Tendring Topics………on line
Dispensing with the Bureaucrats?
Under the new coalition government the NHS, so they say, is to experience the biggest shake-up of its history. Power, and the cash that goes with it, is to be taken from the Primary Care Trusts and handed over to the Medical Practices in their areas. They will decide which consultants we may need to see, and when. They will organise minor operations and through them, patients will be able to say which hospitals they wish to go to and who will operate upon them. Thousands of NHS managers will be sacked. It is envisaged that two or more practices may get together in some cases, to ensure that they give the most efficient and comprehensive service possible.
Wonderful! But who, in each medical practice will make the thousands of decisions that have to be made, and who will make sure that the actions that result from those decisions actually take place.
The doctors? Well, there are of course lots of decisions that individual doctors have to make and some that will probably have to be made by general agreement among the doctors of the practice. They can’t spend too much time in discussion and debate though – at least I hope they can’t. We need them in their consulting rooms and by our bedsides, diagnosing our ailments and trying to cure or alleviate them!
Most up-to-date practices, employing several medical practitioners and nurses, will already have a practice manager. There will also be a number of clerical and administrative staff to make appointments, man the telephones and the reception desk, type letters, keep accounts and undertake the multifarious tasks that exist in any busy enterprise. With more responsibilities, more of these will be needed. There will need to be a deputy and perhaps one or more assistant managers. They’ll require professional accountants to supervise the practice’s finances. More clerical and junior administrative staff will be required to service the professionals.
There is, I fear, a real danger that we shall be sacking dozens of managers and chief executives of Primary Care Trusts and getting rid of their bureaucratic retinues only to replace them with hundreds of rather-less-well-paid managers and chief executives of independent medical practices and combined practices. They’ll need their own, admittedly smaller, retinues. In the twenty-first century not even the smallest organisation can hope to survive without the skills of at least some of those often denigrated bureaucrats!
I wonder if the new streamlined Health Service will really prove to be more efficient, more cost effective and more customer-friendly than its predecessor?
‘More than the Prime Minister!’
It is strange how the Prime Minister is used as a sort of benchmark of annual income. Any public servant with an income in excess of £200,000 is described in terms of shock and horror, to be, ‘earning more than the Prime Minister!’
I may have done it myself. If so I apologise, because it isn’t really a fair comparison. The Prime Minister’s salary, although enormous by the standards of most of us, is quite modest compared with those of quite a few of our fellow countrymen and women. The Prime Minister’s job does carry a few pretty valuable perks though. There are, for instance, two fully staffed palatial homes, one in central London and the other in its own grounds in the lovely English countryside. On retirement, or on being evicted by the electorate, he or she, as well as enjoying a comfortable pension, can reckon on earning many thousands of pounds from writing memoirs and from lecturing and after-dinner speaking. Company directorates and consultancies are theirs for the asking and they might even get a part-time job as a special envoy for NATO or the UN!
The latest subject of press ‘more than the Prime Minister’ outrage, is the head of an inner city (London) school, whose total income last year was described in some newspapers as over £200,000 and in at least one other as £270,000.
+1930s.jpg)
A class of eight year olds at an Ipswich primary school in 1930. I am the
anxious little boy with glasses by the headmaster’s right knee! What an easy
and rewarding job teaching must have been when kids were obedient and
attentive, parents were respectful and co-operative – and there was always
the cane to reinforce the headmaster’s authority!
It appears that the Head Teacher’s actual salary from his Education Authority was £80,000 a year; a lot of money by my standards but, I understand, not at all unreasonable for a hard-working educationalist who has successfully ‘turned round’ an inner city school full of tough inner-city pupils! Most of the rest of his income was derived as awards for that or similar achievements from educational trusts. That said, it does seem that he was rewarded from at least two separate sources for the same, admittedly valuable, work and £200,000 is surely an absurdly high sum.
Nevertheless I felt some sympathy with an email correspondent to BBC tv’s ‘Breakfast’ programme who said, ‘Why pick on the salary of a hard-working and successful head teacher to compare with that of the Prime Minister. What about the incomes of top footballers?’
What indeed? And what about the salaries and continuing bonuses of the bankers whose irresponsibility and incompetence triggered the current financial crisis? What about the wealthy stock holders who use their resources to buy football teams and players, and own luxury yachts in which to entertain compliant members of the Government and the Opposition. It is they who should be targeted by the national dailies; but then, of course, they probably own most of them!
A properly graded income tax, clawing back more than fifty percent of income in excess of, say, £200,000; coupled with measures to curb income tax avoidance, would surely relieve all these people, including the affluent head teacher, of some of their superfluous wealth. It would also do just a little to ease the burden of debt repayment, and help to persuade us that the government is determined that the weight of that burden is shared fairly among us all.
Poverty Kills
I don’t think that anyone in this country, probably not anyone in Europe, need these days die of malnutrition. There’s little doubt though that poverty can undermine our health and impoverish and shorten our lives. Affluence on the other hand, can enrich and lengthen them.
This has been demonstrated by a government study called Health Profiles that provided a study of the quality of life of residents in Colchester and in the Tendring District. Colchester’s St. Andrew’s, St.Anne’s and New Town wards include some of the poorest people in the UK. As a result life expectancy in Colchester generally is 73 years for men and 81 for women. Move a few miles out though to rather-more-affluent Lexden, Wivenhoe, Dedham and Langham and men can expect to live to 80 and women to 84.
Similar results were shown in the Tendring District. In Jaywick and in Clacton’s Pier Ward male life expectancy is below 74 years compared with 81 years in posh Frinton-on-Sea.
Other visible results of the effects of deprivation on our lives are the fact that in both Tendring and Colchester there are more-than-average numbers of pregnant smokers, the number of cases of diabetes diagnosed is among the highest in England, ever more children are found to be obese when starting school, and educational achievement of Tendring pupils is among the lowest in the country.
I don’t live in one of Clacton’s more favoured areas. I once heard Dudley Road referred to by a Planning Official as ‘working class residential’, which I am happy enough to accept. Goodness knows my wife and I did have a struggle when, with two young children and a mortgage, we moved here fifty-four years ago! I don’t think that we ever considered ourselves to be ‘deprived’ though.
Our two sons both did very well at both primary and secondary school and our elder son progressed to Cambridge where he obtained a good degree. Both have professional qualifications and have held responsible and satisfying jobs throughout their working lives; hardly low achievers!
My wife had more than her share of ill-health, partly, I think, as a result of deprivation during World War II when she lived and worked in London through the Blitz. Nevertheless she lived till the age of 82 and, as regular blog readers will know, I am 89. I could perhaps hardly be described as ‘still going strong’ but I am quite definitely ‘still going’ and hope to keep going for a little while yet.
I am not the most observant of persons but my neighbours all appear to be pretty healthy and showing little sign of deprivation. It appears that our ‘working class residential’ road may offer as beneficial an environment as Colchester’s posh suburbs and Frinton’s tree-lined and leafy avenues.
Minimum Wage-Earners?
A couple of weeks ago I referred in this blog to the £91,000 a year that husband and wife team Neil Stock and his wife Sarah Candy were managing to earn from their spare-time voluntary work in Local Government and with the NHS. Ms Candy is a cabinet member of both the Essex County Council and the Tendring District Council, and Mr Stock is leader of Tendring District Council. Ms Candy is also a non-executive member of the Northe East Essex Primary Care Trust.
From their Great Bromley home, the husband and wife team also run a very successful mail order fashion and haberdashery enterprise.
Mr Stock, in explanation, told a Gazette reporter that he and his wife worked incredibly hard for long hours. The £91,000, he said, ‘might not equate to the minimum wage, the number of hours we put in’.
A blog reader, who is better at sums than I am, tells me that worrying about that possibility should not keep them awake at night. She has calculated that if both of them were on the minimum wage and worked a 20 hour day each, they would between them earn rather less than half that £91,000 in a year. They wouldn’t, of course have much time for socialising, running the business that is their ‘day job,’ or indeed for eating and sleeping, but they would make something in the region of £40,000.
The fact that Mr Stock could have imagined, even for a moment, that £91,000 might not equate to the minimum wage, demonstrates how very little well-heeled members of the District and County Councils understand about the problems of the low-paid electors whom they claim to represent.
Dispensing with the Bureaucrats?
Under the new coalition government the NHS, so they say, is to experience the biggest shake-up of its history. Power, and the cash that goes with it, is to be taken from the Primary Care Trusts and handed over to the Medical Practices in their areas. They will decide which consultants we may need to see, and when. They will organise minor operations and through them, patients will be able to say which hospitals they wish to go to and who will operate upon them. Thousands of NHS managers will be sacked. It is envisaged that two or more practices may get together in some cases, to ensure that they give the most efficient and comprehensive service possible.
Wonderful! But who, in each medical practice will make the thousands of decisions that have to be made, and who will make sure that the actions that result from those decisions actually take place.
The doctors? Well, there are of course lots of decisions that individual doctors have to make and some that will probably have to be made by general agreement among the doctors of the practice. They can’t spend too much time in discussion and debate though – at least I hope they can’t. We need them in their consulting rooms and by our bedsides, diagnosing our ailments and trying to cure or alleviate them!
Most up-to-date practices, employing several medical practitioners and nurses, will already have a practice manager. There will also be a number of clerical and administrative staff to make appointments, man the telephones and the reception desk, type letters, keep accounts and undertake the multifarious tasks that exist in any busy enterprise. With more responsibilities, more of these will be needed. There will need to be a deputy and perhaps one or more assistant managers. They’ll require professional accountants to supervise the practice’s finances. More clerical and junior administrative staff will be required to service the professionals.
There is, I fear, a real danger that we shall be sacking dozens of managers and chief executives of Primary Care Trusts and getting rid of their bureaucratic retinues only to replace them with hundreds of rather-less-well-paid managers and chief executives of independent medical practices and combined practices. They’ll need their own, admittedly smaller, retinues. In the twenty-first century not even the smallest organisation can hope to survive without the skills of at least some of those often denigrated bureaucrats!
I wonder if the new streamlined Health Service will really prove to be more efficient, more cost effective and more customer-friendly than its predecessor?
‘More than the Prime Minister!’
It is strange how the Prime Minister is used as a sort of benchmark of annual income. Any public servant with an income in excess of £200,000 is described in terms of shock and horror, to be, ‘earning more than the Prime Minister!’
I may have done it myself. If so I apologise, because it isn’t really a fair comparison. The Prime Minister’s salary, although enormous by the standards of most of us, is quite modest compared with those of quite a few of our fellow countrymen and women. The Prime Minister’s job does carry a few pretty valuable perks though. There are, for instance, two fully staffed palatial homes, one in central London and the other in its own grounds in the lovely English countryside. On retirement, or on being evicted by the electorate, he or she, as well as enjoying a comfortable pension, can reckon on earning many thousands of pounds from writing memoirs and from lecturing and after-dinner speaking. Company directorates and consultancies are theirs for the asking and they might even get a part-time job as a special envoy for NATO or the UN!
The latest subject of press ‘more than the Prime Minister’ outrage, is the head of an inner city (London) school, whose total income last year was described in some newspapers as over £200,000 and in at least one other as £270,000.
+1930s.jpg)
A class of eight year olds at an Ipswich primary school in 1930. I am theanxious little boy with glasses by the headmaster’s right knee! What an easy
and rewarding job teaching must have been when kids were obedient and
attentive, parents were respectful and co-operative – and there was always
the cane to reinforce the headmaster’s authority!
It appears that the Head Teacher’s actual salary from his Education Authority was £80,000 a year; a lot of money by my standards but, I understand, not at all unreasonable for a hard-working educationalist who has successfully ‘turned round’ an inner city school full of tough inner-city pupils! Most of the rest of his income was derived as awards for that or similar achievements from educational trusts. That said, it does seem that he was rewarded from at least two separate sources for the same, admittedly valuable, work and £200,000 is surely an absurdly high sum.
Nevertheless I felt some sympathy with an email correspondent to BBC tv’s ‘Breakfast’ programme who said, ‘Why pick on the salary of a hard-working and successful head teacher to compare with that of the Prime Minister. What about the incomes of top footballers?’
What indeed? And what about the salaries and continuing bonuses of the bankers whose irresponsibility and incompetence triggered the current financial crisis? What about the wealthy stock holders who use their resources to buy football teams and players, and own luxury yachts in which to entertain compliant members of the Government and the Opposition. It is they who should be targeted by the national dailies; but then, of course, they probably own most of them!
A properly graded income tax, clawing back more than fifty percent of income in excess of, say, £200,000; coupled with measures to curb income tax avoidance, would surely relieve all these people, including the affluent head teacher, of some of their superfluous wealth. It would also do just a little to ease the burden of debt repayment, and help to persuade us that the government is determined that the weight of that burden is shared fairly among us all.
Poverty Kills
I don’t think that anyone in this country, probably not anyone in Europe, need these days die of malnutrition. There’s little doubt though that poverty can undermine our health and impoverish and shorten our lives. Affluence on the other hand, can enrich and lengthen them.
This has been demonstrated by a government study called Health Profiles that provided a study of the quality of life of residents in Colchester and in the Tendring District. Colchester’s St. Andrew’s, St.Anne’s and New Town wards include some of the poorest people in the UK. As a result life expectancy in Colchester generally is 73 years for men and 81 for women. Move a few miles out though to rather-more-affluent Lexden, Wivenhoe, Dedham and Langham and men can expect to live to 80 and women to 84.
Similar results were shown in the Tendring District. In Jaywick and in Clacton’s Pier Ward male life expectancy is below 74 years compared with 81 years in posh Frinton-on-Sea.
Other visible results of the effects of deprivation on our lives are the fact that in both Tendring and Colchester there are more-than-average numbers of pregnant smokers, the number of cases of diabetes diagnosed is among the highest in England, ever more children are found to be obese when starting school, and educational achievement of Tendring pupils is among the lowest in the country.
I don’t live in one of Clacton’s more favoured areas. I once heard Dudley Road referred to by a Planning Official as ‘working class residential’, which I am happy enough to accept. Goodness knows my wife and I did have a struggle when, with two young children and a mortgage, we moved here fifty-four years ago! I don’t think that we ever considered ourselves to be ‘deprived’ though.
Our two sons both did very well at both primary and secondary school and our elder son progressed to Cambridge where he obtained a good degree. Both have professional qualifications and have held responsible and satisfying jobs throughout their working lives; hardly low achievers!
My wife had more than her share of ill-health, partly, I think, as a result of deprivation during World War II when she lived and worked in London through the Blitz. Nevertheless she lived till the age of 82 and, as regular blog readers will know, I am 89. I could perhaps hardly be described as ‘still going strong’ but I am quite definitely ‘still going’ and hope to keep going for a little while yet.
I am not the most observant of persons but my neighbours all appear to be pretty healthy and showing little sign of deprivation. It appears that our ‘working class residential’ road may offer as beneficial an environment as Colchester’s posh suburbs and Frinton’s tree-lined and leafy avenues.
Minimum Wage-Earners?
A couple of weeks ago I referred in this blog to the £91,000 a year that husband and wife team Neil Stock and his wife Sarah Candy were managing to earn from their spare-time voluntary work in Local Government and with the NHS. Ms Candy is a cabinet member of both the Essex County Council and the Tendring District Council, and Mr Stock is leader of Tendring District Council. Ms Candy is also a non-executive member of the Northe East Essex Primary Care Trust.
From their Great Bromley home, the husband and wife team also run a very successful mail order fashion and haberdashery enterprise.
Mr Stock, in explanation, told a Gazette reporter that he and his wife worked incredibly hard for long hours. The £91,000, he said, ‘might not equate to the minimum wage, the number of hours we put in’.
A blog reader, who is better at sums than I am, tells me that worrying about that possibility should not keep them awake at night. She has calculated that if both of them were on the minimum wage and worked a 20 hour day each, they would between them earn rather less than half that £91,000 in a year. They wouldn’t, of course have much time for socialising, running the business that is their ‘day job,’ or indeed for eating and sleeping, but they would make something in the region of £40,000.
The fact that Mr Stock could have imagined, even for a moment, that £91,000 might not equate to the minimum wage, demonstrates how very little well-heeled members of the District and County Councils understand about the problems of the low-paid electors whom they claim to represent.
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