5th May 2015

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Dr Mark Porter

In conversation with Roy Lilley

Chair if the BMA - just how relevant is the BMA; does anyone listen to them?

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News and Comment from Roy Lilley

It's been sitting on my desk for a few days; since last Thursday, to be precise. Official envelope with a couple of purple flashes in the corner... my postal vote.  Next to it, burning a hole in my desk, an embargoed summary of a report from the Economist Intelligence Unit; putting the NHS 28 out of 30 OECD countries.


So, here I am, late at night; a glass of Penderyn, having a Russell Brand moment. Why bother to vote? I am fortunate to live in a corner of England; leafy, safe, great schools, the world's best hospital and more GPs than you can shake a stick at. I have a good train service into London.


However, the local Tory council have closed the day centre. It must be the only local authority in Europe that thinks we are going to have fewer seniors who'll need a bit of help. They got away with it because, apart from Waitrose, the most flourishing business in the area is self-pay home-care. I know; I live in a bubble.


My real problem is that I live in (I think) the third safest seat in England. Michael Gove is my MP. He is a Tory. He doesn't live here. He co-authored 'Direct Democracy', calling for breaking up the NHS, replacing it with 'personal health accounts'.


If I vote for Gove no one will notice. They don't count his votes, they weigh them. If I don't vote for Gove, no one will notice. If I vote for someone else I might as well tick the box for Screaming Lord Sutch.


What to do?


In my head I can hear the galloping horses and the roar of the Epsom Derby crowd; the gasps and screams as a woman dips under the rail and grabs at Anmer, King George's horse. The woman was Emily Davidson, a suffragette. She was mown down and died four days later. At her funeral tens of thousands of Londoners lined the route.


Emily is not the only person to have lost their lives in pursuit of the simple democratic right to go, freely, to a polling station and cast a vote, in secret. A privilege hard won. How can I not vote? My problem; I can't change anything.


You might be able to but remember:

How do we know they aren't, all, perjuring themselves in their manifestoes? Dissemblers, obfuscators... all of them?  Special advisors, busy finding reasons why this report is wrong, to be undermined and dismissed.  Or, pounced upon and used to bash the others.  For all the good it would do, if I could, I'd write a letter:


Dear Candidate


If you want my vote:


Don't speak to me in one breath of the 5YFV + finding 8bn and in the next breath speak of 20,000 more nurses, 24-7 opening and parity of mental health provision. Wise up; 8bn keeps the lights on. Anything new will cost new money and to keep going the NHS needs a down-payment, right now.


Tell me you agree the market and Monitor have been a monumental failure and if you are elected on Thursday, by the next Thursday you will have shredded the panoply of costs, lawyers, delays and binned the corrosive Monitor.


I want to hear you understand; every management guru since Edwards Deming in the 60's has denounced inspection as a way of improving quality. It is distracting and creates a climate of bullying, fear and intimidation. Tell me you accept the way to better quality is to share best practice, protect the front-line of care, fund it properly and make it fun to work there.  If you are not sure look at this screen saver in a Trust; 3 hours of meeting to 'prepare' for the CQC inspection and tell me this is a good use of taxpayers' money and staff time.


Tell me you'll do 6 things:

  1. Tell me you value the courage and perspicacity of staff... and show it.
  2. Tell me you will treat people fairly, listen to them... and be held to account for doing it
  3. Tell me you understand that merging health and social care, making it easier for professionals to work together is just sound common-sense... and get on with it.
  4. Tell me you will ask every member of staff what three things they would do to make their work more efficient and effective... and implement the top-of-the-shop ideas.
  5. Tell me you'll make Wi-Fi free in every NHS establishment... and get on and do it.
  6. Tell me you'll publish every scrap of data the NHS has and let us make our own minds up what it means.

I want to know you will have the courage to face the nation and say the Economist Intelligence Unit report is bad news;


"We've squeezed the pips out of the NHS and to give us services you will want to use, in places people will want to work, until we discover a way of stopping people getting older, we will raise your taxes to invest in the future of the world's greatest health service."


Yours sincerely


Confused of Camberley...


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In conversation with
Roy Lilley
18th May 2015
King's Fund
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Imperial College Health Partners.
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This is what I'm hearing;
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>>  I'm hearing - the boss of King's quit unexpectedly because he was not willing to go with the cuts that PWC and Monitor wanted at his Trust.
>>  I'm hearing - some Trusts are playing fast and lose with the Data Protection Act charges; to access scans and records.  Very naughty.
>>  I'm hearing - Monitor are investigating why St George's finances went down the pan a few weeks after they were authorised as an FT.  It might be Monitor are just not very good at their job, perhaps?
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