We found out this morning from Dave West from an article in the HSJ that HM Treasury has agreed an unannounced £740m increase to the health revenue budget for the current financial year.
Since mainstream parties agreed to sign up to ‘efficiency savings’, a euphemism for making cuts in budgets, NHS Trusts all over the land have been trying to reconcile PFI debt with running a bargain basement staff. The current Government and key political stakeholders have resisted at all costs a national minimum staffing level, arguing primarily that this is not the overall number of nursing staff which matters but their suitability of skill sets in nursing environments.
These efficiency savings, nonetheless, have been made by NHS hospitals. Some hospitals have been more successful than others. The idiotic nature of the NHS drifting towards a market, being ensnared by the EU competition laws, that such financial assistance of hospitals come dangerously close to “state aid” which is deemed unlawful.
In England, “state aid” already exists in the form of foodbanks which have exploded in number under this Government. The consensus is that they have primarily supplied a need demanded from deserving members of the public, many of whom have been waiting for unreasonable time for benefits. This is a direct effect of the crass incompetence of operations in handling of benefits under this Government. This incompetence has seen emotional distress from people who are disabled. Some, it is alleged, have even taken their own lives.
The problem with running the country’s “safety net” in such a ‘lean matter’, means that there is no reserve in the system. If a nurse or Doctor goes off sick, the entire rota is thrown into chaos. The NHS ends up chasing its own tail, for example by employing expensive locum staff when it has not had the competence to employ the correct number of staff in the first place.
The mainstream political parties are still, overall, committed to the ‘private finance initiative’, although there have been some noises about how little value for money it represents. Despite the successful campaigning by some on the NHS, the political motivation for providing a solution to this problem appears lacking. There is an issue not only about the exorbitant demands of loan repayments, akin to a corporate ‘Wonga’ strangehold on the State’s finances, but also how private equity firms seemed to have got an amazingly good deal out of it effecting having a level of control and ownership on NHS hospitals which the general public, if they know, would balk it.
The next Labour Government is expected to introduce ‘whole person care’. Everyone agrees that social care is on its knees, but invariably most people agree that this situation has not come about suddenly in the last few years. There has been an insidious promotion of marketisation in the social care sector, which Labour had much to do with. Anyway, living in the now, the social care sector is in utter chaos. NHS hospitals are not able to discharge, often, their patients into social care in a timely fashion. Health and care sectors are intimately dependent on one other.
There is a growing feeling now that the drift in health and care policy across several governments, with a feeling of ungenerous funding, PFI, personal budgets, etc., albeit catapulted with the chaos over competitive tendering over the Health and Social Care Act (2012), has somehow resulted in an almighty mess. Like Lord Sugar, people are scrabbling around for a quick fix, but this is not going to be easy. Some of the strategies are clearly ‘science fiction’, unmarketable, or incapable of any teamwork. There appears to be too many Chiefs and not enough Indians. To coin the phrase by David Cameron, “We can’t go on like this?”
But in the meantime – the first management step must to be to say to Mr. Jeremy Hunt those immortal words…
“You’re fired”
