Nobles Hospital

[Max Power]

34 minutes ago, MrPB said:

Any budget in a front line service like that should have contingencies built into it to account for unforeseen circumstances. You don’t budget for what you know you have to spend. You budget for what you might have to spend if various unforeseen or uncontrollable events occurred as healthcare is demand driven. 

The Health Service is bound to be beset with unforeseen circumstances, trying to apply a strict budget is to misunderstand what the whole thing is about. There are several things which can be controlled like any business, waste, employment costs and capital expenditure. The rest is in the lap of the gods and has a direct effect on your ability to control at least two of the aforementioned.  

[Patient centred]

“But I do know that they need 'A John Spicer' up there - and one that will take no crap from ministers, government or treasury.“

the problem, though, is that these people employ, pay and direct. 

[Manximus Aururaneus]

3 hours ago, Patient centred said:

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. 

I don't run Tesco's - I run a healthcare business, and the people who are telling me to run it more cheaply (whatever the outcome)  are the NHS commissioners of service who contract me.

[Manximus Aururaneus]

1 hour ago, MrPB said:

You assume that’s where the problem lies. Couch was ex head of income tax so presumably well used to dealing with Treasury before he got the job? 

With respect, I don'e assume anything, that why 4 hours ago I wrote;

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.

That is not an assumption, it is a request for analysis and rectification.

[Manximus Aururaneus]

2 hours ago, Patient centred said:

“But I do know that they need 'A John Spicer' up there - and one that will take no crap from ministers, government or treasury.“

the problem, though, is that these people employ, pay and direct. 

What is your opinion of the Age Concern and LaingBuisson view on the subject?

[Non-Believer]

4 hours 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.

Bell, in particular, during his tenure refused point blank to cut Govt numbers following the VAT recalculation, certainly in the sort of numbers that were/are necessary pan-Govt. Instead we had the MARS scheme that allowed a small number of mid/upper ranks to take early retirement on often ludicrous pay off terms.

If there were any significant numbers let go then it was at coalface level which seem to have been replaced with increases in management numbers, again pan-Govt.

I'm convinced that there's a bigger picture here that involves population numbers and the economy and wouldn't be at all surprised if it relates to the annual VAT rebate.

[Manximus Aururaneus]

Just now, MrPB said:

With respect I was responding to another poster. Never mind though you have said the same thing about 4 times now. 

My apologies 

[P.K.]

3 hours ago, MrPB said:

Any budget in a front line service like that should have contingencies built into it to account for unforeseen circumstances. You don’t budget for what you know you have to spend. You budget for what you might have to spend if various unforeseen or uncontrollable events occurred as healthcare is demand driven. 

Unfortunately you can "What if....?" these things forever.

So you rely on experience and data and have to put a stake in the ground despite the urge to go big in case your decisions are found wanting by some totally off the wall catastrophe.

It goes with the pay grade...

[P.K.]

I used to "rightsize" for a living and a fundamental truth is that people generally resist change. Especially if that change might mean their redeployment into the jobs market. That's despite if it means just a tweak or two to some process or other right up to the other end of the scale where a seismic shift in culture is needed.

The absolutely fundamental foundation in all of this is that the "board" have to buy into every aspect of this and make sure that the workforce know they do.

Now this is where the public and private sectors differ. In the private sector it's an absolute necessity that if you have to let folks go then they lose their livelihoods. It's a tough call but if you don't then the whole enterprise could fail and then EVERYBODY will be out of work!

In the public sector it's more about correcting the numbers to match the required outputs but ONLY after the required outputs have been properly defined.

Now I wouldn't have wanted a short tenure on my CV because it shouts "FAILURE!" to all and sundry.

But if you don't have the support from above to do what's necessary then you don't really have a choice.

I wonder if that's what has happened here...?

[Patient centred]

26 minutes ago, P.K. said:

But if you don't have the support from above to do what's necessary then you don't really have a choice.

I think that is exactly what keeps happening. 

[Roger Mexico]

If this is true, what's surprising here is just how short the tenure of this guy was.  Usually it takes more that a couple of months for any sort of working relationship to deteriorate, even Charters hung around for a year or so.

Spicer was only announced to be starting at the beginning of October.  That press release said that he had "extensive experience in a variety of senior roles in health and care services in England", but I can't find a digital footprint that really matches that.   There's one person with a couple of relevant posts, held for less than two years each but the candidate with a longer cv appears to be a doctor, which this guy isn't I think.   Could someone have got them mixed up?

Of course there may be other explanations, such as unexpected personal matters that might cause someone to bail out of a new job, so soon into it

[asitis]

8 hours ago, Non-Believer said:

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

Eddie Teare damaged many things which have negatively impacted the island, UK pensions being just one of them !

[wrighty]

@Roger Mexico don’t think it’s either of those LinkedIn profiles - certainly not the second one who included his photo. 

[Roger Mexico]

3 minutes ago, wrighty said:

@Roger Mexico don’t think it’s either of those LinkedIn profiles - certainly not the second one who included his photo. 

Both looked unlikely to me as well.  Most of the other stuff I found related to the second as well (he's also in his 60s so unlikely to want to leave what looks like a busy life for a short-term appointment).  The other guy doesn't have much experience.  I just expected to find something more online.

[Uhtred]

Are we still in the speculative stage or has someone confirmed that Mr. Spicer has left/is leaving.