Showing posts with label NHS organisation. Show all posts
Showing posts with label NHS organisation. Show all posts

02 December 2010

Week 49 7th Dec. 2010

Tendring Topics…….on line

Prepared for the weather?

Do you remember last winter, how it went on and on? And do you remember how, directly it was over, Essex County Council, as one of England’s largest highway authorities, called a conference of all such authorities, to discuss dealing with snowed-up highways in future years. I can’t remember what the conference decided. I do remember though that Lord Hanningfield (then leader of Essex County Council) announced that it had been a great success. It was, he claimed, yet another example of Essex County Council leading the way and others following!

Well, winter has undoubtedly come onto us early this year and, before the end of November snow covered a great deal of the country. We had the usual toll of traffic accidents and of traffic halted or reduced to a crawl. Highway authorities began salting and gritting major roads in an effort to keep traffic moving. Most of them, (who knows, perhaps they had been inspired by that conference!) announced that this year they wouldn’t be caught out. They had enormous stocks of grit and salt available and had ample reserves accessible if they needed them.

I think that they may have been a little over-confident. They started using up their salt stock before the beginning of December. No-one can possibly know how long the winter will last and how many days and nights of freezing temperatures and lying snow we would have to endure before the spring. Shelley concludes his ‘Ode to the West Wind’ with the rhetorical question, ‘O Wind – if winter comes, can spring be far behind?’ The only honest answer to that is, ‘Yes, sometimes it can be!’ There are no certainties where the weather is concerned.

There were no such boasts from County Hall in Chelmsford. Unaccustomed modesty? Perhaps – but on 25th November the Coastal Gazette carried the alarming report that, ‘Essex may run out of road gritting salt if this winter becomes as bad as last year’. The report goes on to say:

‘Despite improvements to the quality of the salt and closer relationships with other authorities to improve gritting, another bad winter could make public highways dangerous for pedestrians, shoppers and drivers.

Figures in Essex County Council’s winter operational document for 2010/2011 show that Essex will have less than the minimum material recommended every week for the winter. Some depots do not have the capacity to store even the minimum.‘

Norman Hume, county councillor responsible for highways and transportation agreed that the council had made provision only for a ‘normal’ winter and not for the conditions that we had experienced during the past two years. ‘We started with the salt barns full to capacity but the problem was re-supply. As a nation we can’t put resources into a policy not required except in exceptional circumstances’

I would hardly think that conditions that prevailed throughout the last two winters and look set to continue this year could be regarded as particularly exceptional!

The weather has been worse. Here is the sea frozen over near Clacton Pier in the early months of 1963. That year we had hard frosts until well into early spring

The county council does not plan to salt residential or minor roads, but will concentrate on major routes with local councils helping in town centres. Where, I wonder, will local councils find the funding to carry out this Highway Authority task?

Altogether, unless the weather gets much kinder, it is a pretty poor outlook this winter for local motorists, cyclists and pedestrians (and, of course, mobility scooterists; snowfall is the only circumstance that keeps my ‘iron horse’, confined to stable!) It’s not really what those who live in a county with a council that claims to ‘lead the rest!’ would expect.

In Vino Veritas

No, I didn’t have a classical education (I envy those who did!) but along life’s way most of us pick up a few Latin phrases and In Vino Veritas (Truth is in the wine) is one of mine. It means that alcohol loosens the tongue, frees us from our inhibitions and reveals our true nature. Thus, under the influence of a couple of drinks, a road sweeper may be revealed as a true gentleman and a Duke as something of an oaf.

The leaked (by Wikileaks) report of Prince Andrew’s indiscreet speech at a ‘brunch’ in Kyrgyzstan that he had attended as a British trade representative, suggests to me that His Royal Highness should have had a little more ‘tonic’ in his host’s pre-meal vodka-and-tonic. Surely he wouldn’t otherwise have made unflattering remarks about our American cousins with the American Ambassador present.

More serious though was his claim that it was ‘idiocy’ to investigate the allegations of bribery having taken place during the course of a major arms deal with Saudi Arabia, and to have denounced snooping Guardian journalists investigating bribery and corruption in other overseas trade deals. Perhaps even more disturbing was the fact that the American report on the incident said that the other Brits present had greeted these remarks not with disapproval but with enthusiasm.

Perhaps they too had had a drop too much. I hope so. It would be very sad indeed if, when stone cold sober, representatives of our country believed that there was some moral difference between offering a bribe and accepting one, and that it was quite all right for Britons to bribe influential ‘foreigners’ to obtain lucrative overseas contracts for British firms.

Can they really believe that morality, like religion, is a private matter for the individual conscience ………but that business is business and obeys no rules but its own?

Healthy North-East Essex?

I have always believed that the Tendring District, and in particular its coastal area is a good and healthy place to live. Low rainfall, fresh air blowing in off the sea, and lots of sunshine, combine to account for the fact that there are a great many oldies in our district. Some, like me, have grown old here, others have chosen to come here on retirement. More of us than in most areas survive and even thrive, into our eighties.

This is just as well because a recently published NHS report makes it clear that appreciably less is spent by the NHS in north-east Essex, in the Colchester and Tendring Districts, than in other parts of our county. The North-East Essex Primary Care Trust spends up to £8,000 per 1,000 residents less on cancer treatment (cancer is a condition more likely to afflict the old than the young) than Trusts in south Essex. Our primary care trust spends between £140,00 and £170,00 on mental health while in the south-east of the county they spend between £200,000 and £240,000.

People in north Essex are less likely to receive a needed hip replacement than their counterparts in the south and patients with chronic lung disease (another affliction of the elderly) are likely to face a longer hospital stay in Colchester and Clacton than elsewhere in the county. This, says the report, ‘does them more harm than good’.

Will the government’s plan to abolish primary care trusts and put commissioning of health care in the hands of GPs help reduce these inequalities. Bernard Jenkin, North Essex and Harwich MP thinks so. He is reported as saying, ‘What the government is going to do is remove the bureaucrats from the decisions about who gets treated, and the doctors are going to be put in charge of health treatment budgets. GPs choosing what treatments are made is the best way to create greater equality.’

Perhaps – but in the same issue of the Coastal Gazette that carries the NHS report we learn that a Dr Shane Gordon is the joint chief executive of the new GP consortium that will take over health-care budgets for Colchester and Tendring by 2013. I reckon that Dr Gordon will need quite a few lay clerical and administrative staff to help him with this task. Could it be just another bureaucratic organisation in the making

A Question of Extradition

Wikileaks revelations have brought the sad case of Gary McKinnon back into the public eye. I have to confess that I had completely forgotten this young IT genius who – clearly with no evil intent – had hacked his way into the defence secrets of the USA’s Pentagon! The sensible course of action of the US government would have been to ask him how he had done it, and ask him to co-operate in helping them to design a truly hack-proof system.

But no, for this dire offence ‘that threatened US security’ the USA wanted him to be extradited, in accordance with an extradition treaty accepted by Tony Blair, and to face trial in the USA. My opinion of Gordon Brown and David Cameron went up a notch or two when I learned that they had both intervened on Gary McKinnon’s behalf – and my opinion of Hilary Clinton dropped like a stone on learning that she had rejected their pleas.

I remember all too well how American Courts repeatedly refused to extradite convicted IRA murderers to England during the still-recent ‘troubles’. I remember too how a British Government had refused to extradite to Spain, General Pinochet, who had presided over the murders of hundreds of his fellow countrymen and others, and the torture of hundreds more, including Sheila Cassidy, a British doctor*. What a British government could do for Pinochet, its successors can do for Gary McKinnon.

But then, of course, General Pinochet had been a personal friend of Mrs Thatcher (now Lady Thatcher) and of Norman Lamont (now Lord Lamont) her less-than-successful Chancellor.

*See ‘Audacity to Believe’ by Sheila Cassidy, published 1977 by Collins of London, Publishers.

Not all Surprises!

I was certainly surprised by some of the revelations from Wikileaks, which – as I write – are being fed to us daily. I was, for instance, quite astonished to discover that the Governor of the Bank of England’s assessment of the qualities of our Prime Minister and Chancellor of the Exchequer was much the same as my own – though his judgement is of course, much more firmly grounded in knowledge and experience than mine is.

I was not however in the least surprised that the British and American governments were both seriously concerned about the possibility of Pakistan’s Nuclear arsenal falling into the hands of terrorists, who might use those weapons against us and/or India. In fact, I’d have been very anxious had I thought that that they were not worried about this possibility.

I reckon that the fact that Pakistan, India and Israel actually have nuclear weapons should cause us a lot more anxiety than the thought that Iran may possibly one day acquire them.

16 July 2010

Week 29.10

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.
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.