What can I say? My latest post proclaiming an imminent return has come and gone. In effect my promises are as empty as those of most of the politicians currently infecting my TV screens. The post at the bottom of the page when I logged in this morning was written and posted last July. I am clearly useless, have little to say. Or else there is another deeper meaning? Well no doubt the reasons are not deep. I am just generally lazy, I spend too much time on the evil facebook (that post still gets me 600 hits some days – why?) and my general disgruntlement with the NHS pretty much disappeared during the last year.
The job, while not necessarily the best paid has been pretty fulfilling not to mention busy. I also think I have had a reasonable amount of fun on the way. I have been learning to live my life post-child-leaving-for-university. This has involved me doing more than work, cook dinner (anything involving pasta and curry though not together), wash and iron jeans and tee shirts (the clothes of a teenager) and act as a taxi service to a boy who ought to have passed his test by now. No, hubby and I have travelled the country (well been to a few sea side towns and London), stayed in hotels we can’t really afford and eaten in good restaurants. We have also been on a couple of longer trips abroad and generally enjoyed ourselves. Mortgage rates are low, the debts are reducing and some months hubby even has some overtime. Yes life has been good.
Now however we need to get real. It seems that some of us haven’t taken this recession seriously enough. We have enjoyed a period of growth (more money in our pockets and more money in the NHS). Now though all that must end. Firstly the new government (whichever gets into power) will need to tighten the belt (maybe higher VAT or national insurance or both), and the public sector will need to take a hit. The bottom line at work now is this: THERE IS NO MONEY.
This is a depressing message in whatever language you might translate it into. Reading between the lines of: The job of a commissioner is to redesign services to obtain the best value for money tells me that quality is pretty much out and saving money at all costs is in.
A lady interviewed on the London News last week caused a massive chill to move up my back and into my head creating a headache which hasn’t actually left me yet (though the virus keeping me off work today could be responsible for that). This person, a member of the London Assembly I think and who was a Tory said that NHS bureaucrats are dispensable (or something similar), she stated she saw nothing wrong in getting rid of folks like me. This is set in the context of my organisation which has told us it needs to save 30% on management costs (more on that in my next post) and a Tory leadership that would like to freeze public sector jobs as they become vacant.
Over the last few years I have often been critical of the target driven, central control exerted by the Government through the Department of Health. But at the same time there has been progress, and while I might not think this if I was still nursing at the bedside, I do believe that Commissioners can be a good thing. “She would say that” I hear you cry. Well of course as I am one. But having people out there who ask doctors, nurses, midwives, therapists and other clinicians why they do what they do in the way that they do it can only be healthy. The idea of leaving “front line staff” to get on with what they apparently “know what to do best” is frankly scary. I am now just plain scared that on 7th May I will awake to Dave preparing to move to Downing street. I am scared mainly that this will be followed by a large amount of ‘throwing the commissioning baby out with the bathwater’ to save money.
We do need challenge and we do need people to wonder if services are being provided with the patient rather than the practitioner in mind. We do need to make sure that value for money is being thought about because in my experience not everyone treats public money in the way they would their own. Or maybe on second thoughts they do which is why the country and many individuals are in quite so much debt.
Back to the drawing board…….