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IOM DHSC & MANX CARE


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16 minutes ago, Jarndyce said:

Can you back up which clique managed this?  My understanding at the time was that this was a bit of private enterprise by Beecroft, going against both policy and top level advice to get a personal victory in the press.   This is not to criticise the family in question, who I’m sure lobbied effectively for their child - but they’re hardly a “clique”, are they?

More that we agree upon than disagree, I think…but approaching from different perspectives.

Perhaps my sentence structure wasn't clear, so I offer a revision.

Those cliques are canny too, and know how to get to the politicians.  This means that they are never challenged.  The politicians can then seek glory for awesome policies like little Finley getting his special medicine.

Like you, I do not criticise the boy's parents for fighting for his best interests.

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25 minutes ago, Boo Gay'n said:

Perhaps my sentence structure wasn't clear, so I offer a revision.

Those cliques are canny too, and know how to get to the politicians.  This means that they are never challenged.  The politicians can then seek glory for awesome policies like little Finley getting his special medicine.

No clearer for me, I’m afraid - although I concede that I might be a bit thick this morning.

”then” implies a linkage between the cliques getting at the politicians, and the politicians seeking glory for awesome policies - that link isn’t clear to me.

Also, Finley’s medicine wasn’t the result of an “awesome policy” - the minister went against policy when she made that decision.  I wasn’t in the room, but I’ll bet she was advised against it, in Sir Humphrey style (“that would be a very courageous decision, Minister”).

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4 hours ago, 2112 said:

The NPM this morning has an interview with ex Minister of the DHSC David Ashford, who comments that he wasn’t surprised by the CQC report published yesterday. He further says that changing the culture could take decades. 
 

This really is appalling and shows that these politicos clowns either know what’s going on, are turning a blind eye to neglect and incompetence or Ministers in charge are incompetent themselves. Ashford was awarded his MBE based on his all brilliance during the pandemic, so he must have been aware of the culture but chose to do nothing - which is unforgivable. He really is now by his frankness proving that he isn’t fit to work within a department and certainly not fit to be a Minister.

I will say this, that it’s not totally Ashford who is incompetent but also ex CM Quayle who was formerly ex DHSC Minister, along with ex Minister DHSC Beecroft. 

He reminds me of the vicar of Bray, (think I got that right) I learned the poem over 60 years ago

 so may have it slightly wrong.

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1 hour ago, Boo Gay'n said:

Here we go.

There is a lazy myth that all nurses are angels and all doctors are demi-gods.  Flowing from this is a lazy assumption that they can't be criticised.

However, health and social care are full of really nasty people - some of whom don't care about the people that they are supposed to be looking after, and many of whom bully their colleagues relentlessly.  It is often the nasty ones who then form cliques, become union activists and throw out the concept of 'professional autonomy' to fend off any attempts by management to achieve good services that could be benchmarked against the best in the UK (as the CQC has tried to do).

Those cliques are canny too, and know how to get to the politicians.  This means that they are never challenged, and the politicians seek glory for awesome policies like little Finley getting his special medicine.

It can be changed through imposing standards etc. in law - which they are not in the Isle of Man, and obliging professionals contractually to deliver them.  Courage is needed from politicians and managers, but this would not be rocket science.

About ten years ago I fell off the roof, (I know, crazy), After a couple of days I was in so much pain I went to hospital and wasn't even examined by the very officious nurse who saw me. She said it's a broken rib or ribs so we can't do anything for you. I pointed out the pretty bad bruising right across my chest and down my front with no response, sooo I went home. It was so bad after another couple of day I went to the GP who got me an x ray and I was told I had cracked my sternum but there was nothing to do but sit it out and take pain killers. I was actually told that as I wasn't dead I would be ok!

I've purposley not said which hospital or which GP because I may not have re-called it accurately although my wife says I'm right.

A few days after that we saw a TV programme where a woman had fallen off a pavement and because of the pain was helicoptered to hospital in case she had broken her sternum. As it happened, she hadn't.

The massive response to her possible injury did make me reflect on the treatment I received. 

The medics of course got it right but I think more by luck than judgement. I did mention to a nurse relative who said I had been lucky and complaining wouldn't alter the outcome.

Ah well, just thought I'd mention that little story because normally I have always had and continue to have good service from the health service although I believe that the staff that deal with you make or break the response in spite of the broken service they work for.

 

 

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1 hour ago, Boo Gay'n said:

Richard Butt, the editor of the newspapers, has just put this on Twitter -

The CQC report was dropped off anonymously at IoMN nerve centre. We put in queries. Then the DHSC published it to all and sundry before we went to press.

Nerve Centre?????? bwahahahahaha! 🤣🤣

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7 minutes ago, Jarndyce said:

Also, Finley’s medicine wasn’t the result of an “awesome policy” - the minister went against policy when she made that decision.  I wasn’t in the room, but I’ll bet she was advised against it, in Sir Humphrey style (“that would be a very courageous decision, Minister”).

These things have always happened and I think there is even a procedure for such 'Ministerial decisions' (which rather indicates how few they actually do make).  There was a bit of insight into this in another employment tribunal (which again the DHSC lost, but which got little publicity) about a year ago.  Among other issues of clinic procedures and so on, there was this:

38. The Complainant explained that the team had been asked to fund a wheelchair for a service user who had already been provided with a suitable wheelchair as assessed. The cost was claimed at £22,000 approximately and this incorporated additional extras above and beyond what was required based on the user’s assessed need. Specific modifications beyond that needed as assessed fall outside the jurisdiction of the Wheelchair Service

[...] 40. The Complainant raised the matter once again with Ms Hattersley who said that she had to get on with it because the Health Minister, Mr David Ashford and the Chief Minister, Mr Howard Quayle were involved

[...] 60. [The complainant's boss's] understanding was that the service user had wanted all the bells and whistles and that this request had been refused. The Minister had then become involved and “for whatever reason” he had made a ministerial decision that the patient would have the wheelchair that he had requested. Sometimes the Minister will get involved and take a decision. In 13 that situation, it was out of the hands of Ms Hattersley because if there was a clear direction, then it must be followed

You need to read the full section to get the story, but it shows how Ministers do have that power, though they might have to 'own' it.  In this case I think it was an election pledge from Beecroft that she would try to do something about the case.

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54 minutes ago, Andy Onchan said:

Absolutely. He was the one at the back of the "less is more" class that wasn't paying attention. If the taxpayer paid for any media training then it was wasted.

And the shredder ate his homework. 

ETA which reminds me of another personnel issue which he studiously avoided becoming involved in, not. 

Edited by Gladys
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9 minutes ago, Andy Onchan said:
2 hours ago, Boo Gay'n said:

Richard Butt, the editor of the newspapers, has just put this on Twitter -

The CQC report was dropped off anonymously at IoMN nerve centre. We put in queries. Then the DHSC published it to all and sundry before we went to press.

Nerve Centre?????? bwahahahahaha! 🤣🤣

I assume there is an element of self-mockery there.  But it's worth pointing out that, unlike with a UK hospital, there would be no automatic publication of the report on the CQC website (and I can't even see it there now).  The report had been separately commissioned by the DHSC[1] and they could publish as much as they wanted or not at all.  So IOMN having a copy might well have triggered the cosy chats on Manx Radio and the rest.

[1]  Which in turn means there are no ratings for the various areas examined.

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2 hours ago, Roger Mexico said:

I assume there is an element of self-mockery there.  But it's worth pointing out that, unlike with a UK hospital, there would be no automatic publication of the report on the CQC website (and I can't even see it there now).  The report had been separately commissioned by the DHSC[1] and they could publish as much as they wanted or not at all.  So IOMN having a copy might well have triggered the cosy chats on Manx Radio and the rest.

[1]  Which in turn means there are no ratings for the various areas examined.

A friend from 'across' tells me that a similar report regarding the ED of a UK hospital would have resulted in 1. Immediate closure of the unit and 2. Resignations of CEO, MD and DoN.

Obviously we cannot close the only available A&E on island, but we can at least ask the bosses for their action plan to remedy the situation

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1 hour ago, Dr. Grumpy said:

A friend from 'across' tells me that a similar report regarding the ED of a UK hospital would have resulted in 1. Immediate closure of the unit and 2. Resignations of CEO, MD and DoN.

And the rest I'm afraid.....

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2 hours ago, Dr. Grumpy said:

A friend from 'across' tells me that a similar report regarding the ED of a UK hospital would have resulted in 1. Immediate closure of the unit and 2. Resignations of CEO, MD and DoN.

Obviously we cannot close the only available A&E on island, but we can at least ask the bosses for their action plan to remedy the situation

Poor Theresa is still finding her way.  Did we need all these new directors? Or just a competent CEO?

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Ashford's response is quite extraordinary isn't it?:

https://www.manxradio.com/news/isle-of-man-news/former-health-minister-not-surprised-by-cqc-report/

I suppose it's got to the stage where he's now the one who stupid enough to say out loud what the others are thinking.  He's claiming credit for having the idea of CQC inspections (despite others calling for them for many years) but doesn't explain why he didn't have any during all the time he was Minister, including two full years pre-pandemic.  Hooper and others also think they should be patted on the back for doing the bare minimum, but at least Hooper did it.

And Ashford seems to believe that it will take decades to change a corporate culture (presumably he just hopes everyone retires eventually).  Well it might if you do nothing to change it, but more likely it will just continue itself forever.  Such change needs decisive action from the top and the will for that seems lacking from the Board.

Of course such culture isn't just confined to Manx Care/DHSC and can't really be fixed just in there (though it would be a good place to start).  I quoted a paragraph from the report that summed up what is a symptomatic problem:

All grades and disciplines of staff told us the incident reporting system was seen as a tool to apportion blame. The system was described as ‘weaponised’. We were also told that reporting was discouraged. Some staff said they could not access the system, they had to request that someone else input any incidents on their behalf but this was frequently denied.

But we've only just seen the outrageous case of the four anaesthetists, where this was exactly what happened and the AG's Chambers seem to have driven that.  And we've never had an explanation or an apology for that disaster.

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