This talk about the NHS? Labour and Tories Watch

nutz99
Badges: 18
Rep:
?
#21
Report 1 month ago
#21
(Original post by ByEeek)
Absolutely not. A nurse will only experience his or her very limited world e.g their ward or clinic. The chief exec will have a view on the budget of all NHS functions, demand and how best to deliver the care required. At the end of the day there is limited resource to share out. Is a nurse emotionally invested into the front line really in the best place to say "I'm afraid we just can't afford to offer that treatment?"
I mentioned senior managers, of which the NHS has many, not chief executives. The senior managers are responsible for the day to day running of the departments. Nurses will have a much broader view of the NHS than someone brought in with zero experience in that field.

You wouldn't put a plumber on bricklaying yet they are both in the building trade. The same applies to managers!
0
reply
ByEeek
Badges: 19
Rep:
?
#22
Report 1 month ago
#22
(Original post by Wired_1800)
No it does not work, that is that point. Many people both patients and medical staff have complained about the shambles since the introduction of business managers. Even the Government’s own KPIs are being missed by the managers they put in to improve the system because they felt consultants are unable to run the system.

You have to appoint someone who understands the system and can make the right calls. You should not appoint someone alien to the field to make decisions esp those that involve life or death implications. Many medical practitioners have voiced their concern on so-called “managers” not running the system properly because they are interested more in money than patients.

Like I said before, the NHS is one of the few industries where non-specialists are put in charge of the system.
Its a fair point. So they now have GPs to commission treatment in primary care. It must be working because my GP is so busy commissioning treatment that the last time I asked for an appointment took 2 weeks.

Lets face it. The NHS is vastly more complex and busy than it was. Back in th glory days (80s) I used to go into casualty of a regional hospital with my dad who worked there. They would spend most Saturday afternoons sitting in the staff room chain smoking whilst I played with my RC car in a treatment room. Can you inagine a hospital that quiet today? Back in the 80s mental health wasn't a thing, nor was social dysfunction to the point that A+E was a potentially violent place.

I don't think you can blame the cracks in the NHS on management alone. Everything has changed. I am not convinced that removing managers would necessarily solve anything.
0
reply
Wired_1800
  • Political Ambassador
Badges: 20
Rep:
?
#23
Report 1 month ago
#23
(Original post by ByEeek)
Its a fair point. So they now have GPs to commission treatment in primary care. It must be working because my GP is so busy commissioning treatment that the last time I asked for an appointment took 2 weeks.

Lets face it. The NHS is vastly more complex and busy than it was. Back in th glory days (80s) I used to go into casualty of a regional hospital with my dad who worked there. They would spend most Saturday afternoons sitting in the staff room chain smoking whilst I played with my RC car in a treatment room. Can you inagine a hospital that quiet today? Back in the 80s mental health wasn't a thing, nor was social dysfunction to the point that A+E was a potentially violent place.

I don't think you can blame the cracks in the NHS on management alone. Everything has changed. I am not convinced that removing managers would necessarily solve anything.
Yes, the issue is that we have an ageing population and deep issues beyond the 1980s. We don't need “managers” ruining the system. Consultants know how to run the system and can best be placed to decide where resources go in a hospital.
0
reply
ByEeek
Badges: 19
Rep:
?
#24
Report 4 weeks ago
#24
(Original post by Wired_1800)
Yes, the issue is that we have an ageing population and deep issues beyond the 1980s. We don't need “managers” ruining the system. Consultants know how to run the system and can best be placed to decide where resources go in a hospital.
Good idea. Let's take all the highly paid highly trained consultants and stick them in an office to run the NHS. Great idea.
2
reply
Wired_1800
  • Political Ambassador
Badges: 20
Rep:
?
#25
Report 4 weeks ago
#25
(Original post by ByEeek)
Good idea. Let's take all the highly paid highly trained consultants and stick them in an office to run the NHS. Great idea.
Yes, it is a good idea. Better than having an idiot with no clue making decisions that impact life or death. I hope you or your family never experience such evil.

Just last week, a Chief Executive from a local London hospital decided to close the hospital, despite the protests of the consultants. The reason was that they were not making enough profits. He was being paid £190,000 a year:
0
reply
ByEeek
Badges: 19
Rep:
?
#26
Report 4 weeks ago
#26
(Original post by Wired_1800)
Yes, it is a good idea. Better than having an idiot with no clue making decisions that impact life or death. I hope you or your family never experience such evil.

Just last week, a Chief Executive from a local London hospital decided to close the hospital, despite the protests of the consultants. The reason was that they were not making enough profits. He was being paid £190,000 a year:
So if consultants are running the hospital (They get paid £100k+) who is going to treat the patients? There are many factors that affect the viability of a hospital. £190k wouldn't even pay for one consultant when you consider the support staff and infrastructure they require.
0
reply
Wired_1800
  • Political Ambassador
Badges: 20
Rep:
?
#27
Report 4 weeks ago
#27
(Original post by ByEeek)
So if consultants are running the hospital (They get paid £100k+) who is going to treat the patients? There are many factors that affect the viability of a hospital. £190k wouldn't even pay for one consultant when you consider the support staff and infrastructure they require.
There are hospitals where hospitals have consultants as leaders and they work well. They focus on clinical need and support the organisations more.
0
reply
ByEeek
Badges: 19
Rep:
?
#28
Report 4 weeks ago
#28
(Original post by Wired_1800)
There are hospitals where hospitals have consultants as leaders and they work well. They focus on clinical need and support the organisations more.
Agreed. But who is treating the patients?

It is the same with schools. Teachers become head teachers and stop teaching. They become managers paid huge amounts of money. Are they any better than people who have trained to be managers and come into teaching? I would say it isn't conclusive given the number of failing schools. What we do know is that teachers are good at teaching and consultants are good at consulting. Some will be good at managing as well but to simply say that all managers are ineffective and should therefore be disbanded is good enough to allow you to run for election as a typical ignorant politician hell bent on making a name for yourself by changing things for change's sake without any real evidence to support your cause.
0
reply
Wired_1800
  • Political Ambassador
Badges: 20
Rep:
?
#29
Report 4 weeks ago
#29
(Original post by ByEeek)
Agreed. But who is treating the patients?

It is the same with schools. Teachers become head teachers and stop teaching. They become managers paid huge amounts of money. Are they any better than people who have trained to be managers and come into teaching? I would say it isn't conclusive given the number of failing schools. What we do know is that teachers are good at teaching and consultants are good at consulting. Some will be good at managing as well but to simply say that all managers are ineffective and should therefore be disbanded is good enough to allow you to run for election as a typical ignorant politician hell bent on making a name for yourself by changing things for change's sake without any real evidence to support your cause.
I never said that all managers are ineffective. I simply believe that people in the industry are better suited to the management of the industry.

A consultant managing a hospital will understand the system deeply to make clear decisions IMO. However, a manager dropped in wont understand the system that well and make decisions based on finance than clinical choices.

I have no problem with support staff in the system, but not at the helm.
1
reply
ecolier
Badges: 21
Rep:
?
#30
Report 4 weeks ago
#30
They don't need to be there full time though.

A consultant can do management one session per week, five sessions per week or whatever. There could be 5 consultants doing one session per wee, or 10 - that would be a full week. A senior manager is easily double the wage of a starting consultant. A senior consultant will probably never reach the same salary as a senior manager (I am talking Band 9+).

You'd never get a consultant doing full-time management anyway, because they would mean they lose their practice licence for not seeing patients.

And a lot of consultants aren't on £100k+
Last edited by ecolier; 4 weeks ago
0
reply
ByEeek
Badges: 19
Rep:
?
#31
Report 4 weeks ago
#31
(Original post by Wired_1800)
I never said that all managers are ineffective. I simply believe that people in the industry are better suited to the management of the industry.
Nah. And that goes for just about every industry. Why would a doctor who has studied and trained for 20 years on a very specific and specialised illness / treatment suddenly be a good manager which is a completely different skill set? Sure, they know what they need to be effective and if managed well will get that.

There has long been a myth in industry born out through career paths that the only way for technical people to progress is to move into management. The result is organisations full of brilliant technicians who have become sh1t managers. E.g. BT. Throughout my former software development career I was consistently managed by brilliant techies that couldn't manage for toffee.

It is only having come into teaching where management is taken very seriously that I have finally understood what effective management is. And domain is only a small part of that effectiveness.

At the end of the management is like whack-a-mole. It is much harder than people give credit for. But if you have a load of cobsultants who have spent their entire careers dedicated to study and treatment, why on earth would you make them managers when you could simply ask them what they need and then pay a manager to make the universe revolve around them so that they can treat patients effectively?

That is one of the reasons Microsoft were so dominant in the 90s. They recognised that the software devs were their key assest and hired managers to keep them happy and on task at all costs.
0
reply
modifiedgenes
Badges: 17
Rep:
?
#32
Report 4 weeks ago
#32
Being very skilled in a particular career does not make you automatically good at running a business, even if it is a business operating in a related field- at least in my experience.

Business skills are hard to come by- believe me when I say the majority of a business domain is utterly merciless- those who are no good at it soon find out that is the case because they fail. It is one thing being a very successful sole-trader with more work than you can handle but quite another to be a small or medium or large enterprise where you have to recruit, train or retain staff.
0
reply
ecolier
Badges: 21
Rep:
?
#33
Report 4 weeks ago
#33
(Original post by ByEeek)
...Why would a doctor who has studied and trained for 20 years on a very specific and specialised illness / treatment suddenly be a good manager which is a completely different skill set?...
You do realise that we don't just study diseases right? A lot of GPs are also very broad based and certainly don't spend years studying one thing.

There's a lot of other stuff involved being a doctor. GP do a lot of managing their practice. I feel patronised on behalf of our profession.

But if you have a load of cobsultants who have spent their entire careers dedicated to study and treatment...
Again I feel you are mistaking clinicians with academics. We do a lot of other things, managing junior doctors for a start; teaching medical students is another.

Just to reiterate, management is part of our job whether we like it or not. Extending it is not illogical at all.
Last edited by ecolier; 4 weeks ago
0
reply
Wired_1800
  • Political Ambassador
Badges: 20
Rep:
?
#34
Report 4 weeks ago
#34
(Original post by ByEeek)
Nah. And that goes for just about every industry. Why would a doctor who has studied and trained for 20 years on a very specific and specialised illness / treatment suddenly be a good manager which is a completely different skill set? Sure, they know what they need to be effective and if managed well will get that.

There has long been a myth in industry born out through career paths that the only way for technical people to progress is to move into management. The result is organisations full of brilliant technicians who have become sh1t managers. E.g. BT. Throughout my former software development career I was consistently managed by brilliant techies that couldn't manage for toffee.

It is only having come into teaching where management is taken very seriously that I have finally understood what effective management is. And domain is only a small part of that effectiveness.

At the end of the management is like whack-a-mole. It is much harder than people give credit for. But if you have a load of cobsultants who have spent their entire careers dedicated to study and treatment, why on earth would you make them managers when you could simply ask them what they need and then pay a manager to make the universe revolve around them so that they can treat patients effectively?

That is one of the reasons Microsoft were so dominant in the 90s. They recognised that the software devs were their key assest and hired managers to keep them happy and on task at all costs.
I think you are contradicting yourselves. There are consultants who want to and are capable of running hospitals. Many of these people complained when the Tory Government introduced senior managers to run hospitals thereby pushing them downwards.

Many consultants are that level are capable of making clear and important decisions on the running of their hospitals. We should not just assume that all consultants are incapable or unwilling to take managerial positions.

Let me give you an example, if you have two people Jane and Rachel. Jane is a Consultant Neurologist who has spent many years running medical departments with deep knowledge of the industry. Rachel is a former banker and Oxford MBA grad, she has no relevant experience of the medical industry but has been placed to run a hospital.

Who do you think will be in a better position? Jane with years of experience of being and managing in the industry or Rachel with no experience?
0
reply
ecolier
Badges: 21
Rep:
?
#35
Report 4 weeks ago
#35
Interestingly it seems that I am being completely ignored in this thread. :erm:
0
reply
Wired_1800
  • Political Ambassador
Badges: 20
Rep:
?
#36
Report 4 weeks ago
#36
(Original post by ecolier)
Interestingly it seems that I am being completely ignored in this thread. :erm:
I think ByEeek is unavailable atm
0
reply
ecolier
Badges: 21
Rep:
?
#37
Report 4 weeks ago
#37
(Original post by Wired_1800)
I think ByEeek is unavailable atm
It's fine, I just thought that my input (as a soon to be consultant, currently receiving some management training) would be useful but got no questions directed at me, nor points made about what I said.

I did start commenting in this thread fairly early on.
0
reply
Wired_1800
  • Political Ambassador
Badges: 20
Rep:
?
#38
Report 4 weeks ago
#38
(Original post by ecolier)
It's fine, I just thought that my input (as a soon to be consultant, currently receiving some management training) would be useful but got no questions directed at me, nor points made about what I said.

I did start commenting in this thread fairly early on.
What management training have you received? Do you feel that as a consultant you will be able to combine clinical practice with running large often complex hospitals? What key elements do you think should be added to the NHS to ensure it is fit for purposes? We know cases like the 4-hour window may soon be scrapped.
0
reply
ecolier
Badges: 21
Rep:
?
#39
Report 4 weeks ago
#39
(Original post by Wired_1800)
What management training have you received?
Once a year we have to go to management courses.

Do you feel that as a consultant you will be able to combine clinical practice with running large often complex hospitals?
Not as a junior consultant, but with time I don't see why not. My current boss is the head of specialist medicine.

As the LNC rep for my hospital, I attend regular board meetings so meet the Chief Executive and the Chief Medical Officer (as well as other important people in our trust) every month.

But we go to clinical governance and service provision meetings every month, talking about our budget, complaints, mortality, audits etc. etc.

While there's a manager (or several!) there, the meeting is led by the head of department consultant.

What key elements do you think should be added to the NHS to ensure it is fit for purposes?
Woah that's a question that I wouldn't be able to answer in a post!

We know cases like the 4-hour window may soon be scrapped.
The current 4 hour window means that patients are just admitted to another holding ward just before the time is over. Scrapping it, perversely, may mean that patients go home after e.g. 6 hours, instead of staying a few days in a holding ward.
^^ Now, will a manager know this? Probably not.
Last edited by ecolier; 4 weeks ago
0
reply
Wired_1800
  • Political Ambassador
Badges: 20
Rep:
?
#40
Report 4 weeks ago
#40
(Original post by ecolier)
Once a year we have to go to management courses.



Not as a junior consultant, but with time I don't see why not. My current boss is the head of specialist medicine.

As the LNC rep for my hospital, I attend regular board meetings so meet the Chief Executive and the Chief Medical Officer (as well as other important people in our trust) every month.

But we go to clinical governance and service provision meetings every month, talking about our budget, complaints, mortality, audits etc. etc.

While there's a manager (or several!) there, the meeting is led by the head of department consultant.



Woah that's a question that I wouldn't be able to answer in a post!



The current 4 hour window means that patients are just admitted to another holding ward just before the time is over. Scrapping it, perversely, may mean that patients go home after e.g. 6 hours, instead of staying a few days in a holding ward.
^^ Now, will a manager know this? Probably not.
Interesting. Soon you may have sufficient experience to run the organisation.

I am still interested in knowing what key elements do you think should be added to the NHS to ensure it is fit for purpose.

I went to a hospital recently and their process was fantastic. When you got in, you went to the reception and spoke with someone. After about 25 mins, you are seen by a nurse or a medical assistant, who assesses you. If your case is not serious, you are given a solution and sent away. If you case is serious you are asked to wait to be seen by a doctor. I was there for about 90 mins and it was one of my quickest visits to a hospital.

I wonder why many hospitals don't adopt such processes.
0
reply
X

Quick Reply

Attached files
Write a reply...
Reply
new posts
Latest
My Feed

See more of what you like on
The Student Room

You can personalise what you see on TSR. Tell us a little about yourself to get started.

Personalise

Are cats selfish

Yes (144)
61.28%
No (91)
38.72%

Watched Threads

View All