Joe Public wants NHS to spend its cash on cancer, mental health, not digital services The public wants the NHS's £20.5bn cash boost to be spent on cancer care, mental health and recruiting and retaining staff – not digital services. According to a poll carried out for think tank IPPR, access to digital services is the lowest priority for spending, with the highest being better quality cancer care. The survey …
Politicians think things get done by talking about them. So "digital" looks like a logical extension - talking about doing things, but on a computer.
I am sure there are many gains to be had by applying computer power to the NHS, but not in the way politicians want to do it. Healthcare requires people and facilities, both of which are anathema to McKinseyites. Government policies have been delivering overpriced facilities and putting off the very people needed. Privatisation has often been failing where tried because medicine involves a lot of risk and investors don't like it.
Sadly, unless someone finds a way of extracting politicians from the NHS, I can't see things getting better.
What's the point of IT in the NHS when after you use it you still can't get an appointment due to staff shortages?
As a case of putting the horse before the cart this ranks as a classic.
On the other hand if the revolution in IT means that the private sector gets to cherry pick all the profitable bits then I am sure that the government will be more than happy to oblige
Oh, a last thought. If Capita are involved then we know we are stuffed.
The public, those imbeciles the elites despise, show they have a better grip on reality than the elites as usual. Shiny new toys wont do any patients any good if there is anyone available to use them. New IT initiatives will fail so they are not addressing a fundamental problem in health care; it is incredibly personnel intensive with much of the personnel being highly trained and expensive on the payroll.
New IT initiatives will fail so they are not addressing a fundamental problem in health care; it is incredibly personnel intensive with much of the personnel being highly trained and expensive on the payroll.
I don't disagree with you but you need to look a little deeper than the survey. I note it refers to digital access services, i.e. customer facing services. I'm not surprised. I'd expect greater support for back office services if they cut costs and/or improve the service. You wouldn't believe how much resistance you get within the NHS to any kind of change.
For example, I've encountered practices who will for example flat out refuse to accept patient notes via email (typically under the premise "it's not secure, can't you fax it?") despite the fact NHS regulations (and the professional bodies) confirm that approved secure email is in fact the preferred method of transferring notes in an ad hoc manner (fax is only a last resort because of it's security concerns. Oh, and they're contractually required to accept notes by email.
Many NHS IT projects, especially ones that cross organizations, face a difficult deployment because of those attitudes rather than any technical factors.
HIT. NAIL. ON. HEAD.
One of the big problems with the NHS, as with most of the public sector, is cultural. Not the medical staff but the administrators and management. Every time any politician talks about giving more money to the NHS, I grown inwardly, because they don't efficiently spend what they're already getting. Every NHS trust has its own IT, procurement, management, administrative functions. How much money could be saved if functions like these were centralised? But, of course, the senior civil servants resist change like this because if you take away some of their money, you take away some of their power.
>The public, those imbeciles the elites despise, show they have a better grip on reality than the elites as usual.
It shows you can get any answer you want if you write the survey question,
Do you think the NHS should spend more money on lifesaving drugs or cleaners?
- see which answer you get from the public vs an 'elite' infectious diseases specialist
Do you think the NHS should reduce the number of managers?
- and have surgeons ringing around to get a quote on unblocking the drains, or having your cancer specialist spending 3 days/week sorting out the NI contributions for their team
"Do you think the NHS should reduce the number of managers?
- and have surgeons ringing around to get a quote on unblocking the drains, or having your cancer specialist spending 3 days/week sorting out the NI contributions for their team"
You don't need managers for that, one office gopher will do more of it and better than any three managers together.
Net savings: three management salaries at least as that office gopher will earn back his own salary in better quotes and better quality of job done.
> access to digital services is the lowest priority for spending
Not surprising since almost all NHS computer systems are so badly designed and implemented that they end up making people's work environment, stress and efficiency worse.
Rather than allowing IT people to design stuff for the NHS - a group of people they generally know almost nothing about, I feel they should let the medical staff tell them what is needed. In most cases they would point to a non-computerised thing and say "make it do exactly what that does".
FAX machines spring to mind!
Oh, and fatty lard-buckets getting off their portly posteriors and doing some exercise.
Unfortunately, exercise is a poor means of losing weight, due to the remarkably high energy density of a fat and sugar laden diet. The key to weight loss is simply eating a lot less of carbs, fats, sugars and booze.
Now where are bloody scientists when you want something useful doing? They need to do one of three things:
1. Make chips, sausage and bacon have the nutritional value of lettuce
2. Make lettuce taste like chips, sausage or bacon
3. Make me believe that I enjoy lettuce more than sausage chips or bacon.
Any one will do.
Common perception, and multiple localised newspaper/radio reports all have it the the MAIN thing people want from their NHS is free and unlimited parking when they get there.
Mind you, something needs to change. On my last visit to a hospital, accompanying a friend (i rarely need to go myself, yet) i was staggered at the length of the queues simply to purchase a parking ticket. Which certainly are not cheap.
I also wonder about the make up of the "1800 adults" involved in the survey and the detailed breakdown of them.
To, erm, borrow a phrase from above, the lardy-arses, especially if heavily into social media, are going to have a completely different wish list to those of us with a more active outdoor lifestyle.
Common perception, and multiple localised newspaper/radio reports all have it the the MAIN thing people want from their NHS is free and unlimited parking when they get there.
Of course it is, because they can use the free car park all day while they bugger off to work in a car share. I'm afraid to say that the only thing that prevents this is to make it the most expensive available option.
Bloody tough on the (out)patients and their visitors though. Needless to say the problem is solvable but it requires a bit of imagination on the part of the hospital authorities to make it work, and if our local hospital is in any way typical that imagination is woefully lacking; whoever designed the car park put the disabled parking spaces on a slope with insufficient space between adjacent vehicles to open the doors fully to allow a wheelchair - bound patient to get out or into a car without a major struggle. Anyone else here tried pushing a wheelchair up a slope? Or worse still, across a slope?
"because they can use the free car park all day while they bugger off to work in a car share. I'm afraid to say that the only thing that prevents this is to make it the most expensive available option"
There are other options, e.g. sliding scale of charges to make all day parking unattractive, combined with "collect from ward" reduced-rate all-day parking chits if you're a known patient (see below). My local hospital is in an out-of-the-way place (i.e. not attractive for park-and-ride type usage), and yet is in the top 5 in the UK for parking charges income (and frequently you face a 30 minute queue to park).
"Bloody tough on the (out)patients and their visitors though"
Indeed. They are supposed to offer reduced-price arrangements for those with chronic conditions (e.g. cancer) under the Equality Act, but quite a lot don't.
Exactly. It's an entirely false dichotomy. IT is a means to an end, no matter what magic properties the brexiteers may endow it with in their imagination. Insofar as it helps the NHS in its goal of treating patients better (whether directly or indirectly - e.g. by supporting admin), spending on it is justified.
A survey that puts IT in opposition to the goals it supports is somewhere on a scale from disingenuous to clueless.
@Jimmy2Cows - I guess that was directed at me?
It was a reference to the magical thinking that makes IT a "solution" to a problem. As opposed to a means to implement a solution. Brexit seems to be the leading example of that today: those calling for a technological solution seem to be missing the idea that there needs first to be a political solution to implement, and denying all efforts to reach a political solution.
To be fair the public have been asked a few things recently where it could be seen that they got it wrong.
Realistically if you ask a member of the public who knows nothing about the need or reasons for good IT they won't put it up top on a list of priorities, in fact they would prefer if it all went back to paper like in the good old days.
My experience of the NHS is that it is still strongly focussed at old people, those who don't have, or have no knowledge of how to use, a computer. Everyone gets appointments by letter, and it is difficult to interact via modern technology as the tools are often not there.
My GP's service is now partly digital, and that's a good thing. I can go online and book a doctor's appointment, but I still can't book a nurse appointment without using the telephone, and waiting, and waiting, and waiting and... oh hello, yes, I'd like to book an appointment please. (I thought being on hold was something I left in the 80s, but now as I get older I'm being dragged back into the past as I interact more with the NHS.)
I will probably have to wait another 20 years before all the computer illiterate folk die off and we can finally move to a better more modern system.
Unlike others here I don't blame the politicians, I blame the voters -- they are the real twats that force the politicians to do stupid things. If we didn't have voters the politicians could actually be allowed to do a good job.
"Unlike others here I don't blame the politicians, I blame the voters -- they are the real twats that force the politicians to do stupid things. If we didn't have voters the politicians could actually be allowed to do a good job."
You are partly right: the voters should vote for politicians who have first proved their competence in any field but politics (and second hand car sales).
Cor, somebody got out of bed the wrong side this morning.
Being old is, as far as I know, not an arrestable offence and why criticise people who were well into middle or old age before the internet and computing in general? It's not their fault that things have moved so quickly that they are out of their depth with something that is totally foreign to them.
Margaret Thatcher said once that growing old is easy, you just have live long enough. So just wait, your turn will come and you too will be regarded as a burden with nothing to offer, fit only for the knacker's yard.
Vladimir Putin, Kim Jon Un and Xi Jin Ping are politicians who do not need to take any notice of their citizens. Want to live in a country run by these characters?
As the old saying goes "Be careful what you wish for, you might get it".
Speaking as someone who probably qualifies in your cynical eyes as an oldie. I try to do stuff online, But I've only been connected at home since 1995, Logging into "My Health Online" (the online portal for Wales) I find that there are NO appointments available in my GP practice, A situation that has existed since LAST YEAR. The only way to score an appointment is to queue daily @8.am - 1970's style. A situation BBC Wales has covered a couple of times in the last year or so - hardly something the NHS big wigs or the muppets in Cardiff Bay can be unaware of.
The NHS Trust here is more interested in building a new Super hospital miles from any real civilisation in order to run down two more lopcal DGH services that are 40 miles apart, despite having no funding for it AND this being a very rural area with poor road links and almost zero public transport in thier preferred area.
The real issue with the NHS is the moronic manglement. clear out all that dead wood and listen to the CLINICIANS who are supposed to be at the heart of the NHS rather than being treated as an afterthought as is now the case.
You were nearly right... its actually an old boys service - providing ego stroking positions on boards and health authorities for nonentities and politicians friends who should be kept away from making real decisons that impact other peoples lives.
Then tell management what's wrong. Senior management if necessary, and write a detailed memo (the process of which will help anticipate possible attacks on your analysis). Discuss it with any colleagues you can trust.
If that goes nowhere, blow the whistle to the press! At this point, your memo is your chief weapon in being taken seriously.
I should add, I myself failed to do that at the beginning of my career. I just left two jobs where I'd been doing such useless work. In retrospect I regret my lack of self-confidence. By the time I hit 30 I was successfully avoiding projects like that.
Well, that is stupid, with bringing the NHS more up to date with IT you can automate and make it more efficient. App GP's wouldn't have to be in your local area but can prescribe you with the medicine to help. Faster appointments and work from home doctors would mean that you can spend less on staff but still have the job satisfaction. We would still need local GP surgeries to help with issues that cannot be quickly diagnosed via an app. But this would help tonnes of people, speed up service to patients and save money in the long term.
You could even have E Waiting lists so that you don't have to wait in a hospital for 5 hours for an x-ray.
Anyone going against this doesn't know the true power that can be done if this was implemented correctly.
I buy ex-NHS (mainly doctors surgery) computers and printers from a supplier, many of which are just over 12 months old and in immaculate condition.
Although he won't tell me how much he pays, the phrase "literally pennies" has been mentioned. I ran a warranty check on one machine from the serial number and it still had two years of a three year warranty on it.
The printers he can afford to give away for free if you buy half a dozen toners for it.
I realise the need for reliability in the NHS, but surely getting rid of machines after a year isn't going to be cost effective?
If the survey is talking about digital access services, then I understand why end users do not put a high priority on that. But we should be talking about digital transformation, much of which is behind the scenes and involving masses of data. From what I've read, Hancock seems to be clued up about this. All industries and embracing digital transformation as way of reducing costs, improving user experience, and driving innovation. If this is done properly (big if) then it can reap huge rewards across the board. Diverting the cash to propping up the groaning status quo sounds a lot like - too busy chopping wood to sharpen the axe.
This will be some sort of indirect lobbying by one of the many NHS self interst groups.
The survey would do better by asking Joe Pleb where the NHS spends its money and seeign how that correlates to acutal spend.
I think Joe Pleb will be surpised that most NHS goes on privding a talkign shop for OAPS whinging about whatever, mainly being old. And providing a midwifery service to the rst fo the world.
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