18th August 2015

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Health Chat

29th October King's Fund 5.30pm

Samantha Jones NHSE Director of New Models of Care and Vanguards.

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Thank you
News and Comment from Roy Lilley
It's... well... it's just rude. It's like waving two fingers or driving by and sticking your bare bum out of the window.
Maybe ignorant might be a better word? Impertinent? I can't quite find the word. It might be thuggish? A touch of insolent thrown in? Boorish, perhaps?
A couple of weeks ago there was panic in the ranks at Monitor. Suddenly they realised that all the biz-plans they'd been encouraging the Trusts to prepare didn't work.
It's simple enough; you don't need to be an accountant or an economist; just add up all the money Trusts were going to spend, plus the cost of the activity they are planning to put through the hospitals and you get to a number. If that number is greater than the amount of money available in the health economy you are in trouble. Monitor are in trouble.
Boiling it down to the simplest; part of the problem is the Tariff, the amount the NHS pays itself for doing stuff. If the tariff is set too high and Trusts get busy, we go skint. If the tariff is set too low the Trusts can't operate and they go skint.
Monitor has already got itself into a row over the tariff. Several hospitals claimed the tariff was set too low and triggered an objection process. The upshot was the tariff was torn-up and in some instances pretty well abandoned.
The latest Monitor-Mess is the money still doesn't add up and the Trusts have been sent off to do their homework again. By the 25th they have to resubmit their plans minus cuts. In the case of one London Trust, I hear, the cut is 11m.
Most Trusts are already in deficit and as a regulator Monitor have turned out to be as useful as a concrete parachute. David Bennett, the highest paid boss in the NHS (250K) and the CEO (and onetime Chair) of Monitor looks to me to be doing the work of two men... Laurel and Hardy.  
As part of their plans to keep activity high and the finance base low Monitor's bright idea was to advise Trusts 'to fill vacancies only where essential'.  As 70% of NHS staff are nurses you can imagine what's going to happen.
Fair enough, money is too tight to mention and making the NHS books add-up is no easy task but, that's the job and by any measure Monitor has made a mess of things.  I think Monitor makes two short planks look like an astrophysicist. Fortunately Bennett is leaving.
Just when you thought they couldn't look more like a wooden frying pan, Monitor have had another go.
This time in a stupefying act of 'do as I tell you, not do as I do' they've advertised a vacancy; they are looking for an Economics Director (reporting to the Chief Economist), working with a team of thirty five (yes, that's 35) at a cool entry salary of 108,000 a year.
I get a lot of correspondence, emails and what-not and I'm always pleased to hear from you. On this topic I have had 117 links to the advert (Have I seen it?) and a torrent of emails, I've lost count of how many, the content from most I cannot repeat.
You are very cross and I don't blame you. So am I. Double standards doesn't quite do it... The difference between you and me is, I'm a member of the public and I can express and opinion... most of you dare not.
So, may I say, on your behalf (if I may make so bold) will someone get a taxi for David Bennett and get him out as fast as you can.
To the incoming new chairman of Monitor, Ed Smith, may I suggest your task, should you wish to carry it out, is; a very public, zero-based evaluation of your staffing requirements.
Can you show the staff on the wards and communities, the managers at their desks and the public at home you are not running a bloated, out of control, insouciant, casual, self-obsessed, egocentric, up-itself Board whose salute to the sweat, effort and struggles of the NHS front line is composed of one finger.
Thank you.
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Sam Jones
In conversation with
Roy Lilley 
Chief Vanguardista
... and NHSE Director of New Models of Care
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King's Fund
29th October.
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King's Fund 5.30pm
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