A healthy fiasco

How much should it cost to run our health service?

It’s a complex question and a part of the answer must be “It depends on how many people get sick”.

However, there is a widespread and creeping feeling of discontent based on a suspicion that Health is not the lean and efficient machine it could be. A feeling of a bloated bureaucracy feeding off of a sympathetic public purse whilst everyone else struggles.

Do we get value for money from the MSG or is it making the most of its monopoly? Do we really need to import so many nurses and use agency staff, who for some part are the same people employed by Health but working in their spare time?

Do we need to send recruiting parties out to Portugal when we know we have a batch of newly qualified nurses just about to graduate? Yes, this actually happened in the past year.

It was only through that excellent travelogue Island Hospital that I discovered our hospital had an arts curator. How about that for an essential spend in times of austerity?

So who does control Health?

I can’t imagine the political minister or his board having sufficient specialist and in depth knowledge to be in total control but we do expect them to at least grasp the reins with confidence.

The problem seems to be that the real people in charge are many, various, and beyond accountability; hidden within the ranks of the full time civil service at one level or another. Sadly, a story which is repeated in department after department.

Perhaps it’s time for the head of the civil service to go public and inform his paymasters what he is doing to bring efficiencies to his own organisation. Perhaps it’s time to introduce some accountability to this area of public life.

Most users of our health service have nothing but praise for the front line staff and the care they deliver and long may it be so. Compared to the NHS, our organisation is superb and we should not forget it when reforming as reform we must.

The last Health board tried and failed to play the sympathy card by showing that the lack of money was hitting those most in need of care. Its failure was a timely acceptance that even Health needs to make cuts. Not necessarily in the front line but meaningful savings must be made.

Maybe there just aren’t these opportunities for meaningful savings within Health but that is not the public perception. Furthermore it is not the perception from those within the organisation; those who are afraid to speak publicly but who’s views still make it into daylight. Maybe these are malcontents but the suspicion is otherwise and until such suspicion is removed we will all be less than contented with Health.

Let’s face it, nobody is going to say that their job is unnecessary or that it could be amalgamated with another role. Turkeys don’t vote for Christmas. No middle manager is going to tell their boss that neither of them are really necessary as each must feel they are contributing something vital to the smooth running of the organisation. Maybe that is so, but something has got to give somewhere as we can’t keep feeding and growing this giant.

The question is “How can we save money without reducing service”? Can it be done and who is best to do it?

Treasury have already parachuted in a team to look with fresh eyes at the budget so hopefully we can manage this transition without the help of expensive outside consultants. Have a look here to see why.

http://guernsey1-2-1.blogspot.com/2012/02/do-we-really-need-consultants.html

If we had to start again, what sort of health service would you build? Can we get there from here and if not, how can we get there without disrupting services? Most importantly, would such a new system cost less than the current model?

Difficult questions and ones that few of us can answer. It needs the brains and expertise of those already working in the organisation. Hopefully, and with a new political broom, we will see some changes.

At some stage we are going to have to either accept the cost of a good health service or accept the compromises that a lower budget will inevitably bring. Do this having proved that Health is lean and efficient and then let the public have its say.

Personally I’d then rather pay for a proven efficient health system than support the cultural enrichment of the Island. 

Now there is a department ripe for a healthy budget cut.