4th July 2016

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Sir Andrew Dillon
Boss of NICE, in conversation with Roy Lilley
What have we done
News and Comment from Roy Lilley
It's Saturday morning.  I'm sitting on a bench; London's Waterloo  Station.  I missed my train by inches so now I'm parked, watching the world go by.
Lovers meet and embrace.  A frail woman crosses my eye line, hauling a case on wheels. It's big enough to put her inside.  What does she have in there?

A young woman, dressed in black, scuttles past with a cello case strapped to her back.  She looks like a beetle.
A party of young girls sit on the floor, in a circle. They are replicas of each other; nimble, tiny and each have their hair dragged back into a bun.  Gymnasts on the way to a competition... betcha.
A stout man, with a furled umbrella strides past.  His stick thin wife scurries behind, carrying newspapers.
Momentarily, the relentless grey is relieved by a tall African woman in a vibrant yellow, green, and orange dress with turban to match.  She sashayed past; knowing, full-well, all eyes were on her.
There is no shortage of what to write about.  

This has been the week of weeks.  Government stripped bare for us all to see what they really are...
... jealous, liars, confused, frightened and not very clever.  Just like the rest of us.  They have the foibles and the failings of all human beings.

The problem is; we need them to be more than us.  Better, cleverer than us.  
There is no metropolitan elite, there is no ruling class.  There is just a group that happenstance and life's lottery has brought together and when push comes to shove there isn't a leader amongst them. 
They are more Brutus than Caesar,
How many times, in the last few months, have I written:
"The Chancellor has decided, as he is entitled to, he must balance the books by 2020 and accumulate a 10bn surplus.  He cannot borrow more, unable to raise taxes; he can only cut what he spends. Hence the financial pressure on public services and that includes social and healthcare."
Austerity.  Austerity that has meant the bedroom tax, social care delivered by zero-hours contracts and fifteen minute visits.  

Austerity translating into entitlement thresholds raised to the point where, unless you are ready to be carried out in a box, no one is going to carry in your dinner on a plate.
Austerity that has meant one care home a week being driven out of business by the impact of fees, so small, they wouldn't pay for a dog in kennels.  

Austerity that has meant, last year, almost every working day, a GP practice shut up shop.
Austerity that has meant hospitals and the careers of those brave enough to run them, traduced for 'overspending' and 'busting budgets' when really they are simply obliged to provide more care than they are paid for.
Austerity that has meant all thoughts of safe-staffing set aside in a spiral downwards to balance the books.
Austerity that has meant a fruitless waste of money regulating to discover the obvious... if the NHS were a business it would be bankrupt.
Services stripped to the bone, jobs lost, care neglected, people and their needs sacrificed.
Austerity... that has been for nothing.
George Osborne has announced he is no longer attempting to balance the books and accumulated a surplus.  It's over.  He knows he can't do it.
Austerity may be over, but remember; 'it's the economy stupid' so be ready for asperity, acrimony and a Spartan future.
What's next may be much worse. 
The after-shock of Brexit is rattling through the economy.  No one wants to buy government bonds.  Our pensions and insurances could well be at risk.
The economic performance will likely take a dip and it is a fair bet tax income will plateau or drop.
More reductions in public expenditure are on the way.  The 2020 target is abandoned because Osbourne knows he can't wait that long.
A proud dad pushes a Maclaren Stroller across the concourse.  The tiniest of bundles swaddled and swathed.  An exhausted looking mum holds the arm of her man; messenger bag bulging with the kit and caboodle, de-rigueur for babies-on-the move.
Off to granny perhaps?  Maybe.
But for certain; off into a future where it may not be safe to be sick, be poor or get old. 
What have we done?
  Contact Roy - please use this e-address
Know something I don't - email me in confidence.
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'... what did they ever do for us?'
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News and Stuff
News boy
Sustainability and Transformation Fund
Why it's not enough
Interesting analysis from the 
Centre for Health and the Public Interest.
What role can Technology Play in Reducing Variation in Outcomes and Improving Efficiency?
Dr Simon Wallace
Looks at speech recognition software.
This is really a sneaky trade puff but nevertheless it  is worth a read as it takes us into some territory that doesn't get much of a look-in and I think it should
Sir Andrew Dillon
18th July - King's Fund - 5.30pm
This is what I'm hearing;
if you know different,
tell me here
>>  I'm hearing - Worcester are closing their paediatric services at the Royal.  They can't get the staff.
>>  I'm hearing - Prop-Co (Or whatever they call themselves these daqys) are in a mess; data issues, poor implementation.  More importantly the move to market rents is affordable for CCGs.
Need inspiration, a good idea or solve a problem