11 NHS trusts placed in special measures.

[Workingman]

Why? Because they failed, and are still failing, their patients. They have managed to undershoot the minimum standards of care required and have done so on a regular basis over a long period of time.

It is right that special teams are sent in to turn them around, but something has to be done to ensure these failures do not happen again. What is it?

What of those who managed these failures? Where are they now? Where is the list of them with P45s? If they are still with the NHS, and still in management positions, they will be an indication to future managers that failure is rewarded - that is not the way to go.

[KateLMead]

They are firmly ensconced within the NHS Frank... With their fat pensions intact. Those who have left have received mammoth pay-outs. One fat cat physically as well as metaphorically received over a million!! (Sick) along with fat indexed pensions, landing new jobs within government.. The whistle blowers bullied fired under threat, no fat pay-out for them.. And Nichols the abomination of a man still sits at the helm.

[cromwell]

I think it will happen again; I think it's inevitable.
As Kate has pointed out, the management of the NHS remains much the same; and regardless of whether a few managers are eased out, their replacements will be cut from the same cloth.
The problems in other areas of the NHS remain the same. Namely stuff like disasterous Private Finance Initiative deals that were signed to build new hospitals. Labour's policy of "let's chuck a megaton of money at the NHS" without remotely getting any value for money has hamstrung some Trusts. The Mid-Yorkshire trust has a 25 year deal so financially crippling that they are having to sack workers and cut wages just to stay afloat this year.
So the understaffing in some Trusts is just going to get worse, and there is no solution to the NHS financial crisis in sight.
The culture of data, data, data will not change; and to supply that data front line staff have to spend more time box ticking and form filling - so less time with the patients.
So understaffed hospitals, an ongoing financial crisis, more demands on the staff that are left and no change in the NHS management culture.
How can the disasters of Tameside etc, NOT happen again?

[Suff]

There seems to be one constant thread throughout this... Labour.

But of course it's the current Administrations fault for not fixing the mess...

Come election time it will be the fault of the Coalition and we'll get Labour back to "Make things worse".....

It took the winter of discontent to wake people up and make them understand that Government can totally screw the country and our lives up. It took the UK more than 15 years to recover from that debacle and even then with North Sea Oil to fuel the funds.

Until people realise that their vote is important to their lives and that they need to understand at least something of what the "Bandits" standing for office mean, in terms of their long term bottom line, then this will continue until things become so badly broken that it can only be fixed by throwing it out the door and starting again.

And NOBODY outside of government and big business is going to like that.....

[Workingman]

I am not saying that governments are not wrong, far from it, some are more wrong than others. Few are rarely right.

However, I believe that there is a culture within management circles which almost encourages bad practice.

A captain is responsible for his ship, a pilot for his plane and a driver for his lorry. If any of them are ever found responsible, even for an accident, they will be reduced to the ranks and maybe even have their licences to operate revoked. That culture makes other captains, pilots and drivers sit up and take notice - it makes them aware of their responsibilities. It is common for the lower orders to be punished when they are not up to the job.

In management circles it appears that the opposite is true. These people are quite happy to take the high salaries, bonuses and pensions when things are doing OK. But when things are going wrong they are allowed to resign, walk away, take their bonuses and pensions and start all over again - often at a higher rank.

If things are going to improve that culture must change, and change PDQ.

[Lozzles]

Spot on WM!

[cromwell]

In management circles it appears that the opposite is true. These people are quite happy to take the high salaries, bonuses and pensions when things are doing OK. But when things are going wrong they are allowed to resign, walk away, take their bonuses and pensions and start all over again - often at a higher rank.

If things are going to improve that culture must change, and change PDQ.

Yes. Part of the reasons they get their big money is their "responsibilities". But usually when things go wrong in the NHS, NOBODY seems to be responsible.
"It's not the policies, it's how they were implemented" is a 100% reliable get-out-of-jail card for management, because it means they can never be responsible for anything.

[Suff]

I'm aware of that WM. It is the way that we work and improve ourselves.

However, consider this.

PCG's, set up in 1999 by charming and gormless, gave money and power to the GP's. Whilst the hospitals, which they required consultant service from were funded from a different budget.

So let's now take a case like the beverly allitt case.

People took out litigation against the NHS. The fines levied against the NHS came out of the patient care budget of the Hospitals. The PCG's were a different branch. That case created a 11 million black hole in the funding of the hospitals. It meant that 11 million worth of treatment was not going to happen.

The only place for this funding to come from was from the PCG's (The GP's themselves). Because it was the only pool of finance left that could be spread to cover it.

Do you think the GP's were happy to have their budget raided so that their patients could be treated in the hospitals?

So when the hospitals fail to meet their targets and the auditors come with their nicely sharpened pencils, who do you think is going to go first?

The consultant doctors who didn't have the funds to treat the patients?
The management team who couldn't convince the GP's to share the load?
The actual managers who failed to spot Allitt and what she was doing?

Will they even recognise that it was the attempts of families to gain some "satisfaction" from the NHS which caused the NHS shortfall in funds for services in the first place. Should we go after them?

Just who do you blame?

The system is so complicated, responsibilities are so divided and the actual ability to deliver is driven by money and a lack of insurance.

Granted, I believe the person at the top should be held responsible. But that person also has to have Authority. If you divide the Authority, then you divide the responsibility. it is the responsibility of this government to simplify the structures of the NHS to the point where specific people can be held wholly accountable. It will be the aim of those in administration in the NHS to try and derail this and muddy the waters as much as possible.

It takes a very keen knife to find the difference between healthy organisms and dead wood when you start cutting.

[pederito1]

Why don`t the government just bite the bullet and say they just cannot afford the free NHS that everybody craves for without doing something about the terrible waste and follies that go on. Like the huge saiaries and redundancy pay offs, unnecessary high tech gear, IT systems that don`t work, ridiculous compensation payments and rogue consultants who persuade the authorities to have new hospitals with en suite rooms for every patient, nice but for free? As for PFI hospitals words fail me. NHS spending has to be taken in context with all the other government follies like supporting american worldwide terrorism and subversion plus the cost of the booming birthrate amongst immigrant population... surprise , surprise.

[Workingman]

The Beverly Allitt case is interesting. It could be argued that if she had been managed effectively she would not have been able to carry out her atrocities and, therefore, no litigation.

Fines are the bluntest of bunt tools and rarely, if ever, hurt those responsible for failures. If the BBC makes a broadcasting error it ti the licence payers who stump up the money for any fine. If a hospital fails in its standards of patient care the fine comes out of the hospital funds thus hitting patient care - a double whammy. If a commercial enterprise is fined it will almost certainly find ways of passing on the fine, plus a bit, to its customers.

Ped, I couldn't agree more. The NHS is one of the largest employers on the planet. It has the financial clout of a small country, but it is not used effectively. It has been broken up into smaller units all trying to outdo each other, all with limited buying power.