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- God Bless the NHS: The Truth Behind the Current Crisis by Roger Taylor | The Times
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He broke it down into simple tasks and trains lower paid employees to do as much as possible. Learning from business, the NHS is closing small, local services multiplied throughout the country and opening a few large specialist centres which are far more efficient in terms of cost-per-treatment and have better statistically medical outcomes, even if people do have to travel further and at greater expense and inconvenience.
The profit motive is supposedly teaching the NHS's public service how to function. Last week we learned Serco, the private contractor in charge of out-of-hours GPs in Cornwall, falsified data on patient calls , it is suggested, to improve the poor staffing levels.
Nevertheless, according to Taylor, healthcare is a business and needs to think like a business with "chains" of services and NHS franchises for centres of specialism. Toyota makes cars, Costa Coffee makes coffee, and their focus on doing one thing well should be the guide to NHS planning. The hospital chief executive has to oversee each stallholder with their own different expertises, whereas it would be much better apparently if, like Costa, each expertise was catered for by separate specialist treatment centres.
Even if you accept the profit motive as legitimate, Selfridges operates effectively much like a souk, and souks behave like souks, providing what is needed to the community in one local geographical area without having more management than salespersons and stallholders. Moreover, for Taylor's complete solution to the NHS's failings to fall into place, all patient medical and social data should be collected and centralised for the use not just of the NHS, but of all patients and social services and those interested.
People may worry about privacy, says Taylor, but the usefulness far outweighs such concerns. Then doctors will be able to see everything about a patient, but more importantly, patients will be able to take control of their own medical and social welfare. They should have access to all electronic records and then be able to use them to hook up with similar groups of patients on the internet to find out more about their illnesses and treatments.
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Doctors should regard patients as partners that's even a step up from "clients" , both parties setting up an agreed programme of care. Patients would then have "responsibility" for themselves. To be treated with respect is a basic requirement of any person consulting an expert, but if you are currently feeling unwell, or have been told that you have an elevated rheumatoid factor, and lack a medical education, you might find managing your own health a daunting prospect. The benefits to the system, Taylor thinks, would be great, with patients being able to order "additional supplies of wound dressings or colostomy bags".
The rather understated purpose of patient power, as Taylor tells it, seems to be about cost cutting, both in equipment, treatment and medical litigation bills. In addition, patients would probably make more sensible decisions about end-of-life treatment, and that would cut costs too. All of Taylor's ideas are based on improving systems in an incredibly unwieldy NHS. Actually, the question is, is anything really wrong with the NHS? It has never had a higher public approval rate, Taylor acknowledges that. Nicholson had said that NHS reforms were "fraught with risk". At the parliamentary hearing he amended this to "With less money, the NHS needs to change.
What he, and other critics fail to mention, is that the gap is closing after the huge investment of the Labour years, and with continued investment it would continue to close. The base level for these statistics of so called failings is only a few years previous, but if you take the chronic under-investment of the Tory governments of Thatcher and Major you see why we have traditionally done worse than our European partners, but it must be said significantly better than our American peers.
Let it not be forgotten that infant mortality chronic disease care etc is much better also in Cuba than the UK where there is no private involvement whatsoever but privateers simply never point to the Cuban model of healthcare as an example to take ideas from.
As with all NHS critics the Mid-Staffs scandal features prominently in this book and is used as a stick with which to beat whole swathes of the service and even hypothesises that Mid-Staffs is the first of many scandals waiting to come out. If Roger Taylor has evidence to suggest this then he should bring it to light to the authorities instead of throwing speculation about.
One area where criticism is justified of the NHS is its whistleblowing procedure, or rather the following of the whistleblowing procedure.
Private Eye have covered this extensively and uncovered some truly worrying evidence of cover ups and court silencing behaviours across the NHS. Two things are needed to address this — an altering of the culture of secrecy in all public services, not just the NHS, but specifically for the NHS to be taken out of government control and handed to an independent, public sector body free of government interference with all the relevant powers of oversight and decision making capability.
The government sets the budget but this commission, perhaps, makes the decisions. This will end the political blame culture that pervades every area of the public sector. We never look for ways to stop things happening, we look for people to sack when they finally go wrong. This is entirely reactive and unhelpful. On a similar line because so much money is spent on healthcare each new government wants to put its own stamp on the health service so you get change after change after change — no actual change is given chance to bed down to see if it works.
The politics of the NHS is one of the things that may just kill the NHS — every government of the day wants to give it another heart transplant when the one it had might have been working fine, or at least getting better as time wore on.
God Bless the NHS: The Truth Behind the Current Crisis by Roger Taylor | The Times
At no stage does Taylor provide a coherent analysis of why bringing in a layer of shareholding profit makers would improve the health service. There are some interesting ideas of patient involvement in care, though the extent of this is somewhat worrying and seems to be just a way of removing liability for care, good or bad, from the would-be private institutions and onto the individual which strikes me as libertarianism gone mad.
The NHS is not failing, it is improving. I accuse the author of writing a book purely to further his own private interests in making money out of the NHS and shamefully couching his argument in terms of patient care. I accuse the Guardian of aiding and abetting this miserable little tome for similar reasons — the Guardian Trust is no stranger to investing in odd ventures against the interests of the type of people who read their paper. May 03, Sean Scully rated it really liked it. Very easy to read and I agreed with many of the conclusions in the last few chapters regarding more patient power, which, using his analysis and my personal feelings, seems like a positive way forward.
I also thought the examples given of poor patient care to be relevant and poignant. There was a distinct lack of ideology here, which was refreshing. However, I do wish the scope had been expanded to examine the possible consequences of the current reforms and the fact that a lot of people in the Very easy to read and I agreed with many of the conclusions in the last few chapters regarding more patient power, which, using his analysis and my personal feelings, seems like a positive way forward.
However, I do wish the scope had been expanded to examine the possible consequences of the current reforms and the fact that a lot of people in the house of commons and house of lords have vested interests in these reforms and the fact that there is very little evidence to suggest that this particular form of privatization will have a positive impact for patients i. All in all a very informative read for anyone interested in the NHS that should be anyone who has ever used an NHS hospital or had loved ones there, which is pretty much everyone except probably the queen God bless people caring about caring Dec 26, Meow Says The Cat rated it really liked it.
This book gave me new insights into the NHS, the way it's evolving and where it developed from. It also opened my eyes to the many different perspectives of the NHS people have and why. I'm very grateful to have read this book because it forced me to critique my own POV of where the NHS should be headed. Sep 10, Grace rated it liked it.
I really enjoyed this book as a point of personal interest, but i couldn't help but feel that it lacked the systematic structure of a critique or analysis, and that it included a lot of perhaps over-simplifying metaphors and sometimes illogical conclusions. Not that I'm an expert; just the feeling it have me! Apr 11, Garth Johnson rated it liked it. Some really constructive ideas on healthcare.
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Jun 07, Senake Atureliya rated it really liked it. Brilliantly explains the complex challenges in a simple, easy to digest way. Mar 29, Sarah Harkness rated it liked it. Very easy to read, intelligent, a good analysis of where we are and some pointers to what we can do about it.
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