Hospital baclogs, Cataract and other

[Jarndyce]

It’s all been said here before: if you add a few extra layers of management and a board, then you need to find the money to pay them.   The services at the sharp end suffer while “efficiencies” are demanded by the new management layers - and DHSC presides over it all like the sun in splendour, with the Minister now at arms length from the actual workers.   The new management pat each other on the back about how well they’re doing, while the workers at the sharp end face the public and try to magic more from less every day.   Much more expensive - no more efficient - and dents the morale of the workers even more than before.

I note from that clip that TC is an expert in Standard Management Bullshit - when she’s interviewed on the radio, I only hear the buzzwords now…and the soothing tone…

Edited June 28, 2022 by Jarndyce
Improved clarity

[hissingsid]

On the cataract front there was an initial rush I know two people who were called up this is in the early days.    The bed situation at Nobles is impeding a lot of planned procedures that require overnight or longer stays.   A friend was called in last week after waiting a considerable time and a couple of cancellations, went in at 7.00am was seen by the anaesthetist everything fine then a bit later told no beds go home we will call you.   That was last week still no call.    It makes me query the bed spaces available I know someone will number crunch and quote population numbers but we are an older population compared with some cities and as well as needing more medical care older people take longer to recover.

[hampsterkahn]

It is well known that DHSC has a recruitment  and retainment problem for medical staff.

It is not new.It was a problem before the Dr Ranson  tribunal.

The coverage of the disgraceful scandal in various publications read by those in interested in / or employed in health care has been extensive and withering.

Looking at just one publication - the BMJ, the British Medical Journal,it ran a main article soon afterwards and in the last week a supplement that comes with it ran another: 

A  very attractive picture of Douglas harbour, is spread across the top of a double page .Unfortunately, reading the article under it could not be more unattractive for anyone even considering working in the Island’s Health Care System.

Such an exposé  means that the Island’s Health Service  has a negative advertising campaign all of it’s own making.

it is likely to be a successful one.

 

 

 

 

 

[code99]

I’ll wager that when our dim-witted politicos have signed up to this Manx Care (sadly, a totally hands off/ arms-length agreement) that they appear not to have fully understood how inconsequential they would make future Health Ministers. They may have willingly signed up to an excuse for washing their hands off any practical responsibility, but I am not sure that at the end of the day the suffering public will see things that way.

To date Mr Hooper has not made much of a difference to waiting lists (cataract operations, hip/ knee replacements, etc) or the provisioning of the better IOM health services, largely because there is not much he can legally do. Sadly, he is too a product of our current political system where our national leaders seem to think that by preoccupying themselves with trivia, they can make themselves appear to be doing something useful. Meanwhile, they live in the hope that the delegation of the actual responsibilities to the senior CS/PS managers for running the country will somehow work - that the ‘professionals’ would somehow know what they were doing and that ultimately ‘outsourcing responsibility’ would be in best interests of the Island. Given the number of recent resignations, not to mention Dr Glover and Dr Ranson cases, this assumption is clearly a more wishful thinking than tangible reality. 

[Roger Mexico]

1 hour ago, code99 said:

I’ll wager that when our dim-witted politicos have signed up to this Manx Care (sadly, a totally hands off/ arms-length agreement) that they appear not to have fully understood how inconsequential they would make future Health Ministers. They may have willingly signed up to an excuse for washing their hands off any practical responsibility, but I am not sure that at the end of the day the suffering public will see things that way.

To date Mr Hooper has not made much of a difference to waiting lists (cataract operations, hip/ knee replacements, etc) or the provisioning of the better IOM health services, largely because there is not much he can legally do. Sadly, he is too a product of our current political system where our national leaders seem to think that by preoccupying themselves with trivia, they can make themselves appear to be doing something useful. Meanwhile, they live in the hope that the delegation of the actual responsibilities to the senior CS/PS managers for running the country will somehow work - that the ‘professionals’ would somehow know what they were doing and that ultimately ‘outsourcing responsibility’ would be in best interests of the Island. Given the number of recent resignations, not to mention Dr Glover and Dr Ranson cases, this assumption is clearly a more wishful thinking than tangible reality. 

And a lot of us predicted exactly this outcome. but the politicians couldn't see beyond their hope that this would stop those pesky constituents bothering them with their problems.  And of course it hasn't done even that. 

The last few weeks have illuminated the problem of what the DHSC and its Minister are actually for.  If they are are supposed to be monitoring Manx Care and setting its priorities, then they should be the ones publishing this data and the Minister shouldn't be commenting in this way, the responsibility lies with Cope and Foster. 

[Andy Onchan]

5 hours ago, hissingsid said:

On the cataract front there was an initial rush I know two people who were called up this is in the early days.    The bed situation at Nobles is impeding a lot of planned procedures that require overnight or longer stays.   A friend was called in last week after waiting a considerable time and a couple of cancellations, went in at 7.00am was seen by the anaesthetist everything fine then a bit later told no beds go home we will call you.   That was last week still no call.    It makes me query the bed spaces available I know someone will number crunch and quote population numbers but we are an older population compared with some cities and as well as needing more medical care older people take longer to recover.

It's not just the physical beds though, it's the nursing and all the other support that goes with it that counts as a 'bed' statistic.  

[Roger Mexico]

The Manx Radio piece on waiting list times, does that rare thing for them of actually linking to the documentation.  And then, because it's an FoI request, the servlet problem means that such a link will be useless after about five minutes.  For those who want to know what they are talking about, the FoI Case ID  is 2447659 and the Title : Waiting times and targets.

The response confessed that "Unfortunately the reason for referral is not recorded digitally in order to separate out specific pathways".  Which meant they were unable to give any information on waiting time for cataracts.  And these are just the waiting times to see a specialist after referral from GP, there's nothing to indicate how long after that it will take for something to be done.

[war baby]

On 6/26/2022 at 1:31 PM, Passing Time said:

I've asked the same question. When they can be bothered to reply, it's so vague that it's worthless. Hooper as usual just passes the buck on this.

Nobody has ever given me a straight answer as to why they closed the private wing.  I can only suppose it was part of Howard's way to make the island a classless society.

Instead we now have a useless society.  I have awaited a serious surgical procedure so long that I am now told it would be unwise to go ahead as I am unlikely to survive the anaesthetic, although the operation would probably be a success!

[John Wright]

Just now, war baby said:

Nobody has ever given me a straight answer as to why they closed the private wing.  I can only suppose it was part of Howard's way to make the island a classless society.

Instead we now have a useless society.  I have awaited a serious surgical procedure so long that I am now told it would be unwise to go ahead as I am unlikely to survive the anaesthetic, although the operation would probably be a success!

It was closed because it was losing large sums, was out dated and needed updating. 

The idea was to refurbish, and then find an outside operator on a licence or franchise basis.

They were all lined up for that, when Covid came along. It’s been used during covid, and, I understand, for some of the private catch up procedures, for triage, booking in, prep beds, recuperation ( on a day basis ).

I know @wrightywill correct me.

Its not hard to work out, the information isn’t hard to understand, it’s there, and it’s an understandable and reasonable for a place with a population of 87,000.

[Kopek]

21 minutes ago, John Wright said:

t was closed because it was losing large sums, was out dated and needed updating. 

The idea was to refurbish, and then find an outside operator on a licence or franchise basis.

 

Would all that have led to a profit for the NHS?   Is there a case to provide these facilities for those who do not want to wait for an \NHS slot as is their right? Does it in any way detract from the NHS service???

[John Wright]

3 minutes ago, Kopek said:

1. Would all that have led to a profit for the NHS?  

2. Is there a case to provide these facilities for those who do not want to wait for an \NHS slot as is their right?

3. Does it in any way detract from the NHS service???

1. The way it was run was financially shambolic. Costings were not necessarily picked up and billed. That ran from consulting room use charges, imaging, theatre time, nursing. Anaesthetists and consultants billed their own time.

So, first idea was to get a recording and billing system in and stem the losses. Of course by getting an operator in and them paying a fee, they become responsible for doing most of that.

2. That’s a political/moral/ethical question. My personal view is that I’ve no objection as long as it’s not at the expense of the NHS budget or ability to deliver. And by taking some pressure off it may allow the NHS to deliver more.

3. if outsourced properly it shouldn’t. If it does it shouldn’t be allowed.

[code99]

49 minutes ago, war baby said:

Nobody has ever given me a straight answer as to why they closed the private wing.  I can only suppose it was part of Howard's way to make the island a classless society.

Instead we now have a useless society.  I have awaited a serious surgical procedure so long that I am now told it would be unwise to go ahead as I am unlikely to survive the anaesthetic, although the operation would probably be a success!

Sorry but not surprised to hear this – hopefully they can sort out the problem reasonably quickly!

The health services on the IOM are turning into ‘haves’ and ‘have nots’ state of affair, with a clear distinction occurring between those who are left languishing in pain and discomfort and those who can afford to pay private fees to make their pain to go away - by seeking medical treatment in the UK, unfortunately.

[Kopek]

3/. ................

but who would decide 'properly'? We've heard recently about the pressure that the medics can exert on the admin and vice versa?

Who are we public to trust on this being decided in the interests of both NHS and Private patients???

[John Wright]

8 minutes ago, Kopek said:

3/. ................

but who would decide 'properly'? We've heard recently about the pressure that the medics can exert on the admin and vice versa?

Who are we public to trust on this being decided in the interests of both NHS and Private patients???

Well, you’ve got to ensure you’ve got the correct operator under the “user agreement”, that it’s terms are favourable, and workable.

The difference in having Spire or BUPA, or another established corporate hospital operator running the place, as against pre closure,  is that DHSC as owner of the facility and Manx Care as employer of most people who will provide private services in their free time only have to deal with one entity rather than each consultant and the patients.

Before it had to bill the patients and the doctors. 

The current consultant contracts allow free sessions during the week. The chosen operator will have its own admin and admin systems, it will have some nursing, care and ancillary staff, and there’ll be agreed unit, hourly or sessional rates for theatre, and diagnostic, imaging and test facilities.

[Kopek]

OK, if we get an appropriate operator in place that will take care of the billing problems, will add to NHS income.

Given that consultants can take on a certain amount of private work, how do we ensure that this does not detract from their NHS  work? Could a surgeon cancel a 3pm NHS operation because they know they have a 5pm private appointment??? Are the nurses involved those who have signed to an agency having left the NHS?

Of course, this would all be mute point if we had a perfect NHS service!!!

 

I'm sure that surgeons have a moral stance on this matter and would not see someone suffer because they are out of time???