I liked this from Roy Lilley this morning, in a discussion on why he thinks Silly Boy (as he calls Wes Streeting) will get his NHS reforms wrong:
Is there an effective way of looking at the NHS' predicament and coming up with a simple fix?
Yes… it's called the Aristotle school of management!
He laid the foundations for 'structure, inquiry and argument' by asking key-questions. Later Thomas Aquinas divided questions into categories and they have evolved into the 5 W's.
Who, why, what, when and where. For the NHS it means…
- Who is sick
- Why are they sick
- What can we do to fix them up
- When can we do it
- Where can we do it
It's all we need.
Who, older people and children are the heavy users of the NHS... 60% of all of us, pitch up with lifestyle related problems. About half of cancers are discovered in A&E.
Why, because older people are unable to take care of themselves and there aren't enough people to help them. Some families struggle to bring-up their kids without support. The rest of us eat, drink and do all the wrong things and don't do the right things and we don't scan enough people, early enough.
What, to do? Invest in social care, reintroduce Sure Start. Take-on the people making junk-food by taxing the junk and not taxing the rest. Focus on early diagnostics.
When, can we do it? Whenever we want to. Now would be good.
Where, we have thousands of GP premises, 1,257 hospitals of various sorts, 500 community hospitals and 6322 Neighbourhood Health Centres. We just need to maintain and repair what we've got, make sure they have modern kit and in particular, look after the people working in them to make it all productive.
In about 150 words, this looks to me, like a plan that would would pass the effectiveness test.
Can Roy be accused of being simplistic? Of course, he can: an international consultant would charge many millions to come up with these ideas.
Can he also be accused of being effective? I think so: what he says is likely to work.
And can he be accused of clear thinking? Most definitely. That is something Silly Boy will never achieve.
As a result, the NHS will be subject to a great deal of unnecessary reform.
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I suggested some of these things to my MP who has responsibility as a Junior Minister for hospitals. But she responded with concerns about the black hole and “look what happened to Liz Truss”. She was clearly more worried about the health of “the markets” than the health of her constituents in this v deprived neighbourhood. She used to work in NHS admin. She ought to understand the irrefutable logic of what you have written here. Labour have the parliamentary majority, they are the government, what are they waiting for?
The true “black hole” is the absence of a Little Black Book explaining to these amateurish MP’s how the UK’s monetary system really works!
At the most basic level it cant take a genius to work out what we need to spend annually to keep the NHS Estate in good order and its equipment reasonably up to date
Lilley’s assessment is simplistic because it is obvious. Streeting, on the other hand, is working under instruction of those who have paid him and his party to work in their interests and privatise the NHS. No doubt he will be well rewarded. It’s called corruption! I make no apology for saying this as everything points to this being the only conclusion I can reach having considered the actions of this and previous governments. As the saying goes “ if it looks like a duck and it walks like a duck and it quacks, it’s duck”!
Silly Boy is focused on other things, such as his stand-up career. https://www.theguardian.com/politics/2024/sep/22/sue-gray-shot-jfk-and-is-hiding-lord-lucan-jokes-wes-streeting
In Derbyshire, the local hospital in Bakewell is being demolished and rebuilt – much smaller BTW – and the rest of the site is being demolished for ‘redevelopment’.
Bakewell is a market town and is quite a desirable place to live (although the local river has become a threat).
What do you think is going to happen?
As the railways were wound down, loads of railway land went the same way – ‘development’ essentially culling local access to the network, increasing the reliance on roads. Gone forever.
We need to watch the NHS because I guarantee there will be an arm in it (Estates?) where asset stripping will be going on. Why are we having a smaller facility in the face of higher demand with an elderly population?
I would have loved to have been a fly on the wall looking in on the meetings, emails and clandestine lunches that lay behind this decision.
There is a lot of unrevealed corruption going on out here in the shires in my opinion fuelled by greed. We are going backwards you know? We really are.
Very important point
Thank you, both.
Mum joined the newly created Department of the Environment in the mid 1970s and was soon told by her manager how corrupt local government, including our home county, is. Mum has observed in the decades since.
Privatisation of rail, water etc and the closure of military bases. fuelled such corruption.
From 1870 – 1980, all forms of government came to own at least 20%, perhaps as much as 25%, of the UK’s mainland landmass. The figure is a bit below 10% now.
From the seventies onward, governments cant resist tinkering and reorganisaing the NHS .
As this summary – https://lowdownnhs.info/explainers/nhs-reorganisation-a-never-ending-story/of decades of NHS reorganisation says:
” we would much prefer not to be starting from here – an NHS disintegrated and fragmented by over 30 years of marketising ‘reforms’, crumbling after a decade of frozen funding and inadequate capital investment, wracked by chronic staff shortages, and its senior management largely lobotomised by decades of increased dependence on management consultants and their various quack theories that divert money and effort from patient care”
Silly Boy shows every sign of begin enamoured by further ‘quack theories’ diverting money from patient care.
Excellent post – bothRoy Lilley’s and yours.
However – a small point re your punchline, Richard – but I think an important suggestion.
Could you make it standard practice in your posts about and/or responses to politician’s/goverment’s statements , never to use the word – reform – without single quotes around it. It is so abused by these people to imply, or even more brazenly, to declare a benign intention when none is in evidence. It is one of their most insidious deformations of discourse and we need to fight back.
Noted
AND – the contrast with your proper use of the word in your post on HM Revenue and Customs underlines my point exactly!!