Money, money, money

As I read yet another headline how someone thinks they know how to save the NHS, my usually excellent blood pressure soars. 

This time it was a Chief Nurse helpfully suggesting that caring for older people who no longer required the type of medical support provided by hospitals would be better done in the home rather than in hospital beds. No shit Sherlock. There used to be a properly funded Home Care service (I used to coordinate a group of Home Carers) and prior to that convalescence hospitals, all of which gave much needed support to those in real need and prevented a burden on medical beds. Some ‘wise’ soul thought that getting rid of these services would save money (in their budget) without actually understanding the long-term health of a patient or looking at the end to end cost of health provision. The cycle of illness, partial recovery, illness, partial recovery ad infinitum is halted for many and the recurring need for support services is reduced.

I don’t know this Chief Nurse and I’m sure she’s a caring person who has risen through the ranks of her profession and her comments are based on insight from her knowledge and frustrations as she’s watched successive governments destroy the basis of the NHS and Social Services of the UK. Or just maybe her comments are based on work done by some recent graduate to a consultancy firm which has been paid shed loads of money (trust me they pitch they’ll do the work with their best most qualified staff then bugger off leaving you with a spotty graduate who has no idea of the real world) will have spent hours pouring over data that they’ve acquired from over-worked staff in hospitals and come up with the scenario that their predecessors changed a few years ago and drawn up a press release that is then fed to the media. 

Take your pick, I’m hoping it’s the former.

So to be clear, yes I do have a beef with consultancy firms. I’ve seen them in action, all too frequently. They come in, promise the world then deliver something that’s a shadow of their promise and blame the organisation they’re working for for not embracing the process. Oh and they charge astonishingly high rates for the pleasure, promise their top experts will be on-site during the work (see above), and not meet the timeline agreed and yes you’ve guessed it they’ll blame the organisation for that too. Oh and don’t get me started on the latest buzzwords and acronyms that they’ll come up with as a way to woo the chief execs and senior managers who might not have already been swayed by the handshake and presentation.

Now of course that’s a generalisation and yes I have worked with some honourable and hard working consultants but in my experience they are very thin on the ground.

But back to the main point of this post. Organisations, local and central government departments are wasting so much money on reinventing the wheel, or implementing change for change sake. They have staff. Competent, qualified staff who THEY employed to do a job but they don’t trust them to know how to manage their work because……..well I don’t know. Are they saying they employed the wrong people? That their recruitment process is flawed? Yes there will be incompetent staff in organisations but deal with them, don’t ignore it because it’s easy or worse still promote them (therein lies another bug bear).

None of this is rocket science. Remember what works, what you’re there to provide and fund it and stop funding management structures and vanities.

Oh and I know some will respond with the oft-used ‘but there isn’t a bottomless pit of funding available’. But just ask the question where, with a larger working population contributing taxes, is that money and what is it being used for? And re-read this post or if you’re in the lucky position of being able to scrutinise organisations accounts look where the money is really spent, drill right down and see what small percentage is actually used to fund the staff who deliver the service or that they pay to outsource the service. Believe me it will be very scary.

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