How have the mighty fallen? OT.

[June Hughes]

In message , The Reid writes

[June Hughes]

In message , The Reid writes

Same from me Mary.

[Mary Fisher]

I think I'm older than you but in a north facing room with all doors and windows open it's bearable.

:-)

Mary

[Mary Fisher]

Thanks, we have full confidence in the good old NHS :-)

Mary

[Mary Fisher]

Aw - I wasn't fishing for sympathy :-)

But it's nice to know.

Mary

[Mary Fisher]

Indeed. Perhaps they'd consulted YKW.

Mary

>

[graham]

Sorry to hear that, Mary. It must be a worrying time. I hope things go well. Graham

[The Reid]

Following up to Owain

didnt see any!

[Andy Hall]

On Wed, 19 Jul 2006 09:31:32 +0100, Mary Fisher wrote (in article ):

It would be hard to find one worse than the NHS, Mary.

In one sense you are right though. I do spend a lot of time solving difficult problems and have done for many years. Flying around is hardly an exciting prospect any longer when one is visiting four cities in different countries in a week, out of the airport, visit the customer and back to the airport - i.e. there is no excitement in the travel aspect.

However, in working with customers for several decades, (and others say successfully), I have learnt and use several fundamental principles:

- Always try to do what you say you are going to do, and be prepared to move heaven and earth if necessary to achieve that.

- If that is prevented by circumstances that were impossible to foresee, make sure that the customer knows as far ahead of time as possible so that alternative arrangements can be made. Then make sure that the customer is overcompensated for the effects.

- Always tell customers the truth, even if it may not be convenient at the time. It pays back with dividends.

- Involve and encourage customers to participate in solving issues. It makes things run more smoothly and quickly and in the future they can help themselves.

- Over achieve on promises and reasonable expectations. When this is done, the unreasonable ones seldom happen.

- Deliver on the customer's expectation of or the agreed timescales.

- Always remember that the customer is paying for what he is getting and is entitled to expect to receive that.

The result of doing these things is success for both the supplying organisation and the customer.

It isn't difficult, and my experience is of having customers that I have worked with through multiple career/company changes (theirs and mine) and achieving a level of trust that they can safely and effectively work with me.

Of course this relates to the commercial world, but almost all the principles can be applied to any situation.

It does mean that when I am a customer, I expect the same standards from organisations from which I buy goods and services. This does not mean that I am looking for something for nothing or for something for which I am not willing to pay.

I select a supplier based on my own research and on what he says he will do. However, I do expect that he will deliver on his promises both in terms of content and in the agreed timescale. That has been part of selection criteria.

If he over-delivers that's nice but I don't expect it.

More often than not it all works out and what was agreed happens when it is supposed to happen.

Occasionally there is a problem and the supplier takes the trouble to tell me and a fix is agreed. I'm usually perfectly happy with that because if a supplier can demonstrate to me that he can fix a problem if it occurs it gives me confidence that he will be able to do that in the future and that my business is well placed.

However, if something goes wrong and the supplier is either apathetic or worse still lies to me or tries to evade responsibility, I think that it's entirely reasonable to expect and insist that they resolve the issue or refund my money with compensation. Obviously one has to include a factor of reasonableness in terms of what can be expected for the price paid - however, I always factor those issues into the original decision.

All of this relates to normal commercial and consumer transactions, which although important in themselves, are not very significant in the global scheme of things and certainly not in comparison with healthcare, which is the most important purchase that people make - however they do it.

Now.... when I map these principles and philosophies to the way that the NHS operates and my experiences of it, to say that I am a disappointed customer would be a gross understatement.

I think that it would be reasonable to expect that it should deliver on most if not all of the principles of customer service that I outlined above. I have difficulty in finding a single one where it does to any acceptable degree if at all.

I have the ability to fund my own healthcare either through insurance or if necessary out of pocket, so one might ask why I care about it. I could even justifiably complain that I shouldn't need to do this out of already taxed income. Moreover, I could even argue, and on occasions have done, that I should be able to opt myself out of the state system.

However, I would not go so far as to say that people should fend totally for themselves if they are unable to do so. That is not correct and reasonable in a civilised first world country. I would prefer to pay less in taxes but consider it reasonable to contribute towards the healthcare of those genuinely unable to do so for themselves whether it be partially or completely.

I therefore consider myself a customer of the government in terms of its responsibility to fund healthcare for those unable to do so for themselves - I am paying them to do a job, even though it may largely be for the benefit of others.

Successive governments, for half a century have manifestly failed to live up to their responsibilities in this area through the medium of the NHS. If it were possible to fix it, one would think that that would have been done by now. We have seen the effect in the British car industry of what happens when one attempts to maintain the untenable.

If the NHS was actually ever going to work, it would have done so by now. Instead it lives by growing ever larger, increased wastage, worsening standards and spending money on marketing to try to convince its customers that it's doing a good job.

I am angered and at the same time saddened by the whole thing because healthcare does not have to operate in this way, and it is not necessary either to move to a non-state-funded environment.

I would like to see my money being spent properly and see no prospect of that happening all the time that the state remains involved in the delivery of healthcare.

All of this leads me to the inevitable and much considered conclusion, that the only way forward is to close the charade that the NHS has become.

[Andy Hall]

On Wed, 19 Jul 2006 14:00:15 +0100, June Hughes wrote (in article ):

How would you describe it? Do you find what they offer 100% acceptable?

[Andy Hall]

On Wed, 19 Jul 2006 15:22:21 +0100, Mary Fisher wrote (in article ):

Mary, you know full well that the statement was a figurative one to emphasise a point, which is simply that there is no point in tinkering around at the edges of a major issue which cannot be addressed by the methods being employed.

[Andy Hall]

On Wed, 19 Jul 2006 14:36:07 +0100, The Reid wrote (in article ):

Are you stupid or just pretending?

All of the examples listed relate to major, life threatening ailments affecting very large numbers of patients.

[Andy Hall]

On Wed, 19 Jul 2006 14:51:24 +0100, Clive George wrote (in article ):

You are fortunate. The experience of others is not the same. I have seen both rationing and refusal.

The service is supposed to be free at the point of delivery.....

[Andy Hall]

On Wed, 19 Jul 2006 15:26:04 +0100, Mary Fisher wrote (in article ):

The service certainly is.

I can provide you with documented examples for each of the cases that I mentioned.

Wrong, and this is not the issue anyway

[Andy Hall]

On Wed, 19 Jul 2006 16:30:55 +0100, Clive George wrote (in article ):

Well you might ask.

It should be possible for a T2 to test about 6-8 times a day in order to correctly control BG levels with diet and exercise or the possible addition of drug therapy.

This implies around 200 strips a month. At 50p a go, this is a significant sum.

Hence they are rationed or unavailable on prescription, IME.

[Andy Hall]

On Wed, 19 Jul 2006 15:24:07 +0100, Mary Fisher wrote (in article ):

I didn't say that it was, Mary, and I do have a specific and personal reason for mentioning it which has nothing to do with the media.

I am fully aware of where it is indicated and not indicated.

[Andy Hall]

On Wed, 19 Jul 2006 15:03:13 +0100, June Hughes wrote (in article ):

I have had to on occasions, June, and actually it is not something that I enjoy doing in the least.

For NHS civil servant bureaucrats, I could make an exception.

Humph! You seem to have an awful lot

I already am.

[Andy Hall]

On Wed, 19 Jul 2006 15:04:24 +0100, June Hughes wrote (in article ):

Oh no. I never sell anything.

All of those. Actually I can't think of a more important thing than healthcare to get right - can you?

[Guy King]

The message from "Mary Fisher" contains these words:

Ye Kremlin Worker?

[Derek ^]

Excellent post, can't top that.

So here follows an anecdote, it refers to the Leeds General Infirmary Ca. 2,000.

Took my late mum into out patients for a 2pm appointment. We arrived at 1-45 to be early, noticed the waiting room was full with about 20 patients waiting. Went up to the desk and announced ourselves, "You're in the wrong clinic was the reply. ?? This is the right room I protested! "Yebbut this is *this mornings* clinic".

After half an hour or so I discerned a distinct lack of any medical activity. Apparently the doctor had disappeared at around 11-45 am, and nobody could find him. at 2-40 a big Irishman stood up and shouted "Well when is he coming then, I've been here since half past eight and I've got to pick my daughter up at school in 30 minutes", he stormed out.

A bit later on a new secretary, the secretary for my mother's clinic arrived pushing a supermarket trolley packed full to overflowing with patients notes in open cardboard folders. The contents were spilling out in all directions. ...

25% of all X-rays in the NHS are "Lost" leading to patients getting a second dose of ionising radiation. Now I know why.

Oddly enough we are suppliers to the health service. They demand that

*we* operate an ISO 9,000 quality assurance system, audited by an external body. So they do know what is required. However they will not submit to similar disciplines themselves, . They prefer the 40 appointments for one doctor all at 08-30 approach. The idea that patient's files should be treated in such a cavalier manor beggars belief. If they had a quality system all these policies would have to be documented and they could then be compared with the policies of other competing providers and challenged.

DG