The Thatcherite legacy is not only the Tories Fault.

It really annoys me that Labour push themselves as the saviour of the NHS amongst other untruths.
That everything is Maggie's fault. Poor saps, they've never got over that woman and now there's another Tory female PM with a huge popularity rating.

Yes the Tories (but under John Major) introduced targets and with it an overburden of administrators to monitor adherence or not to the targets, but Labour did far more damage.

LABOUR'S Tony Blair was one of the most damaging Prime Ministers when it comes to the NHS. Saddling health trusts with expensive PFI deals that they are paying through the nose for, "reforming" GP contracts that just put up GP's salaries without any increase in cover and also allowing GPs to introduce expensive and impersonal out-of-hours services.

He also introduced no-win-no-fee legal access. In itself a great idea, ordinary people have access to legal redress and not worry about the expense. But the actual legacy is one of Ambulance chasers or Agressive lawyers suing everyone for the slightest thing.

Anna Racoon has started a crusade to enlighten people about the huge burgen that litigation has emburdened the NHS with. Out of a budget of £95Bn, £56Bn will be set aside for litigation. A wholly unsustainable situation where more is spend defending the NHS and settling lawsuits than is actually spent on medicine.

One of the big issues is the payments on these lawsuits is based on the victims of NHS procedures is based on the victim receiving further treatment privately, when the actual truth is they continue to receive treatment from the NHS that caused the issue in the first place.

In effect they bank the money and carry on getting free treatment. There is no mechanism to force people to use the money to get private treatment: the NHS doesn't have a mechanism for excluding people from treatment after suing them. There is also no mechanism to charge the person for treatment by the NHS, thereby getting that money back as the NHS treats them. there's no mechanism to get that money back if the victim dies: it becomes part of their estate. When in truth if they die, treatment ends and the reason for the money being provided ends. There is no clause to repatriate the money back to the NHS on their demise. The money is treated like a windfall for the family.

This dovetails into my previous blogs about the NHS spending millions on expensive cancer drugs, just to extend life expectancy by months, where that money can transform the lives of other patients for decades.

Tere needs to be more oversight of WHERE NHS money is being spent and most certainly SHOVELLING MORE MONEY AT THE NHS IS NOT THE SOLUTION.

Targets are not the solution. More targets means employing more staff to measure them: staff that are not employed in the business of care.

There needs to be an intelligent debate about the NHS budget, whether where it is going is delivering the best care for the country.

The media will dumb it down into a Labour/Tory public/private debate, when it really needs to be a more adult and detailed affair. As the people paying the bills, at the end of the day the media owe us a more accourate account of what is going on.

Human Interfaces

The Brexit thing between May and juncker takes me back to my I.T. days. Back when I worked in Interactive Voice Systems, I did a lot of research into human-machine interaction. I could write reams on how or why unsuccessful IVR systems are unsuccessful.

But the Brexit issues boil down to the same problems. Lack of undertstanding or empathy.

When writing the software for IVR systems, you need to understand the needs of the other party, the customer dialling into the system.

You also need to communicate your needs clearly, so they understand what is required of them to make the negotiation between them and the machine work properly.

You need to also undertsand the nuances of language both whilst communicating your needs and also during their interaction with you. It's so frustrating to talk to someone and for them to not acknowledge with some sort of response. We instantly become unsure as to whether our message has been heard.

In an IVR system, the simple addition of a "Thank you" prompt after each input signals that the machine has heard something. If that input doesn't match the system's requirements then should prompt there has been an error and ask for input again. In essence, the negotiation between the two becomes as natural as normal conversation, because the machine is programmed to respond with an approximation of human interaction.

The Brexit debacle between the UK and the EU is similar. Two poeple talking at each other without an particular empathy towards to other's position.

Theresa may is a leader, she doesn't need to enter into details, she will talk of the big picture, making big descisions and it's for junior ministers in government to action those ideas and take care of the details.

Junker despite his position, is no leader. He appropriates the concensus of others and aproximates leadership, but he doesn't have the ability to make big unilateral decisions. He's a beareaucrat, he loves the detail.

So, the two of them are talking at odds because they are talking about different aspects of the same issue, not because they disagree. Either they have failed to understand each other's different perspective, or the language and interpretation was a bit dodgy, or they just want to set out each other's position. They are talking at each other and not talking to each other. It is not a conversation, it is rhetoric, and for the medai to protray it as anything else is wrong. May is not in a different galaxy, nor is Juncker bombastic.

Either way, the media have now jumped on the bandwagon and portrayed it as a massive rift between the two sides, when actually there isn''t one.

It's going to be like this for the most part through the Brexit negotiations. Until two underlings of equal status and at the same level sit on each side of the negotiating table and start to work on the minutiae of the deals, only then will we get any sense of what actually the Brexit deal entails.

So, ignore anything coming out of the media for the next 18 months. They will play up the minutest difference in position, make mountains out of minute molehills, just to make headlines.

It ain't over until it's over.

Public Service.

I've touched on this before, the waste and the sense of entitlement in public services. One of the best examples of this was the case of  Katrina Percy. She was the boss of Southern Health, under fire for various reasons, but mainly a number of deaths during her tenure.

Under fire from the media and others she resigned from her £250,000 a year job and moved to a new consultancy job.....paying £250,000 a year. The consultancy job apparently didn't exist before she moved into it, the assumption being she was moved to get away from the media spotlight, but got to keep her salary. So it appears the Southern Health Trust decided to magic £250,000 a year from the wages pot to stop bad publicity. But not employ extra front-line staff. Quite a skewed sense of priorities there.

In the end after media scrutiny of her second job, she left Southern Health, but not without getting a £190,000 payoff.

I've previously mentioned my dislike of public servants being paid such high wages. But it also shows that the public service managers see the money not as taxpayer's money to be spent wisely and with care, but an entitlement than can be spent and used as they see fit, whether that gives the best benefit for the public or as with six figure salaries, not.

I dislike public bodies being run wholly on the private business model. Sure, running a public service in the most efficient way, making the money go further like you would in a company is a good model to follow. Even making a profit is a good thing as long as it is ploughed back into service itself.

However, management structure and six figure salaries, these are not in the public interest.

The board structure in most public services doesn't have the checks and balances a private company does. A private company has shareholders, who can overrule pay awards if they see fit. They can veto the appointment of board members too. Where is the same brake on excess in public services? Who has the power to sack board members if they underperform or curb pay excesses?

The case of  Sharon Shoosmith (salary a slightly less obscene £130,000 a year) who successfully sued Haringay council after they sacked her when Ed Balls, the then Children's secretary got involved, shows that even when these high paid higher-ups in public service lose the confidence of their board and/or the government, they can't be removed painlessly.

But these are not isolated examples. If you can get the information, look at the salaries at the top of council departments, Police, charities, health trusts and the like. There will be a lot of six figure salaries.

Unlike the private sector they get all the reward for nothing like the risk in the same position in the private sector.

In some cases such as the Rotherham sexual abuse case exposes the lack of real leadership and the ability to actually earn the salaries they get at the top of all of the different agencies all at once.. And at the top of all of these public bodies are people claiming six figure salaries. With very little by way of consequence when they bugger things up.

The abject waste of public funds supplying senior managers in public service with these massive salaries is wrong. All future governments should be working to reduce this excess and introduce checks and balances to ensure those at the top are actually earning the money the public pay them.  And have mechanisms to remove them if they are grossly negligent, incompetent or inefficient.