Tomorrow ,Thursday 30th July, looks set to see extensive walkouts by teachers and other UK public sector workers in Union-led protests over changes to their largely publicly funded inflation proofed pension arrangments. Although the pro strike votes formed the majority of those cas the "yes" vote was a small minority of those entitled to vote. The silent majority foolishly did not vote at all so lost their voice. They will now pay for that. The walkouts could be the precursor to further disruptions from the autumn as some unions are keen to ratchet up the noise considerably in persuit of not only the issue itself but a seeming desire for conflict anyway with a government whose opposition party they sponsor and whose leader they put into power.
As is frequently the case in these episodes the emotional rhetoric employed to whip up enthusiasm for strike action ignores many of the realities of the case and a lot of those shouting in near hysterical terms appear to have only patchy knowledge of what the deal really is and how they will be affected. Hence the banding about of words such as "robbery", "akin to Maxwell" etc. which are emotive but largely ignore the facts.
The union leaders themselves, mainly in receipt of six figure salaries, will not of course lose a day's pay. Their members will though tomorrow and on any other day owhen they do not turn up for work. The personal financial pain is all theirs.
There are many arguments in support of unavoidable change here. The most basic is the need to avoid the public sector pensions becoming unaffordable and therefore liable to much more painful remedies later. It is obvious common sense that public sector people can not expect those in the private sector to fund endlessly their superior and totally state guaranteed pensions. A high percentage of private sector people have already had to accept far more severe reductions to their future entitlements and they will never be comprehensively state guaranteed in the way public sector deals are. The Government, as in many of its cuts and other policies, has not done well in getting its arguments and simple explanations out to the populace but that isn't entirely new and people do have to do some thinking and calculating for themselves.
The saddest thing for tomorrow's strikers this afternoon is that today may be the last day of long standing relationships and harmony between colleagues in their workplaces. Strikes are often devastatingly divisive, setting participants against non participants (something tacitly encouraged by unions who generally thrive better in places of disharmony rather than harmony). It can easily all become very bitter and people who have got along well enough for years are suddenly thrown into two camps. Trust goes and a lot of personal unpleasantness develops. This breakdown is not worth the tensions and the cloud it casts across the working lives of those involved. The end of work this afternoon could mark the end of an era for many and their enjoyment of the job may be about to be overwhelmed by long lasting post-strike acrimony. It is a dreadful prospect for their quality of life and yet they are sleepwalking into it. Union membership can be a very strange thing. People pay to join and then they surrender their right to stand out against the organisation of which they are now a member,- and they even pay good money for this loss of their own freedom. It is a bizarre notion. The other tragedy is that the status of people formerly seen as true professionals for whom the duty to provide and give care transcended all other considerations will be lost . Teachers in particular will emerge much reduced in stature. The unions, ostensibly there to look after their interests will care not a jot about that. They are far more concerned with their own power and muscle flexing than an individual's well being. Individuality rather than "solidarity" has never been part of most union cultures.
The other feature of this day of action or inaction and its likely successors is that the unions have clearly marked out their pitch as supporting their members in the public sector regardless of the interests of their other members in the private one. This is not new. Similarly they champion their members as suppliers of goods and services rather than their interests as purchasers and consumers.
Whereas businesses and even the public sector have changed considerably over the last few decades, some unions have moved very little and remain wedded to perpetuating old beliefs and behaviours.For many the addiction to old fashioned notions of class warfare and "struggles" is very deep. They blindly ignore the need for radical rethinking of their future role and relevance. If they continue with heads firmly in the sand their likely destiny is to follow those once glorious industries which now vanished into oblivion. Thursday is primarily a slip back into the old glory days of strife paid for by the members not the leadership. It is nobody's real interests. Pensions reform has to happen even if only due to our stubborn insistance on living longer. That's before the profligacy of the last Labour government and its massive increases in state employee numbers and remuneration come onto the stage. The bottom line is that everything in life has to be paid for and there is no way round that however much union leaders and the left in general like to believe there is. Even if they think it's the bankers who should pay there just aren't enough of those to go round. Game over and it's no use Ed Milli standing there wringing his hands and looking soulful while his friends the brothers do their old antedeluvian worst.
Wednesday, 29 June 2011
Saturday, 18 June 2011
Dave,- Time to stop wobbling. It's knees together time.
Downing Street's statement that Danny Alexander's statement on the future of public sector pensions are only proposals rather than definitive is disturbing.
The coalition government set off at a brisk trot in May 2010 on a mission to tackle the spiralling national debt caused by annual government overspending and borrowings to cover it . They also promised to take quick action on whole host of other items ignored, neglected or just got wrong in the 13 years of Blair and Brown administration,- one hesitates to say leadership. The medicine looked bitter but the need for it was understood and with five years to go until the next election the new leaders could afford to ride out any unpopularity.
The pace of intention, if not delivery, continued until a sudden recent bout of skidding and swerving around the road .Let's avoid the emotive, media beloved phrase U-turns .There is no problem with a change or two when a fresh new inexperienced government discovers unexpected potholes or a better ways forward. That's fine so long as the overall forward impetus and clear direction continues and reverse gear is not engaged. Over these last few weeks though there has been a strange loss of confidence and apparent determination behind the wheel. Cameron's jaw has looked less firmly set and some mistakes have crept in as has some dismay amongst observers.
Of all mistakes a leader can make , a visible loss of self confidence is the most serious. Supporters will follow a determined one through thick and thin but the moment he or she apears to waver, show doubts, indulge in self- questioning ,lack of impetus or even fatigue ,that support is threatened. Supporters don't like vulnerability not least because it means they risk being left out on a limb and looking stupid.
Danny Alexander set out the pensions case very clearly and accurately. It is not complicated and will be very familiar to many in the private sector who have already had to accept similar new arrangements though with the added risk that their own funding is not guaranteed by the state. Of course the unions will huff and puff. That is both their job and in their self interest. Their own financial survival depends on public sector employees,- and there being as many of them as possible. Whether the huffing and puffing, even to the extent of widespread strikes (which the employees themselves could not live with for long), has any power depends entirely on the Government response to it. Show weakness, allow protracted "negotiations", susceptability to expensive and unaffordable compromises and the unions have leverage. Avoid all those things and they have hardly any. Harold Wilson's beer and sandwiches at Number 10 was a disaster. Particularly when you have a winning hand as the government now has on the pensions issue the recipe is simply to deny the unions the oxygen and the ability to pretend to their members that industrial action has a chance of success. It will also ultimately help them to realise that their own only long term hope of relevance and survival is to totally rethink their role and how they go about being part of the redesign of the new global world of work and competition rather than the vain defender of one very protected and localised bit of it that has really disappeared.
New governments and new managments in business organisations are always very vulnerable to industrial realtions fun and games in their early days. The union professionals have been in the same game for many years, fought many battles and in some cases have aquired battle reputations of which they are very proud- and find very useful. For a green adversary they even look scary and it is easy to be persuaded that under this unwelcome stress it is safer to seek "Peace in our Time" and to withdraw than press on. It looks very much as if Downing Street may be in this mode at the moment and thereby it risks snatching defeat from the jaws of essential victory. OK, the forrests have been saved,(that was probably a battle never worth fighting anyway) but absolutely crucial NHS reforms look like being at best watered down to quarter strength (ask a panel with a majority uninterested in change for advice and what did they expect the answers to be?), but the public sector pensions issue is now the big one .Retreat would simply say the government has lost its nerve and all of its brave new world just isn't going to happen. If so why elect them next time round?
The coalition government set off at a brisk trot in May 2010 on a mission to tackle the spiralling national debt caused by annual government overspending and borrowings to cover it . They also promised to take quick action on whole host of other items ignored, neglected or just got wrong in the 13 years of Blair and Brown administration,- one hesitates to say leadership. The medicine looked bitter but the need for it was understood and with five years to go until the next election the new leaders could afford to ride out any unpopularity.
The pace of intention, if not delivery, continued until a sudden recent bout of skidding and swerving around the road .Let's avoid the emotive, media beloved phrase U-turns .There is no problem with a change or two when a fresh new inexperienced government discovers unexpected potholes or a better ways forward. That's fine so long as the overall forward impetus and clear direction continues and reverse gear is not engaged. Over these last few weeks though there has been a strange loss of confidence and apparent determination behind the wheel. Cameron's jaw has looked less firmly set and some mistakes have crept in as has some dismay amongst observers.
Of all mistakes a leader can make , a visible loss of self confidence is the most serious. Supporters will follow a determined one through thick and thin but the moment he or she apears to waver, show doubts, indulge in self- questioning ,lack of impetus or even fatigue ,that support is threatened. Supporters don't like vulnerability not least because it means they risk being left out on a limb and looking stupid.
Danny Alexander set out the pensions case very clearly and accurately. It is not complicated and will be very familiar to many in the private sector who have already had to accept similar new arrangements though with the added risk that their own funding is not guaranteed by the state. Of course the unions will huff and puff. That is both their job and in their self interest. Their own financial survival depends on public sector employees,- and there being as many of them as possible. Whether the huffing and puffing, even to the extent of widespread strikes (which the employees themselves could not live with for long), has any power depends entirely on the Government response to it. Show weakness, allow protracted "negotiations", susceptability to expensive and unaffordable compromises and the unions have leverage. Avoid all those things and they have hardly any. Harold Wilson's beer and sandwiches at Number 10 was a disaster. Particularly when you have a winning hand as the government now has on the pensions issue the recipe is simply to deny the unions the oxygen and the ability to pretend to their members that industrial action has a chance of success. It will also ultimately help them to realise that their own only long term hope of relevance and survival is to totally rethink their role and how they go about being part of the redesign of the new global world of work and competition rather than the vain defender of one very protected and localised bit of it that has really disappeared.
New governments and new managments in business organisations are always very vulnerable to industrial realtions fun and games in their early days. The union professionals have been in the same game for many years, fought many battles and in some cases have aquired battle reputations of which they are very proud- and find very useful. For a green adversary they even look scary and it is easy to be persuaded that under this unwelcome stress it is safer to seek "Peace in our Time" and to withdraw than press on. It looks very much as if Downing Street may be in this mode at the moment and thereby it risks snatching defeat from the jaws of essential victory. OK, the forrests have been saved,(that was probably a battle never worth fighting anyway) but absolutely crucial NHS reforms look like being at best watered down to quarter strength (ask a panel with a majority uninterested in change for advice and what did they expect the answers to be?), but the public sector pensions issue is now the big one .Retreat would simply say the government has lost its nerve and all of its brave new world just isn't going to happen. If so why elect them next time round?
Friday, 17 June 2011
Those "Hard working families" again.
With Gordon Brown's departure from Downing Street last year many will have hoped that they never again heard the expression "hard working families". It was these who were said to be likely prey to anything a non Brown government might do to change anything, be they benefits, personal tax rates, VAT,- anything at all. Gordon loved it and trotted it out incessantly as did his henchmen some of whom still seem to occupy front benches in the House of Commons, only opposite those upon which they used to sit in what they clearly felt were their glory days.
Easyjet's new CEO Carolyn McCall, who may have loved the expression in her former days as head of Guardian newspapers, has assailed us with it again, -this time identifying the poor old "hard working families" as the sufferers from air travel taxes. Yes, they are. So are idle ,layabout benefit dependent families, hen and stag party revellers and all manner of n'er do wells of every shape ,size and age, working, shirking or just any unemployed through no fault of their own.
Please Ms McCall and others do not ever again churn out this patronising and ridiculous spine tingling phrase with its absurd vision of downtrodden hard workers uniquely crushed under foot to reinforce this or any other argument. It doesn't. It just makes what might otherwise be a good case suddenly highly suspect and emotive. Just state the facts and let them speak for themselves. Please don't make us all cringe or insult our intelligence again. Leave that to politicians.
Easyjet's new CEO Carolyn McCall, who may have loved the expression in her former days as head of Guardian newspapers, has assailed us with it again, -this time identifying the poor old "hard working families" as the sufferers from air travel taxes. Yes, they are. So are idle ,layabout benefit dependent families, hen and stag party revellers and all manner of n'er do wells of every shape ,size and age, working, shirking or just any unemployed through no fault of their own.
Please Ms McCall and others do not ever again churn out this patronising and ridiculous spine tingling phrase with its absurd vision of downtrodden hard workers uniquely crushed under foot to reinforce this or any other argument. It doesn't. It just makes what might otherwise be a good case suddenly highly suspect and emotive. Just state the facts and let them speak for themselves. Please don't make us all cringe or insult our intelligence again. Leave that to politicians.
Wednesday, 15 June 2011
NHS,- Why "I am the boss around here" should sound alarm bells,- and help the Government.
Yesterdays' noisy outburst by leading consultant Dr David Nunn during a visit by David Cameron and a possee of attendants and journalists did the NHS no good at all. It seems likely that indeed some, although seemingly not Prime Minister's group itself, may not have prepared and washed their hands as is required but there are alternative discreet and courteous ways of dealing with this. It is also reasonable to say that the hospital managers should themselves have ensured this happened before the obviously high profile session began.
The doctor's robust intervention and ordering the whole party to leave smacked of territorial "I am the boss here" grandstanding. One was left wondering what would be the fate of a junior staff member or patient who displeased him. What sort of atmosphere normally surrounds him on a working day? Was this a one off explosion or has it got form? The NHS establishment has been fighting a furious rearguard action against almost any change or threat to its hierarchies and ways of working in what has been portrayed as a defence of the patients' interests against the bogeyman "competition". This in turn has been painted as something almost evil and maliciously life threatening. How something designed to increase patients choice and the ability to select where and by whom they are treated is an unexplained mystery.
The unpleasant and unnecessary scene yesterday should remind the NHS' customers that while many things about it are excellent and good, some are not. Overbearing staff at any level and consultants in particular are in the latter box. Many will have met them in the past and perhaps thought that their era was over. Sadly in some cases it seems not. Yesterday will have left both patients and staff embarrassed and concerned. It would have been less likely to happen if both had a real choice of going elsewhere. In just a few seconds the tip of a rather worrying iceberg came into view. Any monopoly supplier is in danger of behaving badly and this was the supply side of the organisation shown at its worst. The government should not shrink from the task of reforming where reform is needed. It does though need to explain better the rationale and in terms everyone understands and can identify with. It has just been presented with a startling "For example....." with which to start doing that.
The doctor's robust intervention and ordering the whole party to leave smacked of territorial "I am the boss here" grandstanding. One was left wondering what would be the fate of a junior staff member or patient who displeased him. What sort of atmosphere normally surrounds him on a working day? Was this a one off explosion or has it got form? The NHS establishment has been fighting a furious rearguard action against almost any change or threat to its hierarchies and ways of working in what has been portrayed as a defence of the patients' interests against the bogeyman "competition". This in turn has been painted as something almost evil and maliciously life threatening. How something designed to increase patients choice and the ability to select where and by whom they are treated is an unexplained mystery.
The unpleasant and unnecessary scene yesterday should remind the NHS' customers that while many things about it are excellent and good, some are not. Overbearing staff at any level and consultants in particular are in the latter box. Many will have met them in the past and perhaps thought that their era was over. Sadly in some cases it seems not. Yesterday will have left both patients and staff embarrassed and concerned. It would have been less likely to happen if both had a real choice of going elsewhere. In just a few seconds the tip of a rather worrying iceberg came into view. Any monopoly supplier is in danger of behaving badly and this was the supply side of the organisation shown at its worst. The government should not shrink from the task of reforming where reform is needed. It does though need to explain better the rationale and in terms everyone understands and can identify with. It has just been presented with a startling "For example....." with which to start doing that.
Thursday, 9 June 2011
The Archbishop off track in the wilderness called Politics.
Yesterday's political outburst against the UK coalition government's policies took the Archbishop of Canterbury even further off piste than usual. For the unelected leader of the Church of England to stray into the territory of the legitimacy of an elected government's policy or action on the basis that it was not included in last year's manifesto was extraordinary.It also shows a lack of understanding of the need to react to the changing situations of the times rather than stick always to rigid doctrine, something with which the Archbishops' organisation and others similar seem to find extraordinary difficulty.
Perhaps the church leader is looking for distractions to take his mind off the state of his legitimate bailiwick,- the C of E itself which seems for ever entramelled, indeed obsessed, by the gender and sexuality of its membership, potential or actual. It grapples constantly with its historical mysogeny and the view that women are fine for procreration but not really the equals of men and only grudgingly accepts them as priests and certainly not yet anyway Bishops, or Heaven forbid(s) Archbishops. The church's theologians, the equivalent of its head office, examine for ever ancient theology, documents looking for new tealeaves or entrails which either justify its stance or show it ways off the hook though it seems to find enormous difficulty in finding and, even more, agreeing them. The more they look, dither and worry about whether some of their number march off to to Rome (why not let them if they decide they are in the wrong church ?-it's a free world),the more the head office diverges from the real needs of its endangered congregations. It also splits the organisation into two quite distinct parts. The first is the bit most people see and upon which they make their judgements,- the very valuable front line pastoral side doing a great deal of good around the world and ,by actions and example rather than doctrine, bringing in recruits and reaching out to believers and to non believers who at least begin to see the goodness of their actions. The second is the almost pure theological side which is the habitat of the Archbishop. Unlike the Pope, he is an infrequent world traveller and rallier of the faithful and indeed barred himself from air travel for a year as some kind of irrelevant green protest. The academic head office type group clustered around Lambeth and the great cathedrals is remote, theoretical and would more appropriately be based around a university type of institution. To the exasperation of many it isn't doing well in unifying, gaining friends or even laying out its stall coherently. This latest Lambeth Palace outburst adds to the shaking of heads and questioning of what the C of E is all about.
Perhaps the church leader is looking for distractions to take his mind off the state of his legitimate bailiwick,- the C of E itself which seems for ever entramelled, indeed obsessed, by the gender and sexuality of its membership, potential or actual. It grapples constantly with its historical mysogeny and the view that women are fine for procreration but not really the equals of men and only grudgingly accepts them as priests and certainly not yet anyway Bishops, or Heaven forbid(s) Archbishops. The church's theologians, the equivalent of its head office, examine for ever ancient theology, documents looking for new tealeaves or entrails which either justify its stance or show it ways off the hook though it seems to find enormous difficulty in finding and, even more, agreeing them. The more they look, dither and worry about whether some of their number march off to to Rome (why not let them if they decide they are in the wrong church ?-it's a free world),the more the head office diverges from the real needs of its endangered congregations. It also splits the organisation into two quite distinct parts. The first is the bit most people see and upon which they make their judgements,- the very valuable front line pastoral side doing a great deal of good around the world and ,by actions and example rather than doctrine, bringing in recruits and reaching out to believers and to non believers who at least begin to see the goodness of their actions. The second is the almost pure theological side which is the habitat of the Archbishop. Unlike the Pope, he is an infrequent world traveller and rallier of the faithful and indeed barred himself from air travel for a year as some kind of irrelevant green protest. The academic head office type group clustered around Lambeth and the great cathedrals is remote, theoretical and would more appropriately be based around a university type of institution. To the exasperation of many it isn't doing well in unifying, gaining friends or even laying out its stall coherently. This latest Lambeth Palace outburst adds to the shaking of heads and questioning of what the C of E is all about.
Saturday, 4 June 2011
Britishness, Politics and the NHS.,- Why settle for less than the best?
The British have a curious relationship with one of its biggest social benefits as well as an enormous financial albatross around its neck,-the National Health Service or NHS.
The World's fourth largest employer after the Chinese Peoples' Liberation(?) Army, Indian State Railways and Walmart, the consumer of £98.7 billion in 2008/9, the NHS both delivers a service and gobbles up money (taxation) at an alarming rate, each pound diverted from doing something else.Partly as result, many other government activities including infrastructure development get less to spend than they might need. That or the opportunity for lower taxes and more spending money in peoples' pockets is lost.
(Almost) everyone knows that the NHS, while often professionally outstanding, is very poor at other times and in other places. The culture and quality of care can vary enormously within yards in a single hospital and yet any calls to change almost anything result in howls of anguish and political approbrium throughout the land. In reality Britain is almost a health service with a country attatched.
Leading politicians rave "I love the NHS". The rider "...but it needs to change........" is treated with utmost delicacy and asbestos gloves. Some of this is of course pure political hype wrapped around the message that "Honest Tone/Gord/Dave/Nick will look after you"-Note not really, really, "will share your pain". That wouldn't go down well when we are talking about health and hospitals. Another reason is that for them the NHS is indeed genuinely marvellous,- and no wonder. If Dave, Ed (any Ed), Nick or their immediate minions so much as look at the outside of a hospital (or school but that's another story) or indicate they might go there, the cleaning gangs are called in, the loos swabbed and tidied every five minutes and any possible embarrassments cleared away, sent home for the weekend or whatever it takes,- eg "But it's only Tuesday" "Never mind,- you're going home". When Tone's ticker missed a beat at Chequers one Saturday night he was in a NHS hospital double quick. Time enough though for the order to flash in all directions that he must not see or be seen by the usual weekend collection of over festive clients and their results cluttering up A&E shouting the odds at the staff and anyone else in their blurry field of view. The NHS also rightly took excellent care of the Brown and Cameron families but did and do they ever have to wait for hours late at night on hard plastic chairs for their turn to be seen? Unlikely.
When set up by Labour as part, the major part, of its "Land fit for heroes to live in" pledge at the end of World War 2, the NHS was not and probably couldn't realistically be properly costed. Right from the start there were unecessary and costly mistakes which still persist. Thanks to the party's socialist roots and ethos health care was not only deemed to be free at the point of delivery but also to be the domain of a union-pleasing monolithic state supplier which guaranteed high costs , too often indifferent quality and attitudes together with a jobs for life culture able to deliver what and how it wanted with little external challenge. Patients were also barred from making a contribution for their costs, paying for scans, tests etc even if they could and wanted to.
As result, with 1.7 million employees, any unwanted challenge, talk of change, achieving greater efficiency, greater private sector participation is greeted by a storm of invective from all quarters. Any implication that some results may be poor, some staff attitudes abysmal and in need of rooting out so as to support those who genuinely are passionate about the quality of treatment and care are greeted with a wall of hostile noise. Unions usually weigh in on the side of the noise. Sometimes they generate it from the outset. Why one wonders do they so often support the poor performers to the disadvantage of the good, many of whom are also union members? Why the support for the supply side rather than the customers, again many of whom are union members?
The coalition government started off well in being determined to wring higher performance and lower costs out of the NHS. The potential is huge. Even achieving universal cost and quality awareness would be a substantial and beneficial step forward and reduce the sound of money gurgling down the drain. The Lib Dems, as ever rather iffy in the face of the opportunity to be either liberal or democratic when the chips are down, have the wobbles about "with profit" participation and organisational or behavioural change. Labour of course are rabid at anything their union paymasters don't like and highest amongst these dislikes are things which might reduce staff=reduce union members=reduce subscriptions= give them financial pain. They therefore ramp up the emotion and "Hands off our NHS" demands at the drop of a bedpan. There is a real danger right now that the Tory side of the coalition will now go wobbly and emasculate their intended substantial changes to the service. That would not be sensible. There are still nearly 4 years to go until the next General Election so, as with the whole "cuts" programme there is plenty of time to ride out short term heat and fury from the "Do nothing" lobby of Balls and Eds various along with confused Lib Dems wringing their hands.
The new relationship of the British with the NHS should be one where the citizens are in the driving seat as they should have been all along and the howls and screams are not for no change but much more so that they aren't waiting for hours in A&Es, nor months for tests and longer for results but are getting first rate service pleasantly and professionally delivered from a first rate organisation. That should be the common and enthusiastically sought goal of all politicians,patients/customers and the best of the NHS staff. Why should any of them settle for anything less? They needn't and would be crazy to do so. They just need to understand it and be determined to get it,- now!
The World's fourth largest employer after the Chinese Peoples' Liberation(?) Army, Indian State Railways and Walmart, the consumer of £98.7 billion in 2008/9, the NHS both delivers a service and gobbles up money (taxation) at an alarming rate, each pound diverted from doing something else.Partly as result, many other government activities including infrastructure development get less to spend than they might need. That or the opportunity for lower taxes and more spending money in peoples' pockets is lost.
(Almost) everyone knows that the NHS, while often professionally outstanding, is very poor at other times and in other places. The culture and quality of care can vary enormously within yards in a single hospital and yet any calls to change almost anything result in howls of anguish and political approbrium throughout the land. In reality Britain is almost a health service with a country attatched.
Leading politicians rave "I love the NHS". The rider "...but it needs to change........" is treated with utmost delicacy and asbestos gloves. Some of this is of course pure political hype wrapped around the message that "Honest Tone/Gord/Dave/Nick will look after you"-Note not really, really, "will share your pain". That wouldn't go down well when we are talking about health and hospitals. Another reason is that for them the NHS is indeed genuinely marvellous,- and no wonder. If Dave, Ed (any Ed), Nick or their immediate minions so much as look at the outside of a hospital (or school but that's another story) or indicate they might go there, the cleaning gangs are called in, the loos swabbed and tidied every five minutes and any possible embarrassments cleared away, sent home for the weekend or whatever it takes,- eg "But it's only Tuesday" "Never mind,- you're going home". When Tone's ticker missed a beat at Chequers one Saturday night he was in a NHS hospital double quick. Time enough though for the order to flash in all directions that he must not see or be seen by the usual weekend collection of over festive clients and their results cluttering up A&E shouting the odds at the staff and anyone else in their blurry field of view. The NHS also rightly took excellent care of the Brown and Cameron families but did and do they ever have to wait for hours late at night on hard plastic chairs for their turn to be seen? Unlikely.
When set up by Labour as part, the major part, of its "Land fit for heroes to live in" pledge at the end of World War 2, the NHS was not and probably couldn't realistically be properly costed. Right from the start there were unecessary and costly mistakes which still persist. Thanks to the party's socialist roots and ethos health care was not only deemed to be free at the point of delivery but also to be the domain of a union-pleasing monolithic state supplier which guaranteed high costs , too often indifferent quality and attitudes together with a jobs for life culture able to deliver what and how it wanted with little external challenge. Patients were also barred from making a contribution for their costs, paying for scans, tests etc even if they could and wanted to.
As result, with 1.7 million employees, any unwanted challenge, talk of change, achieving greater efficiency, greater private sector participation is greeted by a storm of invective from all quarters. Any implication that some results may be poor, some staff attitudes abysmal and in need of rooting out so as to support those who genuinely are passionate about the quality of treatment and care are greeted with a wall of hostile noise. Unions usually weigh in on the side of the noise. Sometimes they generate it from the outset. Why one wonders do they so often support the poor performers to the disadvantage of the good, many of whom are also union members? Why the support for the supply side rather than the customers, again many of whom are union members?
The coalition government started off well in being determined to wring higher performance and lower costs out of the NHS. The potential is huge. Even achieving universal cost and quality awareness would be a substantial and beneficial step forward and reduce the sound of money gurgling down the drain. The Lib Dems, as ever rather iffy in the face of the opportunity to be either liberal or democratic when the chips are down, have the wobbles about "with profit" participation and organisational or behavioural change. Labour of course are rabid at anything their union paymasters don't like and highest amongst these dislikes are things which might reduce staff=reduce union members=reduce subscriptions= give them financial pain. They therefore ramp up the emotion and "Hands off our NHS" demands at the drop of a bedpan. There is a real danger right now that the Tory side of the coalition will now go wobbly and emasculate their intended substantial changes to the service. That would not be sensible. There are still nearly 4 years to go until the next General Election so, as with the whole "cuts" programme there is plenty of time to ride out short term heat and fury from the "Do nothing" lobby of Balls and Eds various along with confused Lib Dems wringing their hands.
The new relationship of the British with the NHS should be one where the citizens are in the driving seat as they should have been all along and the howls and screams are not for no change but much more so that they aren't waiting for hours in A&Es, nor months for tests and longer for results but are getting first rate service pleasantly and professionally delivered from a first rate organisation. That should be the common and enthusiastically sought goal of all politicians,patients/customers and the best of the NHS staff. Why should any of them settle for anything less? They needn't and would be crazy to do so. They just need to understand it and be determined to get it,- now!
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