Yesterday (18 Sept 2014) I attended what was the second NHS AGM. This was a bit different to normal company AGM's as the "shareholders" are the UK residents. This was also not the NHS for the UK, but NHS England. Which I discovered is different.
The NHS is not a UK wide service but has been split int 4 in 2012. With an NHS for Wales, Scotland and Northern Ireland. This devolution does mean that each region can set its own priorities for health care depending on local needs. However, it was not clear to me about specialisation, research and funding, and cross charging when patents are treated in regions outside of where they live, but maybe this has been sorted!
There was a large percentage of NHS workers in attendance with some specific (there hospital/discipline) issues. A few were vocal and disruptive in their interruptions (passion overflowing). But as they had no mic's they were just a lot of noise to most of the audience.
Like most AGMs there is a lot of "more"and "better"in the future with no tangible measurable specifics. So next year they will not be able to report progress except to say (subjectively) we did "more " and we did it "better". There was a lot of outcomes like quicker and standard waiting times for access to mental health services. Almost as if just by saying it it would happen, no issues to resolve, no time scale and no target times.
There was also a smoke screen statement which was along the lines of - The NHS has had its funding increased above inflation year on year. While you may say it is not enough, look at all the other government departments that have had their spending cut - The implication being 'be grateful it could be much worse'.
More worryingly was that this AGM had a bias towards minorities and their illnesses and access. Don't get me wrong everyone has the right to be treated for there illness by the NHS no mater how unique. However, most companies would focus on their largest and biggest markets achievements and customer base at the start. After all this gives the greatest economies of scale, most benefits to customer and greatest advantage to competition (privatisation).
As an example there were 5 workshops before the AGM with patent groups (interesting one was not represented on stage "an administrative error". But this view was challenged by one member of the audience who claimed that their group had raised some unpalatable issues. Who knows). Of the other four Three were what I would consider main stream, but one was Gender Dysphoria which affects around 0.8% of the population to "some extent". This is not a life threatening but with long term physical and mental implications. While I empathise with this it affects 0.8% of people UK wide but they were commanding 20% of the NHS attention at the AGM.
Like the first time I attended a union meeting in the 1970's I found out that the people that turn up regularly set the agenda, often to their advantage and often at the expense of the other members, who that assume rational decisions are being made.
On the board, as at most companies, there are some great people and one or two wankers. Being one or the other doesn't mean they will or will not deliver benefits to the organisation. Some nice people that had personality and understanding of the NHS and their role were Jane Cummings and Professor Sir Bruce Keogh. Comfortingly the man with a vision is the CEO Simon Stevens. He didn't back away from hecklers and gave "honest", if not full, answers. The main person that I would say "no" to, if it was my company and I was asked to employ him is Ian Dodge. The Strategy person kept say "we don't know"(sometimes adding a "just" in there for variety). Given that Mr Stevens has a clear vision it is incompetent that Mr Dodge does not know how he is going to deliver it. I wasn't expecting a detailed plan but some actions, timescales, milestones and check points.
Napoleon didn't say, I want to rule Europe and his generals respond with "I don't know what or how we are going to do that!" Mr Dodge (and yes he appeared to be a wanker) has worked in the Department of Health for 20 years and admits, it is only recently he has met patients. God give me strength!
The Finance report was a little bland. In summary "this was our budget and this is what we spent." no breakdown of cost per treatment. No break down of how much outsourcing/privatisation had saved/cost. No forecast for next year. I've not read the full annual report, but I have to assume it is in there.however, not so good that it was worth highlighting at the AGM.
Finally of the 20 or so people that asked questions at the end 3 (15%) were from the USA and made the same point - any move towards any element of the US system is bad move.
The NHS is not a UK wide service but has been split int 4 in 2012. With an NHS for Wales, Scotland and Northern Ireland. This devolution does mean that each region can set its own priorities for health care depending on local needs. However, it was not clear to me about specialisation, research and funding, and cross charging when patents are treated in regions outside of where they live, but maybe this has been sorted!
There was a large percentage of NHS workers in attendance with some specific (there hospital/discipline) issues. A few were vocal and disruptive in their interruptions (passion overflowing). But as they had no mic's they were just a lot of noise to most of the audience.
Like most AGMs there is a lot of "more"and "better"in the future with no tangible measurable specifics. So next year they will not be able to report progress except to say (subjectively) we did "more " and we did it "better". There was a lot of outcomes like quicker and standard waiting times for access to mental health services. Almost as if just by saying it it would happen, no issues to resolve, no time scale and no target times.
There was also a smoke screen statement which was along the lines of - The NHS has had its funding increased above inflation year on year. While you may say it is not enough, look at all the other government departments that have had their spending cut - The implication being 'be grateful it could be much worse'.
More worryingly was that this AGM had a bias towards minorities and their illnesses and access. Don't get me wrong everyone has the right to be treated for there illness by the NHS no mater how unique. However, most companies would focus on their largest and biggest markets achievements and customer base at the start. After all this gives the greatest economies of scale, most benefits to customer and greatest advantage to competition (privatisation).
As an example there were 5 workshops before the AGM with patent groups (interesting one was not represented on stage "an administrative error". But this view was challenged by one member of the audience who claimed that their group had raised some unpalatable issues. Who knows). Of the other four Three were what I would consider main stream, but one was Gender Dysphoria which affects around 0.8% of the population to "some extent". This is not a life threatening but with long term physical and mental implications. While I empathise with this it affects 0.8% of people UK wide but they were commanding 20% of the NHS attention at the AGM.
Like the first time I attended a union meeting in the 1970's I found out that the people that turn up regularly set the agenda, often to their advantage and often at the expense of the other members, who that assume rational decisions are being made.
On the board, as at most companies, there are some great people and one or two wankers. Being one or the other doesn't mean they will or will not deliver benefits to the organisation. Some nice people that had personality and understanding of the NHS and their role were Jane Cummings and Professor Sir Bruce Keogh. Comfortingly the man with a vision is the CEO Simon Stevens. He didn't back away from hecklers and gave "honest", if not full, answers. The main person that I would say "no" to, if it was my company and I was asked to employ him is Ian Dodge. The Strategy person kept say "we don't know"(sometimes adding a "just" in there for variety). Given that Mr Stevens has a clear vision it is incompetent that Mr Dodge does not know how he is going to deliver it. I wasn't expecting a detailed plan but some actions, timescales, milestones and check points.
Napoleon didn't say, I want to rule Europe and his generals respond with "I don't know what or how we are going to do that!" Mr Dodge (and yes he appeared to be a wanker) has worked in the Department of Health for 20 years and admits, it is only recently he has met patients. God give me strength!
The Finance report was a little bland. In summary "this was our budget and this is what we spent." no breakdown of cost per treatment. No break down of how much outsourcing/privatisation had saved/cost. No forecast for next year. I've not read the full annual report, but I have to assume it is in there.however, not so good that it was worth highlighting at the AGM.
Finally of the 20 or so people that asked questions at the end 3 (15%) were from the USA and made the same point - any move towards any element of the US system is bad move.
