1st November 2016

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Dr Sir Sam Everington
GP extrodinaire!  In conversatin with Roy Lilley
In conversation with Roy Lilley
9th Novemberr 2016 - King's Fund - tickets here. Half price for IHM members.
Yours too
News and Comment from Roy Lilley
Nick Hulme runs the hospital in Ipswich.  Nice chap.  Formerly he ran a Trust in Croydon.

He was on the BBC Today Programme yesterday

He told us; using technology was going to solve the funding crisis.  He didn't seem to know the amount spent per patient has fallen from around 1000 to about eight hundred.  Neither that the percentage of GDP being spent on the NHS, today, is about the same as it was in 2000.

Reconfiguration, he told us, would get us out of this mess.  Keep-calm, carry on; crisis what crisis.  Ipswich works wonders with flow through A&E, with their red to green strategy and a whole system approach to emergency care improvement, but it is not wonderland.

I suspect his attempt to polish a cow-pat was to ensure that he didn't fall foul of the DH and the consequences they could rain-down on him if he told the stripped-pine truth.

Sarah Woolyone, chair of the Health Select Committee was also on the programme.  She contradicts Nick Hulme; she says the amount of money claimed to be in the NHS amounts to a fiddle; the NHS is at a tipping point.

She repeated, almost verbatim, my eLetter of last week, highlighting the work of the Nuff's and the King's Fund.  I said, they said, we all said; ten billion 'extra' for the NHS is a lie, it drags 2bn across from the last spending cycle.  

The global figures are distorted by cross departmental transfers; 3bn in cuts from the DH passed to bolster NHSE numbers.  Factor in inflation (which is higher for the NHS than the economy generally) and there is about 800m 'extra'.

The Tinkerman and the Department of Health people, who are also working in wonderland, say everyone is wrong; the numbers are wrong and the day after Tuesday is Friday.  The DH hope we are fools, have lost our calculators, can't do simple arithmetic and have forgotten how to read.

Why don't we all agree to tell the truth about the state of the NHS.  Why obfuscate, cover up what is going on?  The answer; a simple word; 'fear'.

I don't believe Nick Hulme doesn't know the numbers as well as the rest of us.  He is doing what we might politely call; 'managing the external boundaries'.

Hulme's Today Programme answers were just like the Tinkerman's, right out of the fudge factory.  Why does a much admired NHS chief executive go on the wireless and frankly, talk rubbish?  Why do politicians make such fools of themselves?

If the NHS is going to land, right way up, in the 200 odd weeks left of the 5 Year Forward View, it will be done by not 'reconfiguration' or technology, it will be done by circling the wagons, closing things and stopping doing stuff... a 2% reduction in demand.

The efficiency gains required are twice what Lord Carter, in his 'buying cheaper bog-rolls' report, thinks possible.

Fear of the consequences of telling the truth.  It is easy for a Trust to suddenly not benefit from new money, or business cases left on the shelf.  Bids 'not quite good enough on this occasion'.  We know how it works.  Hulme dare not tell the truth.

The DH can't tell the truth; it would embarrass the Minister, for the Minister to speak the truth is to embarrass the Cabinet and the Party.

To speak the truth is to invite the disapprobation of the opposition; ever willing to pounce on the tiniest lacuna in policy... even though they have no policy of their own.

Managing-up with soft lies, managing-down with the hard truth.

The truth is; the economy has gone through the wringer, Brexit is creating uncertainties.  The money is what the money is.  It is a lot less than we would all like but we are where we are.

The NHS is accountable for what it spends.  MPs are responsible for how much it spends.  Dump the truth on the Green Benches.  Make the MPs accountable for their decisions. 

Sarah Woolyone has the guts to do what Hulme, the DH, grovelling backbenchers and all the other organisations who depend on access can't do.

She tells the truth and has gone up in my estimation and I hope, yours, too!
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Medicine for Managers

Dr Paul Lambden
'...don't be caught off balance....'
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News boy
Dr Rodney Jones
Another storming paper
Role of a day-of-week cycle in blood biochemistry in the weekend mortality effect.
Simon Stevens
6th December
King's Fund
This is what I'm hearing;
if you know different,
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>>  I'm hearing - why are NICE so coy about the price of a ticket for their conference.  Whaaever people want to do with their own money is up to them!  as long as Trusts don't pay, it's OK!
Need inspiration, a good idea or solve a problem
Dr Sir Sam Everington
Barrister, doctor, leader.
In conversation with 
Roy Lilley
He's been a 'rough-sleeper' and charged with making fraudulent job applications to highlight discrimination.  
The first medic on the scene after the 7/7 bombings.
This will be a really interesting evening.  Medico-politics, the future of Primary Care.
King's Fund
9th November 
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Nominate it for a Health Tech and You Award!'
We thought this was a really good idea so we are partnering the Professional Choice category
Have a look, nominate someone and make their day!