Saturday, 15 September 2012

Job Cuts in the NHS?

My local hospital trust needs to save money. In fact it needs to save "£1 for every £5" spent to balance its budget within five years. So what is it going to do? What would you do if you had to cut back your budget by 20%? Well if most of my expenditure was on staffing then that would be the first thing I would look at but that's not an easy answer.

 There is a five-year plan to balance the books but they aren't sure yet what that plan is, but it is good to know that they have decided on five years. It is also good to know that they are going to ask the public because these financial difficulties have been caused by making services safe and the public aren't to blame for that. Well I can find those savings.

In recent years the biggest developments in the NHS have been with information technology along with huge costs. What are the benefits? Well doctors and nurses still use pens but additional records are placed on the computer. Appointments are made by computer. The additional records and appointments are available to others not on site. Management can be at a distance because of collective staff records. Diagnostic records may be shared with professionals throughout the trust and elsewhere. All sorts of information may be accessed at the press of a button.

Now think of the downside. It takes a second to give an appointment with a pen and paper. Computer training alone must be expensive but add on the costs of the soft and hardware. Have you ever walked into a computer room. It is hot. Add on the heating bill. We don't need instantaneous access for appointments. We just want to know our next appointment. We don't want professionals duplicating information expensively for the sake of the latest technology.

This view is not popular. It is opposed by the technology industry. It is opposed by all whose professional status is raised by association with the latest technology. However I don't want to walk into a casualty miles away and have all my details accessed immediately (with all the consequent risks to data protection).

I love computers. I'm using one now. What I don't like is the way they have added extra burdens. There are some aspects of technology that really make a service more efficient. When I go to a checkout and the stock levels are measured as quickly as I can pack my goods into bags. There are great improvements to the way lectures may be delivered, to access of information, and some information sharing is really useful. However there is too much vested interest in saying that record keeping improves with the latest technology. Reception and appointment services deteriorated greatly in proportion to technological advances.

I have more ideas to help my trust but it will take a radical view to appreciate that the techniques of the 80s are valid today, like ticking someone's name when they arrive in a building. I heard how management supported change with arguments like doctors in any part of the country will have instant access to everyone's detailed medical records. Arguments like every professional can have instant access to every diagnostic test. These arguments are specious if we are to save 20%. Why is it that I think we are heading for job cuts?

Change the world


  1. I agree with you...job cuts are this governments way forward! But do they target the high wage earners? It certainly doesn't feel like it. My wage was "frozen" almost three years back...and the "wonderful" government, who I did NOT vote for, are proposing a further 3 year wage freeze! I don't think the current government will be happy until all the lower paid workers have given up their cars and their dignity and are scratting to make ends meet

  2. As I understand it Sea, these cuts are related to extra expenditure in making our local NHS 'safe'. We are paying for incompetence in our own area. Whether those on a higher wage who were incompetent lose their jobs remains to be seen and we will probably never know.

    In one sense nobody voted for a coalition, but in another sense we all did - even those who didn't vote. This reflects on our outdated system of voting rather than Coalition policy. Nick Clegg has taken a lot of stick for starting to make a clear difference in what the Tories want and what the Liberal Democrats want, but I am glad that we are starting to see a difference.

    As for dignity, there is certainly a relationship with income, but dignity relates to so much more. I drive one of the smallest cars that is produced and I am glad to do so. We all have a duty to look after the environment whatever our income. To be fair to all in the Coalition, I don't think anyone went into politics to make cuts even the Tories, and it can't be a nice thing for them to do.