our health system- in whose interest?

I got very irate last week about our health system. This may not seem like news to the regular reader, but it sort of is. I was annoyed by whole new things I’d not noticed before. There’s always more to discover, new ways to be dumbfounded and annoyed.

I spent Wednesday morning at a conference of the Very Important. With few exceptions, they were also the Very Whiney. The region (approx. 1.8 million people) has an unnecessarily complex system- a government Department, a Health Committee that holds the Department to account, a Health and Social Care Board that commissions services, 6 Health and Social Care Trusts that deliver services (including buying in), a Public Health Agency, several other arms length bodies, and a Patient Client Council  which exists to make sure the system remembers about the patients. We’ve had all sorts of reviews, and recommendations, but really, it’s madness and nobody has the will to change it. I tried to make sense of it once, but didn’t get it right

this is not gospel!

So there I was, intent on finding out how the findings of the latest review were to be implemented. But no. That would be too straightforward. Due to the vagaries of local politics, we don’t have a health minister at the minute. That meant the Chair of the Health Committee got to criticise the Department without comeback. Then a professor questioned the value of the commissioning system. I’m not arguing with that. Then it all disintegrated.

Why wasn’t my profession asked to speak?

What is being done to protect my profession?

Why is nobody doing…?

The level of disengagement from ‘the system’ by the people who work in it was remarkable. The very real issues were somebody else’s fault, so somebody else could fix them. And before anything will actually be implemented, it needs to be approved by the politicians. Great. Even if they were attempting to run this tiny region, it’s clear they’ll never support anything that may result in a change of services in their local area. Nobody in the room full of Very Important staff in health and social care was considering taking responsibility. There was an awful lot of bickering.

I may have been at the wrong event. Perhaps this was meant to be a ‘letting off steam’ session. I’m glad I had a free place. If a charity had paid the full rate £250 for me to be there, it would have been unjustifiable. The organisers made money and 200 people who could have been problem solving in the health service got a morning out to grumble at each other. That’s a good use of resources, don’t you think?

However, that wasn’t my excitement for the day done. I headed off with Ditzy, I’monlyslightly, Chair, Awesome Academic and her mum to a meeting of the Health Committee. Awesome Academic was presenting on our behalf and the rest of us were the support crew. The committee was running late (members delayed by lunch at the conference?) so we had to hang about for over an hour waiting on them to get round to us.


It was possibly even more tortuous than the event in the morning. Awesome Academic and others made presentations and were then questioned. By which I mean that members read out written questions prepared in advance, regardless of whether the question had already been asked, or the information clearly provided in the presentation. One speaker was asked the same question three times. By the third time, I could have answered for him. It was incredibly frustrating- these were the people we’d chosen to oversee our government?

We keep hearing that there is no money to provide services, to support staff. Doctors are flowing out of the NHS, taking early retirement or heading to Australia. There are not enough nurses. Waiting times for urgent neurology appointments can be 11 months. There aren’t the resources to discharge people safely from hospital, which means there are difficulties admitting people. And our so called leaders whine, waste time and pass the buck.

By the end of the afternoon I was considering taking up politics myself. Easy money, and I’d have minions to write the questions for me. I’d be able to doze during committee sessions and nobody would notice.

Surely I’ve already proved my whining credentials?



8 thoughts on “our health system- in whose interest?

  1. I certainly have to agree with all your observations Fiona.
    Why oh why do ‘they’ have to go round the world for a short cut! All gov departmental employees and I’ve never witnessed such incompetence in my life. As you rightly say, such events are one big yawning session and an eye opener into the world of the deluded.
    As for the patients who are practically killing themselves in a desperate effort to be provided with a functioning healthcare system….we don’t stand a chance as they’re wearing us down with pen pushing exercises.
    If we express our anger, even in a constructive manner, then we’re told we’re just being uncooperative and awkward.
    If I hear the trumph card ‘there’s no money’ one more time I don’t think I’ll be responsible for my actions. There’s certainly an unlimited amount of money for time wasting conferences and meetings that provide no way forward.
    I was recently described by a service commissioner, as a ‘ polite ME advocate’
    therefore I’m acceptable.
    Should we perhaps try to be more unacceptable…….but how, without getting arrested for a crime of passion!

    1. The problem of course is that if we are seen as in any way awkward or troublesome, they can easily avoid listening to us. There must be a magic spot somewhere that is acceptable but effective! We’re all learning how to ask the awkward questions in a way that keeps us in the room, and how to make proposals that will be heard as helpful rather than negative, just to be taken seriously at all. Here is where I rant!!

      1. I thought the online School for Health Care Radicals was helpful “how to rock the boat while staying in it”. Of course it is about keeping going and being the change oneself – but also where to keep going so that influence pushes the right places. Nearly sure I found it from you last year – doesn’t have all the answers but did offset some of the frustrations for me. But don’t get me started on the recent dysfunction in politics – local and international.

  2. Your posts always really make me think. I spent a lot of time trying to come up with words for a response, but I couldn’t make it feel right before I ran out of time and now I have to leave for class.

    Maybe I’ll get to finish my thoughts later.

    Keep up the good work over there. Social reform soldiers come in all sizes, shapes and forms. But no matter how under sung, people like you are so important in making us all rethink how our world should work.


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