29th March 2016

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3rd May King's Fund 5.30pm
Niall Dickson Tickets here 
Chief Executive GMC - registration, training and standards for doctors

Bossing things is not running them
News and Comment from Roy Lilley
The low grumbling you might hear is the Medical Royal Colleges waking up.  The junior doctor's walk-out, just around the corner, is dawning on them.
I doubt their harrumphing will do any good.  The Tinkerman is in the Whitehall bunker, tin-hat firmly clamped on.  As he is a Brexit, stayer-inner he is safe.  It looks to me like Cameron needs all the mates he can muster.
My guess; a contract of sorts will be imposed with enough local wriggle room to let the Trusts finesse the whole thing.  And, if they are not careful, doc's will go back to work in a hail of abuse from the papers.
I have a sincerely held belief that the overwhelming majority of NHS staff come to work every day, determined to do a good job. 
A lot of people, busting a gut to do things right amidst a lot of things going wrong.
North West Ambulance Services have been served an 'official warning notice' about slow response times.
Can you imagine there is anyone working for NWAS who does not get the importance of prompt and appropriate response times?
"... failings meant that just 37% of patients, due to have been called back within 10 minutes, received the call in such time, whilst 15% of callers got so little help that they gave up."
The NHS111 service has more grief; South East Coast Ambulance service is embroiled in allegations that up to 20,000 calls taken via the service were subjected to deliberate delays.
Who in their right mind would deliberately delay a response? 
I can tell you.  It will be someone like you and me, struggling with an avalanche of demand, trying to hit impossible response targets.  The regulator becomes more important than the relatives and patients.
Fear.  Fear of criticism, retribution, and humiliation.  Fear of being caught.  With nowhere to ask for help, assistance, understanding or leniency... a lie creates breathing space and an invention a bolt-hole.
I hear some NHS111 services are working with 12 hour delays.
There's more; NHS beds are choc-a-bloc.  I visited a hospital where they had 90 delayed transfers of care; some over one month.  I hear of places where it is much worse.

"Accident & Emergency doctors said the service is already struggling to cope with "unprecedented" levels of pressure and overcrowding, and with growing staff shortages.
...the introduction of caps on pay for agency doctors, trusts in Barnsley, Leeds, Bolton, Plymouth and London had found 50 and 60 per cent of shifts going unfilled.
... NHS figures show nine in ten hospitals are so overcrowded they are deemed unsafe."
These are all the symptoms of an NHS that simply cannot cope and the junior doctors' strike is a symptom of a much deeper malaise.  A fermenting discontent.  A brewing dissatisfaction and despair. 
An NHS that feels like the Edvard Munch painting  and is ready to let out a collective scream! 
The Tinkerman's best shot?  He chips in with; 'If we leave the EU, doctors will leave the NHS'.   I have news; a good few are leaving already.
Now there is a row with Michael Gove;
"Under Jeremy Hunt's stewardship, the NHS has plummeted into a financial crisis."
The Cabinet are at war with each other and the services they superintend are crumbling.  For the Tinkerman to breach year-end financial balance will be the ultimate humiliation.  No wonder the accountants are turning the screws on Trust FDs, making everything more difficult than it need be.

Watch my lips; 'There ain't enough money to fund the activity we are obliged to do'.  Which bit of that is too difficult for you?  
Nicky Morgan's ominous threats to teachers, the Tinkerman's tactics with the junior doctors; hostile and confrontational.  Madness for a government with no money and a slender majority.  But, lucky there is no effective opposition.
I think it is time to point out to the politically distracted; there are departments to run, not the least of them, the NHS. 
Whether a Brexit or a Remain; we will still need the NHS after June 23rd.  Get off your collective back-sides, pay attention; it's time to realise bossing things is not the same as running them.
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