Thursday, 13 December 2007

Happy Days

Dr Ray (In my dreams!)

Apologies for neglecting my blog for the last couple of weeks.
Blogging for some of us is born out of turmoil and strife. It is a cry for help and attention. I hope I am not tempting fate by saying things have been going pretty well recently and my need for blogging has correspondingly decreased.
I started blogging in the closing months of Blair and Hewitt. Contracts were being signed with the private sector to put me and my colleagues out of work and the medical profession were generally getting a good kicking and were too timid to resist.
Now Blair and Hewitt have gone. Mercury Healthcare and a few other private sector "providers" have been told to sling their hook and, even though the medical profession has not become militant, the government is being brought to account by the police over the way they reneged on independently recommended wage rises (as they have done for doctors over many years).
Add to this the total shambles that passes for Gordon Brown's premiership and I am beginning to think the government may lose its appetite for meddling too much more with the NHS for ideological reasons.
The cherry on the cake came yesterday while watching Gerry Robinson on "saving the NHS" (or Rotherham General Hospital to be precise).
Sir Gerry wasn't very complimentary of the consultants when he did his first program last year, blaming them for the hospital's problems and failing to see the bigger picture and understand the reason for their lack of enthusiasm for the changes being foisted on them by managers. A year later he recognised that Rotherham General was just a pawn in the great game the government was playing with the NHS. Even though the Hospital was working flat out and providing a service which was obviously in demand a £12m Polyclinic was being built within walking distance which would make the General Hospital non-viable. And what sort of work would the Polyclinic do? Sir Gerry asked the CEO of the primary care trust. The Polyclinic would be a nurse-run walk in centre for people with bumps and bruises or for people who felt a bit "iffy" while at work. Sir Gerry pressed him on this but that is as specific as he could be. That is the level of planning that has gone into Polyclinics. They are going to target people who are well enough to go to work but feel a bit "iffy". In return the District General Hospital in Rotherham, which serves 250,000 people will probably end up closing. Why does this make me happy? It's because I already knew this was happening but was having trouble explaining it to anyone else. Sir Gerry has exposed the sham of Polyclinics to a much wider audience than I could ever hope for and made Lord Darzi look like a fool. I hope they repeat the program. It's a good thing Sir Gerry already has his knighthood because I don't think Gordon Brown would honour him now, not even for money.

The other reason I haven't blogged is more mundane. A couple of weeks ago I noticed that UK-Radiology, our private radiology set up in Hereford County Hospital, had dropped off the first page of Google for the search term "private MRI scan". It was still on the first page for all the other relevant search terms I could think of but the demotion riled me and I have spent all my free time trying to get back links by doing articles and "press-releases" to post on the web, going on to medical websites and forums and submitting my URL to directories. It takes some time to influence google ranking and I still have a bit more to do but I hope this all works.
My little enterprise with UK-radiology is one year old this week and despite the google set-back is continuing to grow and attract patients from throughout the UK. It has enabled our NHS department to recruit more staff while the rest of the hospital is making redundancies, we run the scanners for longer, offer open access for GPs and our department is in financial surplus. Isn't it amazing what NHS consultants can achieve if they are properly incentivised.


PhD scientist said...

Glad to hear a success story, Dr Ray.

As an ageing public sector socialist, I am a diehard believer in "the people doing the job know what is not working, and if you let them they usually know how to fix it".

My deepest loathing is reserved for Management Consultants, who are basically parasites for hire, the modern equivalent of Hired Gunmen in the Old West

Dr Ray said...

Thanks phd scientist.
One of the principles I have been following is that NO money from our venture goes to the various low lifes that buzz around the NHS like flies around a decomposing body.
Support from folk like you has helped during the inevitable troughs and, like you said before, the fight is not over.

PhD scientist said...

One of the problems Univs and hospitals share, of course, is having essentially a single paymaster, the Govt, who dishes out the money via various schemes which change constantly, and thus calls the tune.

The result of this is the creation of a ramifying cadre of managers whose job is to manage collection of whatever set of figures, or "future vision-ing plans", or "statement of core objectives" is being required by Dept of Education (Univs) or Health (NHS) central control this year to loosen the purse-strings.

So managers endlessly face upwards /outwards (to central control) and either ignore or issue diktats downwards (to the organisation and its front-end staff).

I would hear endlessly from Mrs PhD Sci (one-time med reg, anaesthetics/ITU SHO etc) about all the sorts of things on Gerry Robinson's TV shows (Theatres w full operating team regularly waiting for 40 mins for someone to find a porter to bring the patient down, theatre staff who went to fetch patients being reprimanded for breaching H&S regulations, understaffing and hiring freezes causing knock-on delays through multiple departments etc etc).

My standard question used to be "If your managers don't work to fix these sort of real operational problems, or at least enable the staff to fix them, just what exactly is it that the managers all do all day?"