Anyone a patient at the Royal Free?

[Jeremy]

It does seem strange that the management have to hire a consultant to tell them how to cut costs. I am surprised the management are not capable of deciding for themselves.

However, it's a bit naive to say "why don't they pay someone else 40k to do the job". Assuming that they genuinely need an experienced senior accountant/consultant - for 40k a year they'd be lucky to get a newly qualified accountant.

[Huguenot]

I agree with you Jeremy, I guess they wanted the negotiating crutch of an 'independent expert'.

If that is the case, it speaks volumes about the militant workforce that they've crippled the management into spending this amount of money every time they want to change something.

I wonder whether NHS employees are aware that their constant attacks on management have had such a destructive effect... that it is the attitudes of the employees that have possibly brought the institution into such a parlous state?

Militant workforces often don't realise that running an effective organisation is a two way street.

[SeanMacGabhann]

* raises eyebrow *

Isn't the great militant force here the governments many misguided attempts to marketise the NHS?

But I'm open to hearing examples of the "militant workforce" preventing positive change...

[Huguenot]

The banks

The London Underground

British Leyland.

The coal industry.

The NHS. ;-)

The list is endless.

[SeanMacGabhann]

yes yes yes, I know about other examples in other industries (although I would argue that the staff at London Underground, and Ken, were better judges of what was needed than management)

But in the specific example of the NHS...

[Huguenot]

I'm not sure that I agree with your assertion that a platform cleaner could do better at running a rail system than a trained professional, but each to his own etc. ;-)

My original comment was a hypothetical... 'If that was the case, etc...'

If it was the case that 'any' workforce had undermined the managers ability to manage, then that would indeed qualify as a militant disruptive workforce.

I only stuck the NHS into that list as a ribald joke.

However, my experiences with public health systems elsewhere in the world do suggest that a better job could have been done to date. I think it's convenient and populist to 'blame the management', but the management aren't another race of evil knirds trying to stuff it up - they're undoubtedly trying to do the best they can within the confines of the system.

If the workforce is part of the problem then they need to take responsibility for their negative contribution.

[bignumber5]

I'm not sure that I agree with your assertion that a platform cleaner could do better at running a rail system than a trained professional

Trained in what? Management speak bollox that shows no real understanding of the specific idiosyncracies of the industry in question, glossed over with that wonderful job title "consultant", or training in actually managing that industry?

A few years back, when an A&E department that I was working in was struggling with the monthly targets, the managers were all over us all day every day about what could be done to speed up waiting times. One of the managers even noticed that a lot of the problems were at night, and dutifully signed up for a night shift, volunteering to push wheel chairs and photocopy paperwork and generally do menial but time consuming things to speep up waiting times. After one night shift, one(and not even a particularly busy one) the man looked like Charlie Sheen at the end of Platoon, and he apparently gave a fairly spirit rebuttal in the next target meeting about how the management tier had absolutely no idea what the medical and nursing staff were doing on a daily basis and the pressure that they were under. Target not achieved that month. Manager took full responsibility without blinking. A short lived coup, and his memory proved even shorter as he was back on our backs the very next month, but it meant the world at the time.

Healthcare managers are not (usually) clinicians, and for all that they have a plethora of skills in human resources and various other management guff, they do not understand the very basic concepts of the product that they are managing. Equally, I'm not suggesting that clinicians would necessarily make better managers - far from it, their micro-managment of specific areas without an overview would doubtless bugger up the whole system - but there needs to be a mutual understanding and a cooperative relationship between the 2. As a result of this, nursing and medicine have started to introduce management skills as one progresses up the career structure. But healthcare managers are not required to have any understanding of how healthcare should be delivered, and yet have the power to undermine clinical practice with local regulations put in place with managerial, fiscal or possibly even political motivation.

The bottom line is that the NHS is, essentially, a business from the top down and a service from the bottom up: there's always going to be some uneasy territory in the middle where those ideologies meet. But chucking a management ultra-gimp, with a made up job title and skills that are only really relevant at the extreme business end, into the already uneasy middle ground is not the solution.

Unfortunately, like all grass roots complainers, I have no idea what is.

[Andystar]

We've had someone walking around our lab for the last few months, clipboard in hand, whose job it is to find ways of making us more efficient. I've only caught some of her comments as i've meandered* through while she was discussing ideas, but everything i've heard just sounds like ( what i call ) w*nkspeak. I said that it's easy to make us more efficient, just tell everyone to work faster.

*on review, i don't think meander was the correct word as it implies a slow, graceful & serene movement, whereas i'm alot more powerful & charged like a rocket..or something

[RoosterMcLooster]

Getting back to your original question. I am not a patient at the Royal Free.