h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

I'd better start this by saying that I have received excellent care from the nhs, superior in fact to private care I've had previously.

So - Nurses and doctors not leaving in droves - no - this is because we are importing them from African and India, who deperately need their doctors. This is not because of any improvement TB has made to the health service - feel free to continue despising him.

The lead article in Computer Weekly this week is "Accenture calls for 'resolution' after 260M loss on ~NHS work." Basically this relates to a company bidding low to get the work and relying on getting top ups afterwards (things missed out of the spec) which they can charge the earth for. Sadly for them this particular contract says they will be paid for the delivered system - ie no system - no pay. A lot of companies pulled out over that clause, now the nhs boss (someone Martin ?) is being slated for being so hard on the contractors. He should of course be being praised to the skies.

My local nhs trust suspended a doctor on full pay for bullying. This was after he blew the whistle on a practise of putting an extra bed into a cardiac ward - there were 2 deaths directly related to this. This happened in 2003. That doctor is STILL suspended on full pay - their has just been a judicial review - though the results have not yet been announced. (Dr Raj Mathuru if you want to try googling - there was a Dr Briony someone as well.)

As both an employee & consumer of the NHS, I'm aware that there are shortcomings, but I still have great faith in it. I've lost track of which thread is which with doctors, NHS, but I have a couple of random points.

I was exceedingly impressed with my local hospital which managed to have my notes ready at the relevant desk on two consecutive days for appointments at two totally separate departments.

A colleague of mine, whose contract ends this Summer, was job hunting, only to discover a total freeze on NHS recruitment.

>> A lot of companies pulled out over that clause, now the nhs boss (someone Martin ?) is being slated for being so hard on the contractors. He should of course be being praised to the skies.

To be honest, having worked on two (non-NHS) programmes with Accenture and comparing them with work on three (also non-NHS) programmes where I worked with IBM, my considered opinion is that Accenture are a bunch of words which other users may find offensive. Programmes which they work on have a particular smell: I think it comprises a mixture of expensive hair-product and fear.

To be honest, the only way to control the big consultancies is to take total responsibility for managing the relationship, defining exactly what you expect them to deliver and to take up their references. A former colleague of mine was astonished to find the completely disasterous programme we worked on in Denmark given as a glowing reference-site by the same company when he was in Australia. "I worked on that programme" he said to the consultancy "please will you give me the name and the phone number of whoever it is who is saying that you did a good job there, because I want to find out what planet they are living on, it must be a nice place to be if it distorts his reality that much".

End of rant.

Sorry.

Ben

You should be this morning,
with the report that some GP's are earning up to £250K per year , and that the average is about £120K per year. This as a result of the new contract arrangements which because the Dept of Health got it's figures wrong means the GP overspend is running at £300Million !!! , and is a large part of the Trust problems with finances.

Novo

Catching up is always so much fun.

Otto: <>

Unfortunately, the alternative to capitalism is a service/product so bad that nobody would pay for it.

Arnie: <>

The greatest driver for escalating medical costs in the US over the last few years is often credited to increased cost of medical malpractice insurance, due to increased tort suits. This is said by lying illegitimate sons whose political goals are to enrich their campaign contributors at the expense of the average person.

The real driver is the increased cost of medical prescriptions. The same companies sell the same prescriptions to Canada and other nations for about five times less, because Canada's NHS enforces cost controls. The pharmaceutical companies insist they're taking a bath on these sales, so they make up the difference in markup here in the US. What they're really doing is price gouging, and the government, thanks to many campaign contributions from the pharmaceutical lobby, turns a blind eye.

This is a corrupt government issue, not a privatization issue.

And the only way you can argue that the results are equal or worse is in the areas where medical care is not privatized. The US medical system is a mixed bag of private and public funding, and it's in the public sector where things are pretty bad.

My wife, before I made her my wife, was getting health care for an ongoing problem through the public system. As soon as I made her my wife I added her to my medical insurance and she received private care. The difference was phenomenal. Probably the most significant change was that the private doctors didn't automatically assume she was lying. If you can believe it, I actually had a surgeon from the public hospital come to ask me if she might be crazy.

azahar: <>

Except that, it does. As I mentioned before, my wife received lots of care in the public system, and never got charged a dime. My mother, who is disabled, is also receiving care from the public system... though she's a lot more satisfied with the level of care she receives than my wife ever was. There are a variety of public programs available.

Also, hospitals are not permitted to reject care for patients based on their ability to pay (though there are a few exceptions, like if the individual hospital is entirely controlled and operated by a private HMO... like mine is, and one reason why it gives superior care), so whether someone has insurance or will be covered by a public program doesn't affect their ability to receive emergency services. This actually presents a huge problem for the medical system here in the American Southwest, because there is a significant section of the population who will not have insurance or any other ability to pay for care, and will not be covered by government programs. They create a nightmare for hospitals, because the law compels them to provide care for which they will receive no compensation. This drives their costs up, resulting in budget cuts (reflected in poorer quality care) and price increases for the paying customers (public and private) to offset. There's a bit of a crisis here in Southern California as many local trauma centers have closed their doors because, due to the numbers of uncompensated patients, they could no longer afford to remain in business.

But we're talking about illegal immigrants here, and for some reason saying bad things about illegal immigrants is taboo.

McKay: <>

Accenture changed its name from Andersen Consulting because it was caught up in some nasty exposures in the media. They're the ones to turn to when the desired outcome is an expensive disaster. We hired them here to help us implement PeopleSoft about six years ago (when they were still known as Andersen Consulting), and though things are better now, we're still cleaning up the mess. People here still can't mention the name of the project without spitting. And we're still throwing good money away at it.

Not saying anything good about Accenture, but they actually split from Andersen, who were later involved in the Enron scandal. So that should not necessarily reflect on Accenture. Unless there's something else I don't know about.

Which is not to say they're a decent company otherwise of course.

Andersen Consulting split from Arthur Andersen, which was the accounting firm that destroyed documents for Enron. Andersen Consulting then changed its name to Accenture, though they did this before the Enron scandal.

Confusing, I know.