Perspective

primary_care_training_perspective

News and Comment from Roy Lilley.

Being half a world away gives you a different perspective on life.  For instance, the coverage of Sunday's, F1 Grand-Prix is so much better in Australia.  Channel Ten. 

It's proper coverage.  Not the fatuous 'grid-walks' and pit-lane gossip we are dished-up.  It's all-day coverage with proper interviews with the drivers and the teams.   The classic car parade and all the rest.  

The commentary is not the hysterical shouting match we are used to.  It's measured, interpreted and thoughtful.  Is it better because it's different?  No, it's just better.

We somehow think everything we do in the UK, England, is the best it can be.  We lose perspective.  

I got sent a clipping from the UK's Sunday Times announcing;

 'May orders £4bn Brexit boost to save the ailing NHS.'

It made me think; perspective is about the only thing you can get a handle on.  You may not have control over the situation but you can control how you see it.

So, the Maymite is going to save the ailing NHS.  The first question that comes to mind; why is it 'ailing'.

Is it 'ailing' because it it has done something wrong?  Been badly run?  Managed poorly?  No, it's 'ailing' because it has been neglected, starved of money, fiddled about with, bullied and pushed and punished.  

Good people have lost their jobs when they were unable to meet performance targets that have since been abandoned.  Four million people are waiting for the NHS to treat them.

A more appropriate headline might have been;

 'May apologises to the ailing NHS for screwing it up.'  

It's all about perspective.

Apparently the Tinkerman announced we are to train 3,000 extra mid-wives over the next four years.  Thats about 750 a year.  How many midwifes retire, leave, fall out of training in a year?  

Why 3,000?  What do the demographics tell us? 

The distribution of nurses and midwives as a percentage of population across the EU; UK 8.4, pretty well everywhere else in Europe, a lot more.  Germany is nearly 14.

It's all a matter of perspective.

You can see what's coming.  Everyone will be sick of Brexit.  Sick of watching institutions and relationships ripped apart, life becoming increasingly more difficult and complex.  Switching our attention to a domestic agenda is an attempt, perhaps and unscrupulous attempt, to change our perspective.

In the NHS' 70th year, a 'birthday present' is a tempting piece of lazy politicking, with the view to an election not far off.

The NHS has fallen behind in the EU rankings for health spend.  Fallen behind countries equally beset with the aftermath of the global banking crisis in 2010.  Some countries care about the health care systems and put it centre stage.  They have a different perspective. 

No matter some systems are funded differently, structured differently.  Other countries have put the money it, we haven't.  Our politicians will argue, 'more money' has been put in.  It's true but the trajectory of funding has been little more than a flat-line since 2010.

Annual growth in NHS funding, since 1948, has been roughly 4% a year.  Since 2010 it's been around 2%.  The difference in what the NHS does and what it is paid to do is about £20bn, perhaps more...

The NHS cannot meet its obligations under the Constitution.  Once the CQC hounded good people out of office for missing targets.  "Badly led' they said.  Now, no one seems too bothered.  I doubt they will apologise.  It's all a matter of perspective.

From where I am most people see the shenanigans in Blighty as transparent, election engineering.  Clumsy, taking people for mugs.  Cynical policy wonks desperate to keep hold on power.  Leveraging the NHS its patients and staff to their advantage.

Finding money when there wan't any.  Relaxing rules when it suits and missing them... is embarrassing.

There are three ways to look a things.  Your way, their way and the truth.

It's all a matter of perspective.

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roy.lilley@nhsmanagers.net 

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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.