News and Comment from Roy Lilley

Nothing is what it seems

Zen thinking… and that is why you should challenge and question everything.

Beyond good and bad, what is there? The answer is the truth and even that is subjective.

The truth only appears when all sense of subjectivity ends. Most people’s sense of reality is never really true.

We see the truth through the lens of the personal beliefs we attach to things.

There are some things you know you just can’t believe and for a start, news headlines should never be believed.

Government will spend billions

to build 40 hosptials.

No, the government is not… but they are. It’s called duality; dividing the truth into two opposing pieces, where nether side actuality reflects the absolute truth.

Seen through the eyes of government, they are. Seen through other eyes, they are not. What will you see?

If you are working at; Whipps Cross, Epsom and St Helier, West Herts. Princess Alexander, UH Leicester of Leeds Teaching you will certainly see some jolly pleased people, at the prospect of a new hospital, or lab or whatever.

The shambolic, unfit for the future, has been recognised at last. From the huge backlog, how would you chose who and what to fund?

Paul Scully, is MP for the St Hellier hospital and the conservative party vice-chairman who replaced Stephen Hammond when he failed to vote with the Government over a little matter of Brexit.

One of Whipps Cross MP’s, Tory, Ian Duncan-Smith, a fanatic about leaving the EU.

Robert Halfon has campaigned for a new hospital at Princess Alexander, and voted to leave the EU.

Perception is everything… Zen.

Jonathan Ashworth, shadow No18, denounced the plans, despite Leicester being in his Bailiwick.

The relative world, of subjective contrast and comparison, is a false world, built entirely by each person’s imagination… more Zen!

The capital is to come in two clear parts and later, a mystery. First; £2.7bn to fix-the-six by 2025.

The second tranche is, what’s-in-store-for-the-34; £100m to pay for plans, planning, architects, building consents and signed-off, full business cases and to be built by 2030… providing the cash is available.

The mystery third, is to fund successful plans in an open competition.

In the small print, there is a bit more. The NHS can look forward to multi-year capital settlements, most likely from the next budget, to make planning capital improvements easier.

Fixing-the-six by 2025? I make that, give or take, 260 weeks. If plans are shovel ready, they may still have to go out to tender, or refresh the tenders they have, check, again, with the local authorities and get a wiggle-on.

Post-Brexit building costs will be impacted by workforce shortages, two thirds of construction materials are imported directly from the EU and let’s not forget the slump in the value of the pound.

Also construction material importers will have to pay VAT upfront on anything they bring into the country… which may delay their supply chain.

There is also pressure on the construction industry to build a million new homes, creating a capacity issue.

I’d guess any quote for a project that’s been sitting on a shelf, will need urgent review.

What’s in-store for the 34? If the first six are to cost £2.7bn, that’s about £400m each. Thirty-four will need, getting on for £14bn by 2030. In a post Brexit economy? It’s a gamble, even if it goes well. Taxes, more taxes, or borrowing… or quietly sidelined?

And, as the Health Foundation pointed out;

‘… With a backlog of maintenance and repairs that amounts to more than £6bn – much of which threatens patient’s safety – and dozens of upgrade projects that have been delayed or cancelled, the figure needed is closer to £3bn each year for the next 5 years.’

Finally, there is the ‘competition’, for an unspecified amount, between 2025 and 30. How much of the existing building stock will be on its last legs by 2030, is anyone’s guess.

I think I’d prefer a planned programme of maintenance, refurbishment and renewals… to a lottery, competition, raffle or lucky dip.

When you move your focus from competition to contribution, life becomes a celebration… Zen.

Like I’ve said before, if there is any new money for the NHS, I’ll be first in the queue but…

Things are what they are, we see what we see. Things cannot be two things at the same time. Yet they are. Some will see a future with 40 new

hospitals. Some won’t…

Seeing is believing, yet believing may be deceiving… more Zen.

Contact Roy – please use this e-address – roy.lilley@nhsmanagers.net

Know something I don’t – email me in confidence.

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