Some say it was Henry Ford, others Mark Twain. I have no idea who said it first... but it is true. One, from a rare collection of aphorisms that are truer than true.
Aphorisms; some are like airplanes... they only stay up whilst they are in motion. Witty ones are almost always perverse. Others cleverly distil a complex idea into a few words. Like sushi; life, sliced and diced into enticing portions and you can never get enough!
How do you eat an elephant? That's a good one. In case you are wondering, the answer is 'one bite at a time'. There again; if you have to explain an aphorism... it isn't. Real aphorisms are self-evident; part of a universal philosophy.
The Ford/Twain maxim?
'If you always do what you always do,
you'll always get what you've got.'
The subtext is; do you know what you are doing and why you are doing it? The past does not equal the future. Of course, we can learn from the past and take the best of it into the future but seldom is it worth repeating in perpetuity.
Einstein takes our aphorism to a new level. He said;
'Insanity is doing the same thing over and over again and expecting different results'.
We are at the point where we can no longer do the same things and expect the NHS to give us different results. The 25% cut to the DH budget will see to that.
The critical shortage of front-line staff tells us something. Workforce planning has been poor, foresight, prudence, sagacity all missing.
Is it fair to expect a level of farsightedness that might have avoided our present predicament? My guess is; even if we had, the constraints on nurse and doctor training would not have been nimble enough and could not have flexed.
Limits to funding and placements would not have allowed a swift enough reaction to the sudden demand for nurses. The same is probably true for medics.
Expecting a windfall of additional funding for education and training is to believe in the tooth fairy. As robust as the arguments may be that recruitment and training should be a priority, we are probably past the point of no return and into the 'something must be done' territory.
Putting nurse training on the same basis as all other graduate training; floating on debt, will cause a row. I can't see there is much that the RCN, midwives and Unison can do about it?
There is an online petition which might force a Parliamentary Debate; the outcome of which, it is conceivable, could change policy?
Their predictions that nurse numbers will fall are undermined by the experience of Lancashire Teaching Trust who, last year, started the first non-commissioned nurse training programme.
The first cohort is well under way and was hugely oversubscribed. The second group has 650 applications for 25 places.
The unions might do better to concentrate on bursaries, placements and training places across the new porous boundaries of care; primary, secondary, community and private sector.
For new ideas about medical training I'll take you to an unlikely place. To Milton Keynes University Hospital Trust. Working with Buckingham Uni they have developed their own MBChB programme and condensed it into 4.5 years instead of five.
By zero-base costing they have the fees at �36k pa. Sixty six students started in the first year and 85 confirmed for the second intake. Most students are from the UK.
The curriculum is cleverly phased to emphasise the experiential ingredients of learning and the text-books are in a virtual library. The Uni has been awarded The Times and The Sunday Times 'University of the Year for Teaching Quality' 2015-16.
I've been to Milton Keynes and I can tell you it is a visionary place, tightly run by a popular board with enthusiastic management, who 'get it'.
Progress is impossible without change and I know, it can be a struggle. There is also a melancholy about leaving behind ideas that have served us well. They are part of our beliefs. But, to believe clinical training will never change is to overlook the foresight and vision needed to have started Bart's Hospital in 1123.
Which leads me to another aphorism; 'Pioneers get arrows in their backsides'... that's because they are ahead of the game.
I will be discussing the future of nurse training and other key issues with Janet Davies, the new boss of the RCN, at The King's Fund tomorrow evening.
There are a few tickets left.
Come and join in.
