Busy times November 30, 2006
Posted by MadRad in General.add a comment
Hmm…Its all gone quiet in Madland (if anyone out there has even noticed!).
Two reasons for this. Firstly rather embarassingly I fell over last week, my fall being broken by my mobile phone, which now has a dirty great crack on the screen. So my favoured input device (here) is with the phone doctor at the moment and is hence unavailable for use at the moment.
The time without fully functioning phone was further exacerbated by mobile phone insurance company insisting the phone was 3G enabled and therefore the excess was twice as much. In the end I had to resort to
- emailing the company who sold me the phone (and the insurance) to let me know how to access 3G
- emailing Nokia to confirm the phone was not 3G
- emailing 3 to enquire whether I could connect to the 3 network with the phone [1]
- Googling reviews and tech spec on the phone which stated the phone was 2.5G and lack of 3G was it’s week point then forwarding it to the insurers.
The situation was finally resolved but it added an extra week onto the process.
To be honest it was getting more difficult anyway as the dark nights draw in. Is was only a matter of time before I walked into an old lady or slipped on dog turd.
The other reason is more of a worry. Out department IT manager has given in his notice. They do not anticipate appointing someone into the same role. A decission has been made to move his hardware/back-up functions to the hospital IT department and, for the short term (where have I heard that before), create a team from others who have knowledge of the various discrete IT systems within the department to look after it while long term plans are decided. (The whole department is undergoing a ‘help we’re overspent’ workforce review [2]).
So this team will look after things in the meantime. But they need someone nominally in charge. Guess who’s the only band seven in the team.
So I have been tasked with obtaining all the info I can in five weeks from someone known for being forthcoming. Someone who’s been doing the job for five years.
…And I’ve got to keep on at my day job.
…And the boss would like me to update our intranet site and produce marketing leaflets for the GP.
[1] Interestingly 1 week later and I have still heard nothing from 3. Good job it wasn’t a real problem!
[2] ie can we downgrade/sack/put out to pasture/not replace anyone.
Saving it all up November 23, 2006
Posted by MadRad in General, IT, NHS & Politics.add a comment
So many snippets of information over the last few days; so little time to do something with it.
First up
We’ve got the bastards worried [1].
What is the big breakthrough, in terms of politics, on the web in the last few years? It’s basically blogs which are, generally speaking, hostile and, generally speaking, basically see their job as every day exposing how venal, stupid, mendacious politicians are.
(Matthew Taylor, Tony Blair’s outgoing chief strategy adviser).
..and the problem with that is?
This leads nicely to another episode of NHS doubletalk.
The No Delays Team is supporting NHS staff to provide a healthcare system in which no patient waits unnecessarily for any service. Delays will only occur where patients choose to wait for their treatment or where a medical reason for waiting would produce the best outcome.
(NHS Institute for Innovation & Improvement)
Full article here
Meanwhile to save money our PCT has told us to delay the treatment of their patients and aim for 5 months turnaround.
If nothing else this seems pretty mendacious and stupid (and as for venal we only have to go to the Alan Milburn posting).
Now moving swiftly on to the announcement [2] that
The Department of Health is expected to publish a code of practice allowing hospitals to market their services under the era of choice.
(HSJ, 20/11/06)
The other day I made this statement .
I’d like to add to this by saying “I think every penny spent by an NHS institution an advertising solely for the purpose of luring patients away from another NHS institution is morally wrong.”
If competition was intended to improve the NHS this is a strange way to go about things.
We are being advised how to spend tax-payers money advertising our services to avoid these service being taken over by the private sector. We are spending tax-payers money to attract patients from one tax-pyaer funded hospital to another tax-payer funded hospital.
NHS hospitals will have no option but to invest in marketing tactics, such as advertising, if they are to survive against private firms who will already have large marketing budgets and considerable expertise in selling themselves.
It is a sad indictment of government policy to consider spending public money on advertising NHS services when hospitals are having to make cutbacks in patient care and compulsory redundancies in order to save money.
(Dr Jonathan Fielden, chair BMA’s consultants’ committee)
Voters are overwhelmingly againt this. According to a survey conducted by YouGov for the NHS Together alliance of health unions in a poll of more than 2,000. Thirty nine per cent strongly disagreed and thirty four per cent disagreed with the proposition that ‘I want to see competition in the NHS with doctors and hospitals competing for my custom, such as spending and advertising’. (HSJ, 20/11/06)
+++++ +++++ +++++ +++++ +++++
Radio 4 was entertaining this morning with Patsy wriggling like a fish dodging answering questions on single sex wards and spouting the usual diatribe about how well they’re doing. My daughter couldn’t understand my growing irritation with the woman. I don’t suppose me shouting “Just answer the bloody question” at the radio is the sort of behaviour I should be subjecting her to at that time in the morning.
The Huwitt woman, like a wild animal in a cage, tore off in any direction except an answer to the question. John Humphry’s patience was only equalled by her determination to equivocate.
(akaProfessor from Today Program message board)
+++++ +++++ +++++ +++++ +++++
And finally after my previous posts regarding ‘Lorenzo’ I find an article in the HSJ form 02/11/06 telling me that “CSC used iSoft’s existing iPM software in it’s implementations and will upgrade to Lorenzo later”.
Great. So we experienced all these problems with an existing system. Heaven knows what new bugs will come to the surface when Lorenzo does arrive.
+++++ +++++ +++++ +++++ +++++
[1] Well big fish like Dr Crippin, Wat Tyler, Guido & the Devil – not little fish like me.
[2] I know this is a couple of days old now, but I just had to say something and this is the first chance I got.
Time to go November 22, 2006
Posted by MadRad in NHS & Politics.1 comment so far
Health secretary Patricia Hewitt has hinted that she may resign if the NHS does not break even by the end of this financial year.
(HSJ, 22/11/06)
Maybe we could all help her on the way.
Anyone know how I can charge a new Aircraft Carrier to the department budget?
Secret London base shock November 18, 2006
Posted by MadRad in General.add a comment
Secret base under construction
We’re spending a long weekend with the kids revisiting the bright lights on London (tied in with an appointment for them at one of the specialist hospitals so it’s not truancy OK?).
We found a reasonable deal on the ‘net for North London Days Hotel [1]. Arrived last night, checked in as normal. Noticed nothing out of the ordinary.
Went out to the car this morning to get the old A to Z and noticed the hotel car park is absolutely heaving with British Gas vans.
I’m sure there is some innocent explanation but, as we are in the middle of Daniel Craig/new James Bond fever at the moment, I can’t help imagining the Days Inn is just a front and there is a massive secret [2] base underneath it preparing the way for the British Gas-British Government military industrial complex to make a move on democracy. Just hope we’ve checked out before the grand finale when the whole thing blows up while JB makes a break for it with the tenuously named girl.
[1] Formerly London Gateway Days Inn at London Gateway service, which I still know as Scratchwood services.
[2] Well OK not that secret with all the vans outside.
Scanners November 15, 2006
Posted by MadRad in NHS & Politics, Waiting Times.add a comment
Am I just being naïve in saying that every penny given to shareholders is a penny less spent on healthcare?
A while ago I made this comment in reply to a posting on Dr Crippin’s blog I don’t think I made myself clear at the time and I’d like to take this opportunity to do so. Firstly I was referring to NHS money going to shareholders not payments from insurance companies or self-paying patients. I have nothing against private patients, in many cases I can see why they do it. I do object however to private patients expecting to jump queues in NHS hospitals [1], but that is a different story.
A few years ago the Government supplied quite a number of DGHs with MRI scanners. Many scanners don’t run to capacity. Those that do mainly do so during normal working hours – nine to five, Monday to Friday. This is predominantly due to staffing levels, either radiographers to run the scanners or radiologists to supervise and report the scans. MRI is only one example. Other modalities such as nuclear medicine and CT scanning are in a similar position. These are not insignificant pieces of kit. Any one of these cost between quarter and half a million quid to buy and install, maybe even more if it’s particularly flash. Furthermore they have an accepted life cycle of seven to ten years (Royal College of Radiologists’ figures). After this the technology is superceded, spares are difficult to obtain; they become obsolete.
With all this cyclic capital investment it makes sense to invest in staff numbers to maximise the use of this equipment. It would not be unreasonable to run a scanner 8am to 10pm Monday to Saturday and at least some time on Sundays. Wasn’t it Ian McGreggor who said he paid interest on the loan used to buy the equipment 7 days a week 24 hours a day and should use it by the same principle?
Do we do that?
No! We agree to give 20% of our scans to the independent sector. We pay the likes of Alliance medical [2] more than we would pay an NHS hospital to perform scans for us. We allow them to cherry-pick the easy case leaving the NHS the difficult & costly to perform scans (this means a 25% reduction in the number of patients waiting realistically means only 10% in the time patients can wait). We have a financial crisis. We panic. We freeze posts. We lay off qualified staff further reducing our capacity to perform scans or to react to an increase in demand (if a post is subsequently ‘unfrozen’ you are looking at six months before it is filled[3])
It is this money I begrudge going into the pockets of shareholders.
One hospital with problems… is treating patients with a mobile scanner while its own machine is often switched off. It should run for 10 sessions a week but the trust can only afford six.
(BBC)
[1] I have lost count of the times I have been asked “Can I have it done quicker if I go private?”. The answer is ‘No’. It will always be ‘No’. I do not have the luxury of keeping empty slots for a PP just in case one comes along. I book cases by clinical urgency. Most scans have a 2 week wait anyway.
[2] You will note I refer to Alliance as an example. There are, of course, other companies such as Lodestone, fulfilling similar roles or aiming to do so in future contracts. I am however particularly worried about Alliance. That’s another story. Please refer to the posting entitled ‘Unholy alliance‘ for further details.
[3] Including advertising. shortlisting and interviews. CRB checks are currently taking two months or so and no one in their right mind would give notice until all checks are through. AfC requires 2 months notice.
Unholy alliance November 15, 2006
Posted by MadRad in NHS & Politics.3 comments
The following is nothing new but it sheds some light on comments I make elsewhere on this site. It’s a story about Alan Milburn (remember him?) and Alliance Medical.
Back in 2004 Mr Milburn resigned as Secretary of State for Health “to spend more time with his family”. During this time he took on a £30,000 a year consultancy with the venture capital firm Bridgepoint Capital Ltd, part owners of Alliance Medical Ltd.
When he took up the job with Bridgepoint in March 2004 he was told by the advisory committee on business appointments he could begin the job “forthwith but for one year after leaving office he could not be personally involved in lobbying any government ministers or officials”. As he left the DoH in June 2003 he was free to lobby from June 2004. On 29 June, Health Minister John Hutton announced that Alliance Medical had been awarded a £95 million five-year contract to provide and operate 12 mobile MRI scanners for the NHS carrying out 120,000 scans.
At the time the Allliance Medical contract was announced, Professor Adrian Dixon from the Royal College of Radiologists cautioned: “There are a lot of MRI systems in hospitals which have just been put in by the government which are not running to full capacity. We hope [the deal] will not interfere with proper funding of these machines.”
This deal broke a promise made by Labour in 1997.
“After the 1997 election Labour said its privatisation programme would only embrace ‘non-clinical’ parts of the NHS. The DTC scheme ends this promise…. I recall sitting in a fringe meeting at the 2000 Labour Conference, at which an angry radiographer asked Alan Milburn why scanning services, although clearly ‘clinical’, were being privatised. The former health secretary did not answer.”
(Solomon Hughes, Red Pepper magazine)
The contract itself was controversial. John Hutton told the House of Commons “Standard Government procurement processes were followed in which advertisements were placed and companies were invited to send in expressions of interest. Following a robust negotiation process, Alliance Medical was selected as the company that offered value for money and capacity to deliver services.”
However, using the Freedom of Information Act it was later found that “the original idea for the MRI scan contract had come not from the government but Alliance itself. The only difference between the deal that Alliance finally secured and what it had at first proposed is that the company had also wanted to provide endoscopies, and ultrasound and PET/CT scans.” (Solomon Hughes, Red Pepper magazine).
Sources
Unicorn (http://www.againstcorruption.org/BriefingsItem.asp?id=12433)
Source Watch (http://www.sourcewatch.org/index.php?title=Alan_Milburn)
Pariah on wheels November 11, 2006
Posted by MadRad in General.add a comment
I have a confession. We have a Land Rover Discovery. It has seven seats, two of which fold away in the back. Ideal for when the grandparents visit.Ideal for delivering my children’s friends home after a visit. We live in the middle of nowhere. Their friends live in the middle of nowhere.Widely dispersed.
In my wife’s last job she had to travel around the county down dirt tracks to Nowheresville. A Nissan Micra wasn’t an option.To cap it all, just after we moved to the area, we were hit by horrendous flooding that cut off the North half of the county from the Southern bit.
Now everything has changed. My wife’s job is more office based, we have not experienced any more monsoons, road tax has gone up and we’re pissing through diesel like its water. And then there’s the green issue.
What to do?
I get annoyed when I hear witterings about taxing ‘gas guzzling’ cars for two reasons. Firstly because we are not American and therefore do not use ‘gas’. If we have to resort to clichés can we at least use one of our own (and, being an abbreviation for gasoline, gas is not appropriate for oil burners anyway). Mainly however my annoyance is based on the fact that I am already paying tax on gas guzzling by guzzling gas.
So I get rid of the car. What do I do?
Do I sell it and buy something more economical and eco friendly? But isn’t whoever buys it going to drive it and therefore create the same environmental damage I would have?
Maybe I should scrap it? Even if I could afford to lose more than ten grand how many years of driving is it going to take to produce the same amount of CO2 that will be used to dispose of it and to produce the new I would replace it with? (I think I’ve established the fact that public transport is rubbish where I live).
Surely if the Government wants us to stop using such vehicles (and we’ll forget issues like personal freedom and consumer choice for a moment) the only way to do it is to prevent further vehicles entering the system. Penalise new sales. Create incentives not to buy them more. Anything else would be nothing more than passing our guilt onto the next person.
More taxes aren’t going to stop this cycle. The revenue raised doesn’t allieviate the situation. It pays for expensive mistakes like Iraq. I know it. You know it. They’re not fooling anyone.
Maybe the Goverment could encourage us by starting a car exchange program. We give them our 4X4s, SUVs and executive saloons; they give us approved vehicles in return.
…Oh and they could give up their Jags and BMWs too. There’s only one of them and their driver. What’s wrong with using a Smart?
[1] Or the one further up the chain of cars that rolled off the production line to supply my replacement?
Mapping it out November 6, 2006
Posted by MadRad in IT.add a comment
All is rosey in the garden of Connecting for Health isn’t it? No one complaining; no bad news.
But maybe there is another reason….
Managers have attacked the Connecting for Health IT project for ‘bullying’ people into talking down problems on the ground.
West Herts primary care trust IM&T service manager Roz Foad was among speakers at an IT conference who criticised the scheme to create an NHS-wide clinical computer system.
She told HSJ: ‘There is a bullying aspect to Connecting for Health.’ Local staff felt unable to voice their concerns, she added. ‘We are not allowed to put out anything that is not spin”
(HSJ 9/11/06)
For a year and a half our RIS has quite happily sucked information from PAS as required. Any address changes automatically came over to RIS.
New PAS – a bit slow, other problems with the interface but, still information seemed to come over. Within two weeks of PAS we noticed an increase in the number of DNAs into the department.
Dug a bit deeper. All appointment letters are generated by RIS using the patient demographics. Some letters were going out with partial addresses- no post towns, counties our postcodes.
Looked further. RIS and PAS were talking but every time PAS received updates from the Spine (the data system carrying patient information for the whole of England [1]) the address details were amended, and mapped seemingly to random fields in the address, leading to the problems previously mentioned.
So the spine is wrong; it needs modifying.
But no, they can’t do that. It’s a national system. It can’t be modified.
So, instead, we have currently applied 11 patches (and counting) to our interface to cope with the various permutations of address coming over.
DNAs are down again…but what a bunch of twats!
[1] Remember it’s not a national health service as far as computing goes – politics gets in the way – but that’s another story
