A dysfunctional relationship

On Thursday, the British parliament did something wonderful: it not only put the brakes on the juggernaut trundling to war, but it went further and forced the PM to concede that, certainly at this time, the British people did not want to get involved in another ill-thought-through Middle Eastern escapade. Since then, some people have been banging on about the damage done to the "special relationship" we supposedly share with the US. The Defence Secretary, Philip Hammond, was among this sorry chorus chanting "Woe, woe and thrice woe!". But hold on - if we have any kind of 'relationship' and if we are supposed to be friends, doesn't that mean that we should be able to speak openly, to disagree, to hint pretty loudly that we think the route being pursued by our friend is wrong? Surely true friendship isn't about the bigger, richer friend being allowed to make all the decisions while the weaker, poorer friend merely tags along for the ride, hoping that, if things turn out well, some reflected kudos will maybe come their way? In my book, a true 'relationship' or 'friendship' would mean that each party can say what they feel without fearing that a wrong word will cause a spiteful reaction from the other. If we are in a 'relationship' of any sort - special or not - with a power that might arbitrarily cut us off because our elected representatives had the temerity to listen to the people who put them there, then that is no relationship that we should want to be part of.

The other thing to come out of the vote in Parliament was the story that Michael Gove, the Education Secretary, stood and hecked the Tories who voted against the government by screeching at them "Your'e a disgrace!". No Michael, actually, they are a refreshing change: MPs who were not prepared to cow-tow to the party whips when their constituents had voiced concerns over our getting involved in another war while our troops are still being killed in Afghanistan. What those MPs were doing, Michael, was called democracy as it should be: we, the people, elect representatives to represent our wishes in Parliament. MPs are elected by people within a constituency. Due to the complexities of the British voting system, most people end up voting along party lines but but they are still voting in the belief that, whoever they elect, that person is going to look after the interests of their town, to promote and defend it at a national level. When those MPs voted against the motion last night, perhaps they actually showed that some in Westminster still understand the relationship between the electorate and the elected. Mr Gove's relationship with the democratic process in pouring scorn on their actions would seem to be just a little dysfunctional.

Wrong Comparison

Recently, the Chief Medical Officer, Sir Bruce Keogh, published his report into what might be done to turn around 14 hospitals deemed to be 'failing'. It was a very good report: clear, concise and featured eight actions that, if put in train, might improve not only the 14 hospitals in question, but many other providers that are teetering on the brink of joining them. Then, a few days later, he said this about the need for the NHS to do more with less resources:

“If you go down to PC World or Dixons, each year you would expect to pay less for a PC and you would also expect the specifications to improve. I have all sorts of people [in the NHS] saying to me: ‘Give me £1,000, give me £200,000; I can improve our service’. My challenge is: every other aspect of industry has to improve the quality they offer for less. So we need to change that mindset.”

Now, I don't necessarily have a problem with his stating that we (the NHS) will have to do more for less: that is, like it or not, a fact. With savings of £20 billion already fracturing the service and a further £30 billion that wiil, potentially, need to be found down the back of the sofa coupled with increasing demand, the NHS is going to have to do more with less. What I find a bit misguided is his use of the 'PC World and Dixons' analogy. Dixons disappeared from our high streets some while ago (are you trying to tell us something, Bruce?) and PC World...well PC World are hardly the business that I would like to be compared with. PC World is staffed by too many people who know little about the products they are selling, they are just interested in shifting units. On top of that, their aftersales service, unless it has vastly improved, is awful. As I say, it's about shifting units, not customer care, entirely the opposite to the model I would hope Sir Bruce would want the NHS to employ.

In addition, PC World merely ells the gadgets: it is not responsible (in the main) for the unit cost of those gadgets. That the cost of computer memory has dropped like a stone in the last ten tears is not down to PC World. The technology that PC World sells is getting ever cheaper. The technology that the NHS employs, whether it is drugs, devices, scanners of radiotherapy units, is getting ever more expensive. The costs of training the doctors and nurses to deliver healthcare is, I would suggest, increasing at a rate that far outstips the rise in the wage bill at PC World. To me, comparing the NHS to PC World and Dixons is about about as useful as all those people who say "Running the economy is just like managing a household butdget". It isn't, not even close. And the coming/current NHS funding crisis is going to take rather more to solve than staff rolling their sleeves up and 'piling it high and selling it cheap'.