Global Warning

20 September 2008

My one regret at having retired from the National Health Service is that I no longer receive official circulars.

That same week, another doctor friend, on the brink, like most of the British medical profession, of early retirement, kindly sent me the brochure to a conference to which he had been invited, at a cost of only £399.50 to the British taxpayer, on ‘Lean Management in Primary Care’. ‘Lean thinking is a way of streamlining the patient journey,’ said the chairman of the Lean Enterprise Academy. (So, of course, was the T-4 euthanasia programme in Germany, where the patient journey was streamlined in buses marked ‘Community Transport’.) And one of the talks at the conference was to be given by a person whose position was Lead for NHS Productive Leader, a phrase so horrible that it tortures the mind merely to read or repeat it. The main subjects of this personage’s talk were ‘Releasing Time to Lead’ and ‘Focusing on Value: Experiences of a Productive Leader Site’. Another NHS functionary was quoted as follows: ‘Lean’s focus on delivering care is a refreshing antidote to benchmarks, targets and the traditional approach to performance management.’

It is unlikely, outside the confessional, that a franker confession of the moral, intellectual and financial nullity, not to say corruption, of professional management in the public service will ever be uttered. Perpetual bureaucratic failure is management consultancy’s opportunity, of course: without wilful incompetence, inefficiency and stupidity, where would the fees come from?

‘Lean is not a management fad,’ said the same functionary. And, as Magritte wrote on his painting of a pipe, this is not a pipe.

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timothy

September 19th, 2008 12:14pm Report this comment

Theo - you rock. Or to use your exceptional English; you have truth by the jugular and you allow its gradual breathe to surface for all to see.
I am not in medicine, [ sorry medication ] I am involved in Education. I used to be a teacher but the American trainer [ from which all this nonsense emanates ] at my recent work[sic]shop regaled me with the nuances of differentiation.
The saddest thing about this state of affairs is how much young professionals pay lip service to it.
I am a trainer and differentiated. But I don't know I am. Please discuss.

Chris Ashton

September 19th, 2008 1:48pm Report this comment

You're better off out of it mate. We all are. The NHS is a third world entity.

Kpar

September 20th, 2008 2:24am Report this comment

Timothy,

Speaking from the other side of the pond, I assure you that "all this nonsense" does not necessarily emanate from here- which is not to say we don't have our problems. We on the right here in the USA view with horror the UK's capitulation to socialized medicine, and greatly fear the destruction of the world's greatest medical system by our own dimocrats.

Yes, almost any trainer in any field from the USA is likely to be a lefty loonie, because the folks who decide who to invite are more interested in promoting their own agenda than in showing what works.

God Bless Lady Thatcher and Ronald Reagan- both interested in results, rather than cant.

Do something!

September 20th, 2008 10:53am Report this comment

One wonders why on earth, we who are on the rational side of this garbage have allowed it to proliferate.

Something is the matter with us. Laziness. Do nothing - then expect more of the same.

Do we think we are so few that we cannot make a difference? It takes 5 minutes to write a letter or send an email protesting every time we encounter garbage and even 50-100 protests would help towards eliminating it.

Sara Waterson

September 29th, 2008 7:39pm Report this comment

The idiocy and myopia of the NHS Management is so engrained, it's impossible to get to grips with it.

I recently had a fairly minor but entirely necessary sinus operation - until I had it I was incapacitated. Our local NHS Trust has conceived the wonderful notion that operations are scheduled according to surgeon slots, whether there is a bed available or not. Busy surgeons, anesthetists and fullly trained theatre staff therefore come in to work in the hope they will be able to use their skills and their well-paid time. Often they cannot, since there is no bed available for the waiting patient - this happed to me, and the staff were so mad they told me how often it happens.

The fact the hospital is the main - indeed only - A&E over a very wide area, and that a lot of wards have been closed, only exacerbates this situation of course: A&E 'victims', often little old ladies who have fallen over and live on their own, take priority. The chronically sick like myself - having what was laughingly referred to as 'elective surgery'! - must be pushed to the back of the queue.

Sympathy for the busy professional and the working or even stay-at-home mum, who have all had to re-schedule work and family committments for their operation, seems entirely lacking in the Management; the hospital is of course run for their convenience and no-one else's. So long as every bed is full at every moment, that's all that counts.

It's not they who have to bear the brunt of the patients' fury and distress, of course - it's the staff who have to break the news that one is being sent home un-doctored, and will have to psych oneself up again, re-make all the arrangements and pay the taxi fares all over again. Maybe more than once... Yes, next time I went in I was again told there was no bed....

Since then I've heard of numerous people who've had the same experience. the waste of Surgeons' time is a scandal.

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