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Having learnt little from the problems caused by school league tables, now Wes Streeting looks interested in introducing hospital league table into the NHS.
Its just what a workforce already patterned by overwork, exhaustion & burnout, does not need.
With the NHS already losing staff as fast as it can train & recruit them, this just looks like one more body blow intended to strengthen the appeal of the private sector...
not so much a 'solution' as a further attack.
@ChrisMayLA6 Jeez. What a shithead. What is it with these people?
@ChrisMayLA6
I always thought it would be good if Ofsted found a school 'unsatisfactory' they have to stay there and help fix it until it's good. Make them part of the solution - problem solvers instead of problem finders.
@ChrisMayLA6 Didn't work last time; won't work this time...
I'm not surprised to find David Spiegelhalter is one of the authors of a paper I remember reading about thirty years ago. Shame the figures are missing from this version.
Thanks, useful (vital) historical context & boosted....
@ChrisMayLA6 The history of adjustments to data should warm him off, but it won't!
I trust those hospitals highest in the league table will get their funding cut. Due to their higher performance they don't need so much money for the same tasks. Those near the bottom should get more so they can employ more staff on a higher salary, like the London weighting allowance, was introduced to encourage more staff to work in London.....
Or are we going to see widespread closures in remote & poor areas?
I so wish they would adopt the logic in your main paragraph in the University sector.... but as you (ironically) expect it will be the 'poor performers' who will likely be punished via de-funding ensuring they can never better their 'performance' in real terms.
@ChrisMayLA6 of course the problem is Streeting sees the world as a zero sum game. So rather than enriching all of England by raising the health and health care across the board, he can only see it as winners and losers. Funny how Shelley summed it up so well "The rich get richer, while the poor get poorer" and that music hall song keeps on playing,
"it's the same the whole world over,
It's the poor what gets the blame,
It's the rich what gets the pleasure,
Ain't it a blooming shame!"
@ChrisMayLA6
"naming and shaming" is the most toxic way to treat any kind of performance issues. It does absolutely nothing for morale (already at rock bottom in a service that I know and have loved all my working life) but it also completely fails to address the underlying underfunding and lack of investment in both NHS estate and in its most valuable asset, those workers at all levels who keep it afloat. And I know whereof I speak when it comes to both the NHS and toxic shame.
Yes, but its all too predictable that they would want to introduce it even if its demonstrably had toxic effects elsewhere its been rolled out.... its at times like thus that I have some sympathy for critics who want to label it 'neoliberal'.... as while I have my problems with the general use of the term, when it comes to the imposition of these sorts of management methods, it does have some analytical purchase.
@ChrisMayLA6 well it is a table of which bits are the most profitable to be sold.....
@ChrisMayLA6 he will use the “league tables” to pick off parts of the NHS to privatise.
Cutting the NHS is extremely unpopular so he needs a narrative to justify moving sections of the health service into the private sector and he thinks the league table will provide that
yup, my reading of the likely strategy too.... (and others in replies)
@ChrisMayLA6
Has he actually looked at how hospitals work these days? In the last few years I've been treated at four different ones because each is the regional centre for certain conditions. My local hosp, Bedford, sent me to Luton for oral cancer surgery, to Cambridge for prostate cancer radiotherapy and to Stevenage for renal anemia treatment. How can 'Ofhosp' or whatever they call it compare them? The man's a fool, but dangerous.
@Walrus
@pthane @ChrisMayLA6 @Walrus I guess as medicine progresses meaning specialists rather than generalists and technology becomes more prevalent the old idea of a local hospital cannot be maintained
@ChrisMayLA6 League tables in the NHS will be gamed in the same way as CQC inspections were.
A vast amount of middle management time will be spent in massaging the figures and scoring imaginary points.
The time and energy that senior managers will spend coercing those further down the heap will be wasted when all of them want to get on with enabling the clinical staff to provide better healthcare.
I cannot see how areas of health deprivation can be compared with areas of health excellence; how to compare areas where staffing costs & supply are challenging; or how to compare units in 'state of the art' facilities with those struggling in Victorian buildings (or worse - 1980s schemes!).
No fiddling with algorithms will compare them.
It's a bonkers idea that (I hope) will be quietly dropped afte a few years.
we can but hope (that its dropped), but sadly inside the M25 & in the Westminster Village its treated as a cure-all... so my hopes are expecting to be dashed
That is of course what happened last time round in the first half of the 2000s. #Wesstreeting used to know this but seems to have chosen to forget - one has to hope that his amnesia is not shared by #rachelreeves and #darrenjones !
another hope that might be dashed, I'm afraid....
Last time #alanmilburn damaged the reputation of the #nhs for cost effectiveness - and thus its credibility with #hmtreasury . However given abundance of resources at the time this was not fatal and in term successors - most notably #andyburnham - managed to repair it. This time round we may not be so lucky!
Last time #alanmilburn damaged the reputation of the #nhs for cost effectiveness - and thus its credibility with #hmtreasury . However given the relative abundance of resources at the time this was not fatal and in time his successors - most notably #andyburnham - managed to repair it. This time round we may not be so lucky!
@MikeFromLFE @ChrisMayLA6 A few years? The NHS doesn't have a spare few years to prat around with idiocy like this.
@MikeFromLFE @ChrisMayLA6
Indeed and these sort of schemes end up with unexpected and distorted consequences with loads of time spent to meet a target at the cost of best practice for the patients
@ChrisMayLA6 as someone who for 20 years avoided doctors for fear of what it might cost, I can only say that the US Medical Industry is the worst possible model, not something to which one should aspire.
Even if you have insurance, & all goes well with the procedure, the hospital will hound you to pay staggeringly high bills while the insurance company drags its feet. Eventually the hospital will accept a fraction of the amount that the uninsured are billed.
Expensive inefficient & stressful.
@ChrisMayLA6 additional context - my step daughter works in hospital billing, all day every day is spent negotiating with her counterparts over which parts of an invoice that may run to dozens of pages will be paid by insurance, which will be a surprise bill to the patient, and what will be written off.
She hates her job, and in what sane society would it exist?
Mark Nicoll 3.5%
@ChrisMayLA6
"The NHS already losing staff as fast as it can train and recruit them"
So they've decided to improve pay and working conditions to help with retention, whilst cutting the cost for students studying medical courses to aid recruitment.
No?
Huh, I wonder why.
@ChrisMayLA6 @WilliamNB And just as 'choice’ has caused increased traffic on the school run as parents chose schools further away, and local schools were left to fester, this will have the same affect on hospitals and traffic.
It may not be entirely coincidental that #alanmilburn has just been appointed as Senior Nonexecutive Director at the Department of Health and Social Care!
One has to hope that #alanmilburn will not become the #didoharding of the current #ukgovernment - a decorative but expensive albatross round the neck of the #nhs !
@ChrisMayLA6 What use is an NHS hospital league table supposed to be? It doesn't offer the punter any choice, as there's (outside a few large cities) likely only one NHS hospital you can be referred to anyway.
@ChrisMayLA6
That boy ent rite in the head. 