Absolute stupidity of NHS Reorganisation

Before the last general election in the UK the leader of the Conservative Party declared that he wouldn't impose yet another re-organisation on the NHS if he was elected as the new Prime Minister. Promptly on arrival as the new PM he handed control to a dubious politician called Andrew Lansley. This silly man promptly set about reorganising the National Health Service. He has this "bee in his bonnet" that is he removes layers of management from the NHS and hands control to General Practitioners (Doctors) they will magically reduce the public costs of the NHS. This man Lansley has the stubbornness of a dead donkey and the listening ability of a beach pebble when it comes to listening to the views of the massive majority of the health care professionals. Just about everyone says scrap the new new re-organisation.

Here's some of the problems:

• The GPs are independent contractors (I have a letter from the Dept of Health confirming that); their own profit comes first. Giving them control of the purse strings give them the opportunity to avoid any measure that would reduce their profit.
• The GPs won't have spare time to run the national organisation or even local ones. They'll just re-employ the bureaucrats who used to run the defunct Primary Care Trusts. It won't save money.

Here's a real life example of the changes in progress right now. A friend of mine is a Nurse Practitioner. She's a highly skilled medical practitioner who has a cluster of medical degrees, over 30 years experience who works without the need for clinical supervision at the level of GP/Registrar. Her costs are about half that of a highly paid GP. As a direct consequence of the re-organisation she is being made redundant. Well not exactly redundant, the patients she used to see are being redirected to the local A&E department. The cost the public purse per patient has increased by a factor of three and queues will lengthen in the A&E. 

This senior nurse's redundancy settlement has yet to be agreed, but by the Departmental rules the additional cost to the public purse will be close to £500,000 if an unfair dismissal claim is to be avoided. Meanwhile the same group of GPs who pushed for the closure of the Nurse Practitioner's department are looking to employ her on a freelance basis at a Doctor's rate of pay. The nurse didn't ask for the re-organisation and she doesn't want to be made redundant. She is a strong proponent of the NHS. How many times is this type of situation going to be repeated throughout the NHS?

Who's snooping on your site?

We occasionally check who has been accessing the websites set up for each of my published books. This is fairly easy to do because every time someone visits a web site there's an electronic trail left in the log files on the web server computer. From those details we can check who owns the IP Address of the person/organisation making the enquiry.

On the Company Mole web site we found one interesting entry(IP: 30.100.21.18) leading back to a company called Cyveillance Inc which is owned by QinetiQ. QinetiQ is the research company which was spun off from the British Ministry of Defence. It is often involved in classified work and the Intelligence services.

The log entry showed Cyveillance had scanned all of the Company Mole web site. A look at the Cyveillance public web site shows as part of their public activities they are involved in "Brand Protection" for major corporate organisations. Interestingly our CM web site is set up so it can only be accessed by name "www.companymole.com", so this was no random search. Maybe Cyveillance has discovered the truth about the Foundation of Honour? Is Adam Cranford now recorded on a secret massive intelligence database?.

GPs in charge of chaos in the NHS

I've posted before on the matter of NHS Walk-In Centres being closed in the UK, now I've experienced it for myself. Unusually I've come down with a cold which has migrated into a chest infection. For the first time in 15 years I've phoned my local GP Practice to ask for an appointment to see my GP so I can get a dose of antibiotics to knock this infection on the head. No appointments for 3 days, even then that would be with a locum doctor. GPs should not be allowed to hold the NHS purse strings.

What do they expect - should I let the infection progress until I end up in A&E?  There used to be a Walk-In Centre in the locality managed by experienced nurses where I could be seen fairly promptly, but that has been closed, the next nearest WIC closed a couple of months ago.

I'm going back to bed and hope that my body can deal with the infection. I've contributed money to the NHS all my life, and now when I need their assistance I've been let down. Nice one Andrew Lansley! He is so keen to listen to the well paid GPs and let the Walk-In Centres slide into oblivion.

Black Hole devours nurses

I've earlier written about the death of an NHS Walk-In Centre, I'm now watch the terminal stages of this process in one location. It's nothing new I've seen it before and I'm sure the remaining Walk-In Centres will suffer a similar fate.

This is a direct consequence of Andrew Lansley's misguided leadership of the NHS. Abolition of the Primary Care Trusts have left Primary Care Walk-In Centres without any real sponsors. The General Practitioners (GPs), who now hold the purse strings in advance of actual parliamentary approval, will not save the Walk-In Centres because it disturbs their Edwardian business model of private practice partnerships.

No, the WIC I'm watching has been handed over to the black hole of a local A&E department of an Acute Trust Hospital. The once highly efficient team of Primary Care Nurses is being torn apart. This is a team which has worked for 10 years, rarely breaching patient time waiting targets and almost zero serious patient complaints. Nurses who were trained to work as autonomous practitioners who are qualified and able to assess medical conditions and to prescribe treatment. Their clinical leader has been elbowed away and replaced by an A&E nurse manager who has no experience of Primary Care medicine. The remaining Primary Care nurses are looking for new jobs having been told they are "not competent" by someone who has no experience in their skills. The GPs who once worked as part of the team are refusing to work with the new management. Within a few months little trace will be left of what was once a strong team.  

One remaining question  is what happens to the funds assigned to the WIC Nursing team? Does it get buried in the A&E hoard? What happens to the (average) 200 people who used to go to the Walk-In Centre? Their needs don't go away.

Update May 2012:
The Matron of the A & E Dept which absorbed the WIC has resigned. She's tired of the bullying from senior managers and clinicians, meanwhile the Matron of the now closed WIC is in the final stages of redundancy. It all seems a silly waste of resource to me.

Lottery strategy

When buying a lottery ticket, only buy one row on the card. The odds against winning are so remote buying additional rows doesn't make a great deal of difference. It's a bit like dividing infinity by two, it is still infinity. Your lucky day will either happen or it doesn't.

Now I'm going to suggest something contrarian. If you buy one ticket, always buy a second ticket but using exactly the same numbers for the same day as your first ticket. In that way if you win the jackpot you guarantee getting a greater share of the jackpot if other people also get the winning numbers. At the very least you can tell the wife that you have a winning ticket for the lottery in all good faith ....

Stupid Vendors

It's been a really annoying past couple of days. The angst has been caused by stupid vendors and their idiotic approach to identity checking. The trouble started on Sunday when my wife tried to change mobile phone supplier and purchase a new phone. The phone was only £70 and the monthly contract was only £20 a month. She's already got an existing mobile phone service supplier, but has to change for external reasons, at her new offices only O2 has any real coverage and she's with Vodafone. So after waiting close on 20 minutes for an O2 shop assistant and another 15-20 minutes while he fussed over the paperwork while my wife gave full personal details banks, accounts, produced bank cards, etc the assistant finalises the order then peers at the screen and announces that my wife has to produce a passport or driving licence plus a utility bill. Why couldn't he have done that at the start?

We found it really annoying, I had my driving licence, but that was not good enough. We've lived in the same location for 29 years, own the property outright and have good high paid stable professional jobs. My wife didn't have a passport/driving licence with her, so we told they they'd lost the order and walked away. When we got home we placed the same order on-line with Carphone Warehouse and it was accepted, or so we thought.  This evening we got an email from Carphone Warehouse saying the order with O2 had failed on a credit check!! We have do debt, we've never been late in paying bills. Carphone Warehouse cynically suggested we tried other vendors through them, but if we wanted to check the credit issue we should talk to Equifax. 

To talk to Equifax we have to create copies of three identity documents and send them to Equifax, wait for that to be processed, create an account, purchase a credit report (using the same credit card rejected by O2) and wait until the report is delivered. If there is anything wrong on the report we can then "challenge" the record.

It was at that point I remembered getting a call from the ISME.com (a catalogue company) security department asking if I'd raised an on-line credit account with them. To which I replied "No, I never use credit accounts." After a couple of weeks they came back to say they'd investigated and realised that someone other than use had used our address and obtained goods on credit and then not paid for them. ISME put a marker on our credit file. We'd not done anything wrong, but ISME had been stupid enough to send goods to another address, because they'd never delivered to our house. So through ISME's poor procedures our home address has a black mark against it through no fault of our own.

O2 are probably relying on the Equifax report which probably has reference to the ISME screwup. It doesn't appear to be relevant to O2 that I already have two active  mobile phone accounts with them registered to that same address. They'd prefer to mess my wife around with their crude credit processes.

Well, they will pay the price for their poor procedures. I always punish such bad service. They're going to lose one of my mobile phone accounts and that will cost them dear. If Equifax has the slightest wrong data on our files I'll be getting them to provide evidence in support or I'll be off to the Information Commissioners Office.  O2 and their parent Telefonica will pay in the long term too, unless they come up with a respectable solution. I often get the opportunity to steer the telecomms business of some quite large companies in many locations in Europe.

To top it all Amazon's computer system insisted I use amazon.co.uk instead of amazon.com. It really screwed up the testing I doing for the release of a new book. Nice one Amazon, set your business policy on what Amazon execs want rather than what the customer needs.

Edit 26th Jan
My wife decided to bite the bullet and go back to the O2 shop with a print of her clean credit record, driving licence, utility bills. We were in the shop for 105 minutes as the shop assistants struggled through the O2 computer procedures to issue a £70 phone. It is unfortunate that O2 have a service monopoly in the large building where she works otherwise we'd have told them to get lost. However they won't escape my punishment.

Send to Kindle

I've recently come across a free new tool from Amazon. It is an application which allows you to send documents from your PC to your Kindle device. It converts to either pdf or azw. The application can be found here. Here's some more information about the tool. It seems to work quite well with a couple of minor issues on font conversion which I'll investigate further.

It is definitely worth a try.