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Manx Care - Sir Jonathan Michaels Report

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I haven't yet had an opportunity to read thru the document, save for the Recommendations summary.

Lots of talk about integration and transformational change etc. But it's clear from reading just that alone that the real devil will be in the detail.

I sincerely hope that we have the right people in place to deliver this. If not, I foresee a whole new breed of Cyrils and clinical admins being imported to see it through. If that happens there'll be a significant increase in MARS applications. The question then is: what effect will that have on the revenue & pensions budgets and more importantly is it affordable??   

I know it's not quite the same but my experience from business tells me that the type of transformational change required here will have a significant impact on cost over and above what would normally be required for operational needs.

Unintentional consequences spring to mind.

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32 minutes ago, The Duck of Atholl said:

Change means making decisions that may prove in the short term as unpopular. Unpopular decisions see MHK's ousted at elections. Ergo no change, status quo prevails

One of the thungs that would ptevent me from standing is that I dont think the public are supporters of the shock and awe required. Id quite happy stand for one term and get the job at least underway, but I dont think folk would vote for someone pointing out the brutality of what would be required; swingeing public sector cuts, higher taxes, privatisation of some services and some recognisable austerity. 

 

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7 minutes ago, hissingsid said:

Duck...you have hit the nail on the head, unfortunately this does not just apply to this report but to any other contentious item.   I have never ever seen such a bunch of frightened and cowardly MHKs more concerned about re election than reform in case they become unpopular.   Why are they so desperate to cling onto their seats, perhaps they do not have the skills to do much else with the same reward ?

It's not just the job of instigating the necessary change that's the workload to be scared of.

It's actually confronting the entrenched attitudes and culture of the management and attached CS that's offputting and could potentially take several years to undo - longer than an elected term. With the potential to be unelected half way through the job, such is the unpopularity that might be roused.

So the easy option is to just ignore, kick the can down the road or at best, tinker at the edges. How many times have we seen it, over and over? 

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Posted (edited)
47 minutes ago, The Duck of Atholl said:

Change means making decisions that may prove in the short term as unpopular. Unpopular decisions see MHK's ousted at elections. Ergo no change, status quo prevails

Surely once the legislation is in place to create the new Manx Care vehicle there'd be no reason why any MHK should have to worry about unpopular decisions, those will be done at arms length by Manx Care? Won't Tynwald's main function be to ensure that Manx Care provide the service based on the policy underpinned by the funding?

Edited by Andy Onchan
Typo

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The Review Team, like the DHSC leadership, actually don't seem to know what operational facets need to be changed, although their expert informed / experienced / gut feel suggestions in the review are probably near the mark, because DHSC doesn't have the data. Until they have actual factual data about performance of services the actual operational changes necessary cannot be determined or prioritised.

I was disappointed but not surprised to learn that the DHSC and hospital management don't have the data needed - and for that reason alone it would be fair to say that the management of the island's health services has been incompetent.

 

To quote Peter Drucker "If you can’t measure it, you can’t improve it."
And W. Edwards Deming: "In God we trust, all others must bring data.”

 

Without the data they're buggered. With the data they can execute operational change one piece at a time, quite comfortably, which _might_ have a significant impact on user's perceptions of service quality. Given how long the island has been messing around with health / hospital IT systems the claimed data gap is lamentable.

The culture change necessary is a different matter, and the very absence of adequate operational metrics is indicative of the massive cultural transformation necessary - a culture which believed in self-improvement would demand the creation of metrics.

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57 minutes ago, Derek Flint said:

One of the thungs that would ptevent me from standing is that I dont think the public are supporters of the shock and awe required. Id quite happy stand for one term and get the job at least underway, but I dont think folk would vote for someone pointing out the brutality of what would be required; swingeing public sector cuts, higher taxes, privatisation of some services and some recognisable austerity. 

 

Thereby lies the problem Derek. The same reasoning is almost certainly preventing more suitable candidates from standing.

Whilst the last election had the highest turnout of voters for a good  while (68.8%) it also meant a substantial amount of eligible voters failed to turn out. So if a third of the eligible voters can't be bothered voting, how can we expect a better calibre of candidate to bother putting his/her head above the parapet?

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When so much of the electorate is employed by the government, it is very hard to get elected standing on a platform of reform. Turkeys christmas etc...

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30 minutes ago, TheTeapot said:

When so much of the electorate is employed by the government, it is very hard to get elected standing on a platform of reform. Turkeys christmas etc...

You are absolutely right, as I found out to my cost! There is very little stomach for change of any description amongst many of those who can be bothered to vote, the negativity is depressing.

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Posted (edited)
2 hours ago, craggy_steve said:

The Review Team, like the DHSC leadership, actually don't seem to know what operational facets need to be changed, although their expert informed / experienced / gut feel suggestions in the review are probably near the mark, because DHSC doesn't have the data. Until they have actual factual data about performance of services the actual operational changes necessary cannot be determined or prioritised.

I was disappointed but not surprised to learn that the DHSC and hospital management don't have the data needed - and for that reason alone it would be fair to say that the management of the island's health services has been incompetent.

 

To quote Peter Drucker "If you can’t measure it, you can’t improve it."
And W. Edwards Deming: "In God we trust, all others must bring data.”

 

Without the data they're buggered. With the data they can execute operational change one piece at a time, quite comfortably, which _might_ have a significant impact on user's perceptions of service quality. Given how long the island has been messing around with health / hospital IT systems the claimed data gap is lamentable.

The culture change necessary is a different matter, and the very absence of adequate operational metrics is indicative of the massive cultural transformation necessary - a culture which believed in self-improvement would demand the creation of metrics.

Without viable data how did Sir Jonathan Michaels come up with his recommendations?

It can't be based on anecdotal surely....

Edited by P.K.
Typo

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1 hour ago, Neil Down said:

Thereby lies the problem Derek. The same reasoning is almost certainly preventing more suitable candidates from standing.

Whilst the last election had the highest turnout of voters for a good  while (68.8%) it also meant a substantial amount of eligible voters failed to turn out. So if a third of the eligible voters can't be bothered voting, how can we expect a better calibre of candidate to bother putting his/her head above the parapet?

You can be sure that when Lord Lisvane presented his findings the first thing the denizens of Tynpotwald would have done is run a quick SWOT with keeping their unbelievably cushy numbers intact and unaccountable as the main driver....

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A service......"Constrained by bureaucratic inertia" is the phrase that stands out and sums everything up for me.

Applicable across and caused by the whole Govt job creation scheme. Hobbling and hamstringing any sort of efficiency of service.

But with this report highlighting its effects on Health, a subject close to us all, perhaps it's going to see some change implemented.

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2 minutes ago, Non-Believer said:

A service......"Constrained by bureaucratic inertia" is the phrase that stands out and sums everything up for me.

Not forgetting "a tacit acceptance of mediocrity and even failure"

So not only four trays but five:

IN

OUT

PENDING

TOO DIFFICULT

JUST ANOTHER FUCKUP

"Next!"

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7 hours ago, Derek Flint said:

One of the thungs that would ptevent me from standing is that I dont think the public are supporters of the shock and awe required. Id quite happy stand for one term and get the job at least underway, but I dont think folk would vote for someone pointing out the brutality of what would be required; swingeing public sector cuts, higher taxes, privatisation of some services and some recognisable austerity. 

 

The fact that you don’t notice that attitude is patronising is why someone like you will never get voted in.  how long did you last in a junior post in Noble’s Derek.   What did you achieve as a business manager? 

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7 hours ago, Andy Onchan said:

Surely once the legislation is in place to create the new Manx Care vehicle there'd be no reason why any MHK should have to worry about unpopular decisions, those will be done at arms length by Manx Care? Won't Tynwald's main function be to ensure that Manx Care provide the service based on the policy underpinned by the funding?

Absolutely, nice to see a comment from someone who has understood the report and the political outcome. 

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7 hours ago, Andy Onchan said:

Surely once the legislation is in place to create the new Manx Care vehicle there'd be no reason why any MHK should have to worry about unpopular decisions, those will be done at arms length by Manx Care? Won't Tynwald's main function be to ensure that Manx Care provide the service based on the policy underpinned by the funding?

Best point made in this thread so far. Yes, same vehicle should be done with the SPC too. 

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