Nobles Hospital

[Derek Flint]

8 minutes ago, Uhtred said:

What follows is complete guesswork on my part (but I’ve strived for logical guesswork).

Taking the Transformation Director as an example, whilst of a fixed-term nature, this is/was presumably still a civil service appointment. The government website makes it very clear that, in terms of officials, the health transformation agenda buck stops with the Chief Secretary, so it seems very likely that he was one member of the recruitment/interview panel. At such a senior level, it’s equally likely that Ashford also participated. These two being involved is perhaps backed up by the fact that they were the rent-a-quotes in the media release about Mr. Spicer’s appointment. All organisations these days have an HR/CIPD figure on interview panels so I’d say that would be person 3. And possibly a qualified medic...Medical Director? So I’d nominate that quartet, or very similar, as those who selected Mr. Spicer.

I’d say you were pretty bang on there. But remember this was a management / Cabinet Office appointment for the transformation of all of Health and Social Care. I reckon there won’t have been any medical representation on the interview board.

[Manximus Aururaneus]

20 minutes ago, Uhtred said:

What follows is complete guesswork on my part (but I’ve strived for logical guesswork).

Taking the Transformation Director as an example, whilst of a fixed-term nature, this is/was presumably still a civil service appointment. The government website makes it very clear that, in terms of officials, the health transformation agenda buck stops with the Chief Secretary, so it seems very likely that he was one member of the recruitment/interview panel. At such a senior level, it’s equally likely that Ashford also participated. These two being involved is perhaps backed up by the fact that they were the rent-a-quotes in the media release about Mr. Spicer’s appointment. All organisations these days have an HR/CIPD figure on interview panels so I’d say that would be person 3. And possibly a qualified medic...Medical Director? So I’d nominate that quartet, or very similar, as those who selected Mr. Spicer.

That seems logical even if it does involve some guesswork, but even then at least 50% of that panel are relative newcomers (Ashford and MD) so again I fail to see the opportunity for conspiracy. 

In fact I'll go slightly further than that - what Nobles actually needs is in fact a 'Cabal' of long-term, far sighted top management with perhaps the oversight of a a panel of ratepayers / patients etc.

If four or five sets of Ministers and Management have consistently overspent the budget by +/- the same amount  - Then perhaps it is the budget that is wrong not every set of management. I know for a fact that there is considerable financial wastage in the hospital due to short term firefighting rather than long term strategic decision making. Personally, from what I see happening on a daily basis, I would give serious consideration to diverting a serious chunk of the DOI's budget to Nobles.

[Non-Believer]

Eddie Teare cut (or at least pegged) the DHSC budget when he was in office. It has overspent ever since.

[Manximus Aururaneus]

8 minutes ago, Non-Believer said:

Eddie Teare cut (or at least pegged) the DHSC budget when he was in office. It has overspent ever since.

That is pretty much my point. So what should be the correct setting for the budget - Eddie Tears' that lasted only one round?

It is a very easy task to save money against the budget for one isolated period - especially when you have already moved on when the repercussions are felt.

[finlo]

A blank cheque book still wouldn't cover it.

[Manximus Aururaneus]

13 minutes ago, finlo said:

A blank cheque book still wouldn't cover it.

I agree, with the recent lack of strategic thinking then a blank cheque book would indeed fail to solve the issues. But the current fire-fighting is neither saving money, solving the budget issue, or providing a safe reliable service - so what is the point of 'more of the same'?

[yootalkin2me]

1 hour ago, Manximus Aururaneus said:

That seems logical even if it does involve some guesswork, but even then at least 50% of that panel are relative newcomers (Ashford and MD) so again I fail to see the opportunity for conspiracy. 

In fact I'll go slightly further than that - what Nobles actually needs is in fact a 'Cabal' of long-term, far sighted top management with perhaps the oversight of a a panel of ratepayers / patients etc.

If four or five sets of Ministers and Management have consistently overspent the budget by +/- the same amount  - Then perhaps it is the budget that is wrong not every set of management. I know for a fact that there is considerable financial wastage in the hospital due to short term firefighting rather than long term strategic decision making. Personally, from what I see happening on a daily basis, I would give serious consideration to diverting a serious chunk of the DOI's budget to Nobles.

But what is the po8ntbin that, you're only throwing good money after bad. If there is profligate wastage then surely the answer, or at least the first step, is to address that issue, and then when done to make that department run more efficiently whilst also delivering a quality service divery funfs from elsewhrre, if needed, to make the service even better.

[Manximus Aururaneus]

1 hour ago, yootalkin2me said:

But what is the po8ntbin that, you're only throwing good money after bad. If there is profligate wastage then surely the answer, or at least the first step, is to address that issue, and then when done to make that department run more efficiently whilst also delivering a quality service divery funfs from elsewhrre, if needed, to make the service even better.

I can only repeat (for the third time) ..

I needs a properly funded, long term, Strategic solution. At the moment, we the taxpayers, are paying over-budget for headless chickens covering up inadequacies with money-wasting, short term fire-fighting. 

I am not, and never have, suggested throwing more money at more of the same. The money wasting up there is breath-taking - but it is wasted because of the lack of a long term strategic vision, a plan, and a properly funded execution of that plan.

In 1992 I purchased a business out of receivership from KPMG following the financial collapse of Canary Wharf. It was losing a six-figure annual sum equating to about 25% of its turnover, it employed 72 people. The following year the workforce was 15, and we broke even. Another year on, the workforce was down to 4 and we made a six-figure profit. I can slash and burn, cut waste, and balance budgets with the best of them when needed - but pretty much anybody can do that, it's easy. Doing that whilst creating calm, stability, and profits needs a realistic, properly funded, strategic vision and plan. In 2006 I bought another 'unmanageable' business run not by the owner but by a 'clique' of so-called 'Health professionals'. They are all gone, (it took 2 years) I still own the business (with my wife) today - and it makes an annual profit each year bigger than was the original investment. I am not a 'chuck money at the problem' type person.

Open cheque book - no. Long term, properly funded, strategic change for the better - yes.

I don't know John Spicer, neither do I know if he is (was?) the right man for the task. But I do know that they need 'A John Spicer' up there - and one that will take no crap from ministers, government or treasury. It should be his job to properly determine what budget is required to do the job asked of it - and to then convince Government of the justification for it.

When Managers are spending 95% of their time managing a 'budget' rather than managing a 'Hospital' then something is wrong. It may be the managers that are wrong, it may be the budget that is wrong, it may be (probably is) a combination of both, but either way it needs to be identified and sorted. You cannot manage a task if you are only concentrating on managing a budget.

[WTF]

33 minutes ago, Manximus Aururaneus said:

I can only repeat (for the third time) ..

I needs a properly funded, long term, Strategic solution. At the moment, we the taxpayers, are paying over-budget for headless chickens covering up inadequacies with money-wasting, short term fire-fighting. 

I am not, and never have, suggested throwing more money at more of the same. The money wasting up there is breath-taking - but it is wasted because of the lack of a long term strategic vision, a plan, and a properly funded execution of that plan.

In 1992 I purchased a business out of receivership from KPMG following the financial collapse of Canary Wharf. It was losing a six-figure annual sum equating to about 25% of its turnover, it employed 72 people. The following year the workforce was 15, and we broke even. Another year on, the workforce was down to 4 and we made a six-figure profit. I can slash and burn, cut waste, and balance budgets with the best of them when needed - but pretty much anybody can do that, it's easy. Doing that whilst creating calm, stability, and profits needs a realistic, properly funded, strategic vision and plan. In 2006 I bought another 'unmanageable' business run not by the owner but by a 'clique' of so-called 'Health professionals'. They are all gone, (it took 2 years) I still own the business (with my wife) today - and it makes an annual profit each year bigger than was the original investment. I am not a 'chuck money at the problem' type person.

Open cheque book - no. Long term, properly funded, strategic change for the better - yes.

I don't know John Spicer, neither do I know if he is (was?) the right man for the task. But I do know that they need 'A John Spicer' up there - and one that will take no crap from ministers, government or treasury. It should be his job to properly determine what budget is required to do the job asked of it - and to then convince Government of the justification for it.

When Managers are spending 95% of there time managing a 'budget' rather than managing a 'Hospital' then something is wrong. It may be the managers that are wrong, it may be the budget that is wrong, it may be (probably is) a combination of both, but either way it needs to be identified and sorted. You cannot manage a task if you are only concentrating on managing a budget.

but the snag is we can't cut CS service job numbers or even their pay in most areas,   a few folks were done over like airport police and bus drivers but try and adjust 1000's rather then 10's and 100's and you won't get anywhere with the IOM government clique.

[Dr. Grumpy]

Very interesting development, if true. One has to wonder who is taking accountability for these appointments. Having said that, whoever is making the decisions obviously thinks that a part time CEO is sufficient for the DHSC. if the same person is still in charge, God save the DHSC!

[Manximus Aururaneus]

13 minutes ago, WTF said:

but the snag is we can't cut CS service job numbers or even their pay in most areas,   a few folks were done over like airport police and bus drivers but try and adjust 1000's rather then 10's and 100's and you won't get anywhere with the IOM government clique.

I'm not sure that staff headcount is the primary problem at the hospital - I think that lack of direction, closed doors, and short-termism are bigger issues tbh.

doc.fixit is on the right track.

[WTF]

when some management dress as ward staff during an inspection you know there are too many managers,

[Dr. Grumpy]

6 hours ago, Patient centred said:

I think it was 2 meetings although maybe the second hadn’t happened by the time he left (if he has). Perhaps being new to the place and role, attendance might have been seen to be a priority?

You do not need a post called “Director of transformational change” on an island as small as ours. 

Who keeps making these bad appointments? They clearly have very poor judgement. I predict the same will happen with the part time, fixed term CEO. 

I also hear that one of the current consultants who enjoys a lot of trust and has succeeded in bringing warring factions together as a clinical director didn’t even get shortlisted for the medical director role. Seems to be replaying the farce of when Adrian Dashfield was passed over for the role by outsider Jugnu. A complete and unmitigated disaster. Lessons are not being learned. One can only conclude that those at the top do not want real change. They want to look like they are doing something whilst maintaining the status quo. They do not want anyone at the top who knows where to shine the torch. Politics seemingly more important than money and certainly more important than patient safety or quality of care.

Hmmmm..... So the major dysfunction endemic within the department of anaesthetics hasn't dampened your enthusiasm for Dr Dashfield's leadership then?

[Manximus Aururaneus]

4 minutes ago, WTF said:

when some management dress as ward staff during an inspection you know there are too many managers,

You cannot discriminate against cross-dressers these days.........

[Patient centred]

52 minutes ago, Dr. Grumpy said:

Hmmmm..... So the major dysfunction endemic within the department of anaesthetics hasn't dampened your enthusiasm for Dr Dashfield's leadership then?

Dr Dashfield hasn’t been the clinical lead for anaesthetics for at least a year!

 

and to the money making and slashing CEO you cannot run healthcare like Tescos. The more operations and episodes of care you undertake, the more money you spend. You get the money back in another department budget such as social care or employment.