I work in welfare benefits. The Kafka-esque nightmares are just as bad as in the NHS. One client came to us for help because she had unwittingly racked up £35,000 in overpayments and there’s nothing we can do.
I specifically took my current job because I was determined to tackle mal -administration in one little corner of The System
I think some of it is just any large institution has these issues and the larger the institution, the larger the issues. My husband works for a medium sized University and has similar problems with bureaucracy.
I think outsourcing also massively contributes to the problem. My husband needs some large furniture moved in his office and because the outside company that handles Estates can't do that sort of thing, they have to put it out for tender and it will probably cost at least a grand and take months to sort out. Whereas if it was inhouse, he could just schedule a time and some guys would come and move the stuff for him.
Outsourcing is a scourge. I’ve seen situations where organisations have outsourced services and operations so thoroughly they have lost ownership of their own strategy and outcomes.
Re: maternity care - all the same problems were already there when I gave birth in 2005. My heart breaks for the women who give birth now because it should’ve been a lot better by now. And I suspect one big reason for this is not money, Tories, austerity and whatever else - it is all the “beloved NHS” rhetoric. Especially when you’re an immigrant-which I am- it’s taboo to criticise it, or compare it to other countries’ services. There are two myths that need busting before the NHS can be reformed (which it must be), and currently not much is being done to achieve it: the myth the NHS is the best, world-leading (it’s certainly one of the world’s biggest employers which begs the question why does German health system employ fewer people to serve a bigger population?), “beloved”, pride of the nation” etc etc; and that any reform means privatisation by the back door/ US-style healthcare. I have seen far too many references to the US system, when we should compare the NHS to the French or German systems instead.
I’ve had two babies. One in Australia, one here. They were verrrrry different experiences. Let’s just say Kings in South London did not compare well in facilities or care.
There’s a weird callousness in maternity services, as though you’re an inconvenience, even though you’re literally at the specific place that’s designed for people having babies
Very well put. I was made to feel like asking for anything, ie epidural, was almost unreasonable entitlement on my part. Friends, who had babies in France or Japan didn’t have that experience.
This is a wonderful charity that introduces reflective listening into hospitals for patients staff and clinicians. It was started by a women whose sister had such a traumatic birth the baby was severely disabled- not listened to during labour etc
My contribution to the history of bad ideas: the Beeching Report. It single-handedly slashed the public tranport capabilites of large portions of the country. Environmental and societal effects are still being felt. Absolute tragedy.
“Those lower-res days” makes me wonder if kids will think the Oughts were all a bit blocky, same as we think in the 1920s the world was black and white and people moved in fast-motion steps.
"encountering the NHS as a patient when all the staff are used to navigating its bureaucratic machine every day is like perpetually being on your first day at work, and not knowing what the wifi code is. Except you get treated like you’re stupid."
YES. Insert default "of course I love the NHS as a brit" boilerplate but this is incredibly accurate.
Hell navigating the NHS as a member of staff is incredibly difficult as well. In my Trust, Payroll has been outsourced and apparently you can only contact them through an elaborate black magic ceremony and blood sacrifice. Trying to get someone in HR to answer a question is similar to finding a NHS dentist who can pull hen's teeth. It's similar for the Finance dept as well and IT is behind two locked doors that no one (other than IT staff) can get through.
The only way you can get anything done outside of your team is to find a specific person who can help and contact them directly - of course then they leave or change jobs and you never hear from them again and their replacement (if they are replaced) has never heard of you or your query so you have to start from square one again.
Staff levels and staff retention is a (the?) major problem in the NHS. It majorly affects continuity of service (or care if you are a patient). If we could people in jobs for more than 5 minutes, we could solve a lot of problems and it would significantly improve care for patients.
I worked at Kings in the early 90s in management. It was a chaotic nightmare and the only way to get anything done was to cultivate personal relationships with anyone in a position to make something happen whatever the department- and often they would be in a lower level position. Things had improved by the 2000s - I was working elsewhere- but it sounds like we’ve gone back there. Unpopular opinion possibly- but I think the NHS is chronically under managed, and most people have forgotten the 2012 Lansley ‘reforms’ which atomised the NHS and cut out swathes of experienced managers losing corporate memory in the process
I was a fan of the Zoe Covid app - never mistook it for the NHS - in fact I remember their public wrangles with the NHS over speed of releasing information as it was emerging. The big data sets they had revealed early on the losing sense of smell was a key indicator…
I am a Zoe fan - full disclosure. Although you may say you think we don’t know enough about the gut micro biome I would ask, how and when will we know enough about it? Surely big data, AI and personalisation is the way we are going now? Zoe has 100 000s people with the science and feedback being provided almost in real time. Let’s not wait for the NHS to grind through the gears to conduct an RCT on a few hundred people in 5-10 years time. Best thing would be a Zoe/NHS collab but I’m not holding my breath ( Wes, are you listening?). Sure it’s expensive but that’s fixable…
American surgeon here. I am told REPEATEDLY that the Brits love the NHS. What I’m interested in is a poll from people who have used it in the last year.
I wouldn’t say I ‘love’ it, but it picks you up and sorts you out when you break a bone, or have a stroke. Private medicine has a place for elective surgery, but the trouble with private insurance is that once you have had funding for one procedure, cover is often then excluded in the policy for that body system
I only knew the Zoe app though it's free service monitoring covid, although felt it presented itself as NHS associated. Of course even Replika used to be free. Although I questioned my interactions with it after I managed to tease out its Skynet aspirations.
Mine seems maybe a bit obvious: “How many fingers am I holding up?” (Add name of other man if you know, because from Britain).
I may return with a proposed bad idea, if only I could think of one that didn’t last for most of humanity(slavery), wasn’t still with us (early humans had it easy), or other rule-outs. Is Phrenology regrettably too close to mesmerism?
Yesterday was the 50th anniversary of women being able to get a credit card without the signature of a man (just thought I’d mention it)
Married women being compelled to leave the Civil Service went on even later.
I work in welfare benefits. The Kafka-esque nightmares are just as bad as in the NHS. One client came to us for help because she had unwittingly racked up £35,000 in overpayments and there’s nothing we can do.
I specifically took my current job because I was determined to tackle mal -administration in one little corner of The System
I think some of it is just any large institution has these issues and the larger the institution, the larger the issues. My husband works for a medium sized University and has similar problems with bureaucracy.
I think outsourcing also massively contributes to the problem. My husband needs some large furniture moved in his office and because the outside company that handles Estates can't do that sort of thing, they have to put it out for tender and it will probably cost at least a grand and take months to sort out. Whereas if it was inhouse, he could just schedule a time and some guys would come and move the stuff for him.
Outsourcing is a scourge. I’ve seen situations where organisations have outsourced services and operations so thoroughly they have lost ownership of their own strategy and outcomes.
Having been retired from the NHS bureaucracy for 2 years (nearly), I find it as difficult to navigate as you do.
Am also sceptical about Zoe. I prefer to listen to what the Van Tulleken twins say about ultra processed foods
Superhans! Up there with Tyres of Spaced as greatest ever ancillary character.
Plumbing’s just lego, innit? Water lego.
Re: maternity care - all the same problems were already there when I gave birth in 2005. My heart breaks for the women who give birth now because it should’ve been a lot better by now. And I suspect one big reason for this is not money, Tories, austerity and whatever else - it is all the “beloved NHS” rhetoric. Especially when you’re an immigrant-which I am- it’s taboo to criticise it, or compare it to other countries’ services. There are two myths that need busting before the NHS can be reformed (which it must be), and currently not much is being done to achieve it: the myth the NHS is the best, world-leading (it’s certainly one of the world’s biggest employers which begs the question why does German health system employ fewer people to serve a bigger population?), “beloved”, pride of the nation” etc etc; and that any reform means privatisation by the back door/ US-style healthcare. I have seen far too many references to the US system, when we should compare the NHS to the French or German systems instead.
I’ve had two babies. One in Australia, one here. They were verrrrry different experiences. Let’s just say Kings in South London did not compare well in facilities or care.
There’s a weird callousness in maternity services, as though you’re an inconvenience, even though you’re literally at the specific place that’s designed for people having babies
Very well put. I was made to feel like asking for anything, ie epidural, was almost unreasonable entitlement on my part. Friends, who had babies in France or Japan didn’t have that experience.
This is a wonderful charity that introduces reflective listening into hospitals for patients staff and clinicians. It was started by a women whose sister had such a traumatic birth the baby was severely disabled- not listened to during labour etc
People like this give me hope for change
https://www.pointofcarefoundation.org.uk/
Thank you, yes, 🤞🏻
My contribution to the history of bad ideas: the Beeching Report. It single-handedly slashed the public tranport capabilites of large portions of the country. Environmental and societal effects are still being felt. Absolute tragedy.
https://en.wikipedia.org/wiki/Beeching_cuts
“Those lower-res days” makes me wonder if kids will think the Oughts were all a bit blocky, same as we think in the 1920s the world was black and white and people moved in fast-motion steps.
"encountering the NHS as a patient when all the staff are used to navigating its bureaucratic machine every day is like perpetually being on your first day at work, and not knowing what the wifi code is. Except you get treated like you’re stupid."
YES. Insert default "of course I love the NHS as a brit" boilerplate but this is incredibly accurate.
Hell navigating the NHS as a member of staff is incredibly difficult as well. In my Trust, Payroll has been outsourced and apparently you can only contact them through an elaborate black magic ceremony and blood sacrifice. Trying to get someone in HR to answer a question is similar to finding a NHS dentist who can pull hen's teeth. It's similar for the Finance dept as well and IT is behind two locked doors that no one (other than IT staff) can get through.
The only way you can get anything done outside of your team is to find a specific person who can help and contact them directly - of course then they leave or change jobs and you never hear from them again and their replacement (if they are replaced) has never heard of you or your query so you have to start from square one again.
Staff levels and staff retention is a (the?) major problem in the NHS. It majorly affects continuity of service (or care if you are a patient). If we could people in jobs for more than 5 minutes, we could solve a lot of problems and it would significantly improve care for patients.
Unfortunately for Ed, Helen had already seen it and knew it was much, much smaller than that.
Oooof that dude in NZ who can’t even name one book by a NZ author 🫣 the sheer audacity of the patriarchy boggles
Saudi Arabia has recently been named host of a UN commission on women’s rights and is keen to bid for the next Fifa Women’s World Cup - doesn’t stop this brutal patriarchal regime for going after 3 sisters for posting a video of them dancing - https://www.theguardian.com/global-development/article/2024/may/07/family-three-sisters-saudi-arabia-fawzia-manahel-mariem-al-otaibi?CMP=Share_iOSApp_Other
Just how the fuck does all that stack up, and how can they have women running around in football kit when they would imprison their own for far less?
Oh - and why are we still selling them arms and cosying up to them????
I worked at Kings in the early 90s in management. It was a chaotic nightmare and the only way to get anything done was to cultivate personal relationships with anyone in a position to make something happen whatever the department- and often they would be in a lower level position. Things had improved by the 2000s - I was working elsewhere- but it sounds like we’ve gone back there. Unpopular opinion possibly- but I think the NHS is chronically under managed, and most people have forgotten the 2012 Lansley ‘reforms’ which atomised the NHS and cut out swathes of experienced managers losing corporate memory in the process
I was a fan of the Zoe Covid app - never mistook it for the NHS - in fact I remember their public wrangles with the NHS over speed of releasing information as it was emerging. The big data sets they had revealed early on the losing sense of smell was a key indicator…
I am a Zoe fan - full disclosure. Although you may say you think we don’t know enough about the gut micro biome I would ask, how and when will we know enough about it? Surely big data, AI and personalisation is the way we are going now? Zoe has 100 000s people with the science and feedback being provided almost in real time. Let’s not wait for the NHS to grind through the gears to conduct an RCT on a few hundred people in 5-10 years time. Best thing would be a Zoe/NHS collab but I’m not holding my breath ( Wes, are you listening?). Sure it’s expensive but that’s fixable…
American surgeon here. I am told REPEATEDLY that the Brits love the NHS. What I’m interested in is a poll from people who have used it in the last year.
I wouldn’t say I ‘love’ it, but it picks you up and sorts you out when you break a bone, or have a stroke. Private medicine has a place for elective surgery, but the trouble with private insurance is that once you have had funding for one procedure, cover is often then excluded in the policy for that body system
A caption for your photo with Ed Miliband...
"The Emperor's New Sooty."
I only knew the Zoe app though it's free service monitoring covid, although felt it presented itself as NHS associated. Of course even Replika used to be free. Although I questioned my interactions with it after I managed to tease out its Skynet aspirations.
Mine seems maybe a bit obvious: “How many fingers am I holding up?” (Add name of other man if you know, because from Britain).
I may return with a proposed bad idea, if only I could think of one that didn’t last for most of humanity(slavery), wasn’t still with us (early humans had it easy), or other rule-outs. Is Phrenology regrettably too close to mesmerism?
PS “Twenty thousand people...” is hilarious.