24 September) that the consultation was a sham exercise because it focused on a restricted range of issues relating to access, but marginalised others such as continuity of care.

The documents also reveal that Opinion Leader Research was asked to write a proposal for the Your Health, Your Care, Your Say consultation before other organisations were even asked to tender."

It also found out that OLR were chosen instead of other pollsters, ICM and MORI, even though the OLR tender, at over £2,000,000, was more than 10 times higher.

OLR are also involved in "consultations" over nuclear power. An item on the Channel 4 website is eerily familiar:

"In the videos - alternative viewpoints had doom-ridden music in the background. The government's view was then given against calm, relaxing music. I feel I have been mugged."

"Not at all a consultation, merely a sleek marketing ploy."

"I went in with an open mind... myself and others felt we were being misled and manipulated."

So-much-so that Greenpeace withdrew from the consultation and made a formal complaint to the Market Research Standards Board. Unlike the recent Citizens Jury on the NHS, which I documented last month, many people have come forward to complain about the conduct of the Nuclear Energy consultation. Their description of events confirms the tactics routinely used by OLR to give the government the answer it wants while appearing to consult.

OLR's stated aim is to "enhance the client's reputation". Taxpayers are footing the bill for enhancing NuLabours reputation. Well, you can't polish a turd (not even with another turd) so this is money wasted and NuLabours reputation further damaged, if that were possible.

Here's a novel idea for the Clunking Fister. How about we give real democracy a try and let us elect our own Prime Minister?


Anonymous said...

Now, You know that Nu Labour isn't going to do that. Its all about CONTROL.

No one elects prime ministers anymore. Nu Labour is there to tell us who to elect :)

The Dr Ray Fan Club

Anonymous said...

PRESS RELEASE FROM THE DOH. One for you to blog Dr Ray.

Department of Health (National)

(DH) New data shows NHS working smarter

'Better Care, Better Value' indicators show increased productivity in NHS

New figures show that the NHS is working smarter to improve productivity, according to latest data published by the NHS Institute.

The latest Better Care, Better Value indicators show that in the past year, the NHS has released £363 million by working more efficiently. The indicators show trust-by-trust performance across a number of key efficiency and productivity indicators. They help the NHS identify and share best practice throughout the health service and improve efficiency and productivity.

The statistics show that in the last 12 months the NHS has increased productivity on a number of key clinical indicators. Highlights include:

£152m was released by reducing the length of stay;

managing variation in emergency admissions released £79m;

increased prescribing of low cost statins released £77m; and

£40m was released through managing variation in outpatient appointments.

The Better Care, Better Value figures also show that there is variation across the country in efficiency and productivity - but significant benefits to patients could be delivered if Trusts learn from best practice. Enabling Trusts to compare themselves to other NHS organisations gives local staff the opportunity to identify where they should be focusing their efforts to improve services.

Health Minister Ben Bradshaw said:

"These figures demonstrate a significant achievement. In the same year that the NHS is back on a stable financial footing, productivity across a range of key indicators has also increased. But productivity is about working smarter, not harder - improved efficiency will deliver better patient care as well as better value to the taxpayer.

"With record investment delivering improvements to patients - such as waiting times at their lowest ever, improved access to cancer treatment, and increasing choice for patients across a range of care - it is only right that we work with the NHS to improve its productivity.

"The NHS is becoming more efficient and productive, freeing up more money to reinvest in patient care. But more can be done - the NHS budget is not infinite and I want all trusts to look at these figures to see what they can do to become even more efficient with taxpayers' money."


Notes to editors

1. The figures are published on the NHS Institute website at

2. The indicators have been selected on the basis that they are areas that could have significant impact on patient care. The data is published on a quarterly basis and NHS Trusts will be informed how they compare to similar organisations to help them identify best practice and areas of underperformance so that they can put plans in place to tackle them.

3. The productivity opportunity for each indicator is calculated by assuming that organisations improve their performance to that of the top 25% of organisations for that particular indicator.

4. The indicators are:

Reducing length of stay

The number of bed days that would have been saved if there had been a 25% reduction in the amount of time spent by patients in excess of the median length of stay for patients with the same age, sex, diagnosis, method of admission and social deprivation. This is expressed as a percentage of all bed days in the trust.

Increasing day case surgery rates

The percentage of all operations from the Audit Commission basket of 25 procedures performed as a day case.

Reducing pre-operative bed days

The percentage of all bed days for patients undergoing a procedure in hospital between date of admission and date of operation, where valid data were available. Note that trusts that perform well on this indicator may have scope for larger improvement than trusts that perform less well if they have significantly more activity.

Managing variation in surgical thresholds - PCT

The surgical thresholds indicator shows whether the rate of operations for a basket of five procedures is higher or lower than would be expected given the PCT population. The indicator is the ratio of the number of procedures that took place to the expected number, so each operation is weighted in the indicator according to the relative level of activity.

Managing variation in emergency admissions

This indicator shows the ratio of actual emergency admissions to the expected level, given the age, sex and need of the population for 19 conditions. These conditions have been identified as ones where community care can avoid the need for hospitalisation.

Managing variation in outpatient appointments

The ratio shows the level of first attended outpatient appointments compared to the level that would be expected given national rates and adjustments for the age, sex and need of the population.

Increasing low cost statin prescribing

The indicator is the number of prescription items for low cost statins (simvastatin and pravastatin). This is expressed as a percentage of the total number of prescriptions for all statins (excluding combination products).

5. The productivity opportunity has reduced in each indictor by the following amounts:

Length of stay £152m
Day case rate £2m
Pre-op bed days £4m
Surgical variation £9m
Emergency admissions £79m
Outpatients £40m
Statins £77m

Garth Marenghi said...

great piece,

citizens' juries are a disgrace, it should be illegal to name them as such,

I just wonder how much money they are wasting in pretending at democracy, they couldn't break their habit and listen to us could they?

no I forgot, they're c*nts

Dr Ray said...

Anonymous #2
Thank you,
I do believe the NHS is becoming more efficient but what the press release hides is that front line services are suffering to achieve this.
It is like a football club saving money by not having a goalie. If an accountant looked at a football game it would seem that the goolie is really an unnecessary cost as he is only working for a few seconds during the 90 minutes. Developing skill-mix in the defending players and getting rid of the goalie would seem sensible and would result in increased efficiency.