Posted May 31st, 2009
by hsb10
Next week I am taking a trip to Venice for four nights and leaving the laptop at home. I’ve not written as many posts in the last few weeks because I have been busy working on a new project called Life in Leeds, and I launched it this week.
Impact of the recession
Since I am away on my holiday, I thought I would open up this post and I would like to know where you are going on holiday, how you have booked your holiday this year and has the recession impacted where you are travelling to.
Normal service will resume on my return.
This post was syndicated from the Travel Rants blog. Signup for the free Travel Newsletter or subscribe to the Travel RSS feed for regular updates like this.
Venice, my life in Leeds and recession impacting holidays
Posted in Other Ranters, Rants
Posted May 31st, 2009
by hsb10
So I’ve got all these fancy blog posts planned. More than planned, actually — they’re well underway. But it’s also been a busy couple of months, so nothing’s really ready yet.To make my schedule even worse, I kind of sort of got myself a little bit addicted to the writings of this one blogger. Normally I can’t frigging stand blogs, including my own. Everyone always asks me what blogs I read,
Posted in Other Ranters, Rants
Posted May 31st, 2009
by hsb10
Over the holidays I read a neat book called Predictably Irrational: The Hidden Forces That Shape Our Decisions, by Dan Ariely. The book is a fascinating glimpse into several bizarre and unfortunate bugs in our mental software. These bugs cause us to behave in weird but highly predictable ways in a bunch of everyday situations.For instance, one chapter explains why bringing an uglier version of
Posted in Other Ranters, Rants
Posted May 31st, 2009
by hsb10
We’re getting close to the end of my blog. After today’s entry, I only have three left to write. After that, I’ll only blog anonymously or (more likely) not at all.This is part three of five in my "Programmer’s View of the Universe" series. I struggled for a while with how best to introduce the ideas in this installment, and ultimately opted for a short story.This is a science fiction short
Posted in Other Ranters, Rants
Posted May 31st, 2009
by hsb10
Booking your holiday online can sometimes be frustrating and time consuming if you are looking for something out of the ordinary. If you want to book a package holiday, 7 or 14 days, then the process of booking online can be a breeze when you decide on the destination.
Consumer requirements changing
Consumers have become more adventurous, or know the hotel and how and where they want to depart from. Some holidaymakers do not like staying in the same place and prefer a multi-centre holiday and this is when booking online becomes frustrating.
One reader ranted that he knew the Paris hotel that he wanted to take his partner to, and they wanted to travel on Eurostar, but could he find an online travel agency to meet his requirements, no. Quite rightly he wanted to book through a reputable bonded agency.
To be honest; he would have been quicker booking it himself.
More travel agencies need to change with the times
I think this is one of the things that frustrate me in that ABTA, CAA, tell us to book holidays through their members, but, they are not flexible enough to deal with consumer’s demands in 2009. Time has moved on, the number of people demanding simple holidays has reduced in the last four years.
I am interested to hear what frustrates you about booking your holiday online.
This post was syndicated from the Travel Rants blog. Signup for the free Travel Newsletter or subscribe to the Travel RSS feed for regular updates like this.
Lack of flexibility when booking holiday online
Posted in Other Ranters, Rants
Posted May 31st, 2009
by hsb10
You want to feel like the travel agent wants your business and a rant received questioned the commitment and helpfulness of some travel agents. As the ranter said, you’re not asking for miracles, you just want the agent to give you the impression that they want to help you book your holiday.
You do not want to feel like you are an inconvenience.
Coming across as helpful
I have sometimes come across the same issue, but to be fair, it’s not an issue just associated with travel agents.
This weekend I took my sister to an Italian restaurant for lunch, the food was average, but what annoyed me more was the lack of customer friendliness by the staff. I’ve probably put a few people off going there because I ranted about them today at work.
Word of mouth is powerful
Travel companies have to realise that first impressions count.
Consumers have the tools to be able to share their experiences, and we can be nit-picky, and while their holiday might be fantastic, how the agents come across when booking is vital to the consumer’s impression of the company, and word of mouth is very powerful.
Interested to know of any negative experiences you have had with travel agents.
This post was syndicated from the Travel Rants blog. Signup for the free Travel Newsletter or subscribe to the Travel RSS feed for regular updates like this.
First impressions count when booking with a travel agent
Posted in Other Ranters, Rants
Posted May 31st, 2009
by hsb10
This week I had the opportunity to interview John McEwan who is one of the two candidates for the role of chairman ABTA, the Travel association, an association that should be focusing more on the issues that affect travel consumers.
Why is holiday financial protection so confusing and what improvements are needed to make it more understandable for consumers so that we can make a more informed decision if the travel company fails or when booking our holiday?
In an ideal world there should be a common protection system for travel. And part of that would be for a single point of reference for consumers in the event of a business failure – this is a role that ABTA could potentially take on while the CAA continues to administer the business and financial end of the scheme.
What most people want to see is a universal protection scheme that goes beyond the traditional package market. That means a levy on all holiday elements – accommodation and flights. That way we could sweep away the confusion about what is and isn’t protected. Airlines have been against this and that is why the current inadequate system has remained in place.
I agree that it doesn’t do us any favours to have people referred to their credit card companies for refunds. There is a real fear in our industry that credit providers might not want to work with travel companies in the future if they are the ones taking on the risk all the time.
We don’t want the situation where people can’t pay for their travel by credit card, or are asked to pay a big fee for the privilege. This is another reason why sorting out the bonding issue must be a priority.
There are so many ways to book a holiday, and most consumers assume that they have been to a travel agent so it’s a package holiday that they have booked. So you think it’s the role of ABTA to ensure that their members spend time educating the consumer so that there are armed with the full facts before they book the holiday? I personally don’t think this happens.
ABTA certainly has a role when it comes to making sure travellers are fully informed and satisfied with their holiday purchase. Members must abide by a comprehensive Code of Conduct, which governs things such as booking conditions, communication and how complaints are handled as well as complying with relevant UK and EU legislation.
Historically the travel industry has never spoken about the issue of financial protection to consumers, because it was perceived as a negative thing to talk about businesses failing. But in recent months, big companies such as Thomson and Thomas Cook have been highlighting their ATOL bonding and the protection that offers.
Given the millions of holidays taken each year there is a tiny rate of complaint, which proves ABTA members are doing an excellent job on the whole. And the facts show that ABTA’s conduct committee is able to resolve the vast majority of issues to everyone’s satisfaction without the need for legal action.
Air Passenger Duty is a complete joke because there’s no proof that the millions generated is going towards helping the environment so what you think would be the perfect solution for the industry, consumers and the environment?
I don’t think people really have an issue with green taxation per se. The trouble with it is that there is no evidence that the money collected actually goes towards environmental issues. In fact, the Treasury has gone on record as saying it just goes into the general pot.
Nobody likes paying taxes, but consumers would accept it more readily if the money was ring-fenced and everyone could see where it was being spent – whether that was specific green projects or research on things such as cleaner fuels as you suggest.
The planned changes to APD, which will have a detrimental effect to some countries that really rely on tourism, show how the government doesn’t have a joined-up policy when it comes to travel and jobs.
It shows why the industry needs to speak with a united voice. Airlines, operators and agents are all against the way it is levied but the protests are very fragmented. Perhaps the ideal situation would be to link charges to load factors and incentivise airlines to operate cleaner, newer aircraft.
I was not aware that ABTA had ‘elections’ to elect its chairman. It will be a challenge because there’s so much to improve about the travel industry. What do you think are the biggest challenges ahead for the elected chairman?
ABTA current president Justin Fleming is now completing his three-year term in office and the decision has been taken to replace this role with an elected chairman, to increase transparency. So these elections are a historic first for the organisation. We’ve already touched on the major challenges for the chairman – APD and consumer protection are obviously the two hot topics.
ABTA is a very broad church so the new chairman has to embrace the whole of the industry to get it speaking with one voice, and not be divided down the historic lines of tour operators and travel agents.
ABTA really needs to start punching its weight in terms of lobbying – which will be in the interests of both travel companies and consumers. Inbound and outbound travel companies contribute a huge amount to the economy, employing hundreds of thousands of people in the UK.
I’ll be taking an interest in wider business issues too, such as red tape, law and taxation, so the sector goes from strength to strength. ABTA must have the ear of government when it comes to tourism and transport policy-making.
Thanks to John for taking the time to respond to my questions. If you have any questions that you would like to ask then please leave them in the comments section.
This post was syndicated from the Travel Rants blog. Signup for the free Travel Newsletter or subscribe to the Travel RSS feed for regular updates like this.
Q&A with John McEwan. Discussing the future of ABTA
Posted in Other Ranters, Rants
Posted May 31st, 2009
by hsb10
a onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://2.bp.blogspot.com/_srKLQ9PUso4/SeM76HOI-1I/AAAAAAAAAhY/cmyV56pFFKg/s1600-h/Einstein.jpg”img style=”margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 300px;” src=”http://2.bp.blogspot.com/_srKLQ9PUso4/SeM76HOI-1I/AAAAAAAAAhY/cmyV56pFFKg/s400/Einstein.jpg” alt=”" id=”BLOGGER_PHOTO_ID_5324165054038866770″ border=”0″ //abr /br /It’s always good to see when the Mainstream Media catches up with bloggers. This week three welcome pieces have appeared, two in BMJ, and one in the Times.br /br /a href=”http://www.bmj.com/cgi/content/full/338/apr07_1/b1457″Tony Delamonthe this week in BMJ/a has a good piece on “What to cut?” It’s suggestions for what spending the NHS should cut when the cash runs out. If the credit crunch forces some sanity on public squandering (investment?) then some good may come out of it.br /br /It’s great to see ideas similar to ours being taken on board. It shows that those who know anything about medicine are beginning to form a firm view that the last 12 years of New Labour meddling with the Health Service have achieved nothing, and that most of their changes could be stopped with no loss of function.br /br /We’ve been saying that loudly and raucously for some time now as you can see in the links a href=”http://www.drrant.net/2007/04/nhs-what-is-to-be-done.html”here/a and a href=”http://www.drrant.net/2007/03/management-spaceship.html” here/a and a href=”http://www.drrant.net/2007/01/unacceptable-face-of-cronyism-in.html” here/a. It’s great when a prophet no longer has to cry out in the wilderness.br /br /In the Times this week a href=”http://www.timesonline.co.uk/tol/comment/columnists/camilla_cavendish/article6054832.ece”Camilla Cavendish/a has drawn a a href=”http://www.spectator.co.uk/coffeehouse/3525366/the-productive-and-the-unproductive.thtml”useful distinction/a between the two types of public service worker. These are firstly the direct, frontline public sector staff who have simple job titles, and you know what they do. Doctor, soldier, teacher, receptionist, nurse, street cleaner, fireman, policeman. The second category are the mostly useless managerial cadre, a href=”http://www.blogger.com/the” net=”" 2007=”" 06=”" html=”"twaterati and the clipboarderati/a, who give themselves long job titles, rearrange the department, liaise with all stakeholders, and call more a href=”http://www.slowleadership.org/blog/2008/06/the-more-meetings-the-less-trust”meetings/aa whilst wondering why /aa href=”http://www.timesonline.co.uk/tol/news/uk/health/article2049245.ece”no-one/a wants to a href=”http://www.drrant.net/2007/07/engagement-or-divorce.html”engage with them/a. This second category is mostly a hindrance to anything other than buffing the figures to make it look as if all the targets have been met, which can then be spun as “improved performance” to the public by mendacious Labour politicians. Cutting this second category would be a blessing to service users, service providers, and the taxpayer. Things would improve, and cost less if we decommissioned this second category.br /br /Which brings us onto the death knell for a href=”http://www.bmj.com/cgi/content/full/338/mar12_1/b832″Practice Based Commissioning (PBC)/aa. Dr Rant has never thought much of PBC. We’ve always thought that its /aa href=”http://www.drrant.net/2007/07/promised-land.html” messiahs/aa were somewhat strange, and that it offered /aa href=”http://www.drrant.net/2007/11/practice-based-commisioning.html”nothing of real significance/a to already too busy GPs. Seems now that even people who are nominal enthusiasts for the policy are damning it.br /br /Officially it’s a policy being a href=”http://www.newstatesman.com/roundtables/group_discussion_view.php?group_id=7amp;grouptopic_id=10″“reinvigorated”/a this year. Gillam and Lewis basically raise the question of whether it should be a resuscitation or palliative job, “But if tangible results remain elusive, evidence based policy makers will wonder whether this patient needs palliative care not reinvigoration.”br /br /A bit like the British Economy really. Apparently a href=”http://iaindale.blogspot.com/2009/04/imf-let-softening-up-process-commence.html”an unnamed minister/a has suggested that a visit from the IMF should be thought of as a “recuperative exercise”, and not as a sign of economic near death.br /br /Credo est, quia absurdum. Bit like the whole government and all its policies at present.div class=”blogger-post-footer”img width=’1′ height=’1′ src=’//blogger.googleusercontent.com/tracker/28089527-4493584923534907075?l=www.drrant.net’//div
Posted in Other Ranters, Rants
Posted May 31st, 2009
by hsb10
a onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://4.bp.blogspot.com/_srKLQ9PUso4/SeemsYJZj1I/AAAAAAAAAho/lQZY11oHZtY/s1600-h/Labourisntworking2.jpg”img style=”margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 191px;” src=”http://4.bp.blogspot.com/_srKLQ9PUso4/SeemsYJZj1I/AAAAAAAAAho/lQZY11oHZtY/s400/Labourisntworking2.jpg” alt=”" id=”BLOGGER_PHOTO_ID_5325408365715230546″ border=”0″ //abr /br /This year the Commons All Party Parliamentary Group on Primary Care and Public Health is running an enquiry with the title? “Was the NHS Plan really a blueprint for the NHS – 10 years on?” You can contribute via a href=”http://www.pagb.co.uk/appg/PDFs/termsofreferencepressnotice.pdf”this link/a.br /br /There’s nothing quite as sad at looking back at the wreckage of a href=”http://www.rc.umd.edu/rchs/reader/ozymandias.html”grandiose/a plans. They sounded good at the time. They had full sa href=”http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2800%2902544-7/fulltext”takeholder support/a, and “user buy in.” The a href=”http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2800%2902563-0″Lancet/a and a href=”http://www.bmj.com/cgi/content/full/321/7257/315%20″BMJ/a had been co-opted to the cheer party. A bright new government was in office, and the dinosaur Frank Dobson had been retired to the Natural History Museum for a spot of taxidermy.br /br /br /So in 2000 the a href=”http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4010198″NHS plan/a was launched.br /br /And each of its aspirations sounds so reasonable and obvious that you’d have to be against motherhood and apple pie to reject them. We now recognise this as New Labour mood music, which is designed to unethically hypnotise its hearers, and destroy all critical faculties in rather a href=”http://iraqdossier.com/sexing/how”less than 45 minutes/a. It’s worked rather too well for too long, but soon they’ll pay for their mendacity and incompetence at the polls. I suspect we could forgive their incompetence (marks for effort etc) but we won’t forgive them for taking us for mugs… a href=”http://www.dailymail.co.uk/news/article-1167576/Dont-forget-toothbrush-Jacqui-After-porn-films-furnished-home-taxpayer.html%20″barbecues …plugs/a… a href=”http://www.order-order.com/2009/04/new-mps-scam-breaking”second homes/a etc.br /br /Dr Rant thought it would be fun to see how well the ten core principles have stood up to the last ten years. The original a href=”http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4002960″DH text/a is in ordinary type and span style=”font-style: italic;”our comments are in italics/span.br /br /“We the undersigned” span style=”font-style: italic;”Some of the medical great and good were far too easily taken in by the New Labour spin machine, and deserve castigation for their gullibility. /spanbr /support these principles, and commit ourselves to a span style=”font-weight: bold;”modernised/span span style=”font-style: italic;”(one of the great weasel words of our times. Dr Rant calls for a a href=”http://www.drrant.net/2007/03/call-for-national-debate.html”national debate/a on a new modernised word going forward into future documents. Why does everything have to be modernised? Why is the old so in need of reform? What if it wasn’t broken before? What if the fix is really a fix for administrators, not patients? What if change is worse than what already was? New Labour’s falsest assumption has been that “new” and “modernised” is automatically good, and that change towards this must therefore be good in itself.)/span NHS on the basis of these principles reflected in this NHS Plan.br /br /1. The NHS will provide a universal service for all based on clinical need,br /not ability to pay.br /Healthcare is a basic human right. Unlike private systems the NHS will not excludebr /people because of their health status or ability to pay. Access to the NHS will continue to depend upon clinical need, not ability to pay.br /br /span style=”font-style: italic;”Great but:-br /Dr Rant, and many other taxpayers, now have to pay for their a href=”http://www.drrant.net/2007/10/theres-hole-in-my-tooth.html”dentists privately/a.br /Demented patients have to sell their house to get residential or nursing care.br /Infertility treatment is not covered by the NHSbr /Erectile dysfunction- the NHS failed to rise to this opportunity.br /Cancer treatment- some a href=”http://www.dailymail.co.uk/news/article-503146/Karol-Sikora-Commentary-Why-shouldnt-cancer-sufferer-pay-prolong-life.html”not available/a- personal and postcode lotteries.br /Many clinical needs go unmet.br /Mortality rates are a href=”http://tpa.typepad.com/bettergovernment/2008/01/major-study-on.html”worse/abr /a href=”http://tpa.typepad.com/home/files/wasting_lives.pdf”Mortality amenable to healthcare/a is higher under our systembr /br /Yes the NHS is a very comprehensive service…that over time has comprehensively and covertly reclassified problems so that they are not medical any more but social…and so come out of a different budget.br /br /Private systems- that a href=”http://blogs.telegraph.co.uk/daniel_hannan/blog/2009/04/06/americans_dont_copy_the_british_healthcare_system”great old bogeyman/a, that entirely justifies the NHS as “the envy of the world.” Of course. And let’s not look across to a href=”http://www.drrant.net/2008/01/europe-not-america.html”Europe to see how anyone else might have got it better organised/a. They’re all a href=”http://www.progressive-vision.org/policies/health.html”out of step /aand unethical except our NHS./spanbr /br /2. The NHS will provide a comprehensive range of servicesbr /The NHS will provide access to a comprehensive range of services throughout primary and community healthcare, intermediate care and hospital based care. The NHS will also provide information services and support to individuals in relation to health promotion, disease prevention, self-care, rehabilitation and after care. The NHS will continue to provide clinically appropriate cost-effective services.br /br /span style=”font-style: italic;”The NHS probably manages to provide this…mostly because of the internal motivation of doctors and nurses, and despite the a href=”http://www.telegraph.co.uk/health/healthnews/5006037/Patients-died-due-to-appalling-care-at-Staffordshire-hospitals—Healthcare-Commission.html”poor/a quality of management./spanbr /br /3. The NHS will shape its services around the needs and preferences ofbr /individual patients, their families and their carersbr /The NHS of the 21st century must be responsive to the needs of different groups andbr /individuals within society, and challenge discrimination on the grounds of age, gender, ethnicity, religion, disability and sexuality. The NHS will treat patients as individuals, with respect for their dignity. Patients and citizens will have a greater say in the NHS, and the provision of services will be centred on patients’ needs.br /br /span style=”font-style: italic;”This was sound good fluff then, and is now exposed as utter bollocks. Patients have never had less say on their local services than now. The government abolished a href=”http://www.newstatesman.com/200102190016.html%20″Community Health Councils/a, and replaced them with a mishmash of talking shops. (A typical new Labour modernisation- take something that at least works partially and totally bugger it up)br /br /Local services are decided from the centre, cooked up in PCT plans agreed with DH and SHA beforehand. No public voice present in any of them. Fake consultation and grand listening tours ensue. But let’s be clear. These consultations ask a question “Just how good do you think these plans are?” and the answers range from, “Whatever, you’ll do it anyway” to “Agree” to “that’s the greatest new paradigm in health service management since the last one. Go straight to beaconicity status” Read Michael Mandelstam’s excellent book if in any doubt about this.br /br /Dr Rant’s patients go to the local foundation trust centre of excellence and come back saying, “They altered my appointment four times, they ran late, they weren’t interested in me, I couldn’t understand the doctor, I was too scared to ask the doctor, you’re just a number to them”…etc. Dr Rant’s patient centred response is “Tell me more, it gives me grist for my blog!” /spanbr /br /4. The NHS will respond to different needs of different populationsbr /Health services will continue to be funded nationally, and available to all citizens of the UK. Within this framework, the NHS must also be responsive to the different needs of different populations in the devolved nations and throughout the regions and localities. Efforts will continually be made to reduce unjustified variations and raise standards to achieve a truly National Health Service.br /br /span style=”font-style: italic;”That’s why the Scots and Welsh get free prescriptions and free car parking at hospitals, whilst the English taxpayers subsidise the Celtic fringe.br /br /What about responding properly to the one population who are properly the concern of an illness treatment service- the sick? What about treating people on grounds of illness, not on basis of ethnic origin?br /br /What about providing a href=”http://www.drrant.net/2008/05/please-dont-admit-anyone-hospitals.html”enough beds/a in a href=”http://www.drrant.net/2008/01/deep-clean-more-like-whitewash.html”clean/a hospitals?br //spanbr /br /5. The NHS will work continuously to improve quality services and tobr /minimise errorsbr /br /The NHS will ensure that services are driven by a cycle of continuous qualitybr /improvement. Quality will not just be restricted to the clinical aspects of care, butbr /include quality of life and the entire patient experience. Healthcare organisations and professions will establish ways to identify procedures that should be modified orbr /abandoned and new practices that will lead to improved patient care. All thosebr /providing care will work to make it ever safer, and support a culture where we can learn from and effectively reduce mistakes. The NHS will continuously improve its efficiency, productivity and performance.br /br /span style=”font-style: italic;”This is the biggest failing of the lot. Donaldson is supposed to be an expert on this kind of thing. He set up, “the organisation with a memory.” One of Dr Rant’s biggest frustrations is that the NHS has still no system for learning from its errors. It just doesn’t take safety as seriously as the airline industry. There is a cynical theory that it is easier and cheaper to pay out a few indefensible cases, run many into the long grass, or six feet under, than it is to spend the same money on getting the system right in the first place. Maybe a few damaged or dead patients, and a few ruined medical and nursing careers are an affordable price to the administrative mind? Or at least that seems to be the risk management calculation the NHS is often making.br /br /a href=”http://news.bbc.co.uk/1/hi/health/7872501.stm”Negligence/a is paid out…with no one giving details of cases, or any discussion of what is learnt from the episode. Individual patients and doctors suffer, and the compensation agreement always has a “confidentiality-no publicity” clause built in. At one level this keeps everything quiet, and avoids adding public embarrassment to professional chagrin, and at another it just seems that medicine deals with individual tragedies and no overall lesson is learnt.br /br /Lots has been spent on audit, and clinical governance, and quangos such as the “care quality commission” and “NICE” and “NPSA” but the relationship of these organisations to coalface workers is distant at best and antagonistic often.. NICE is arrogant and NASTY and thinks it knows how to do other people’s jobs. It has so many hidden assumptions and false values and false valuations behind its pronouncements, that it deceives itself that it has any value. NPSA has never yet made any difference to patient safety, and no one ever reports anything to it…and even if we did no one is certain anything would follow from so doing. Another expensive quango that takes in time money and data….and successfully produces another glossy report. The Healthcare Commission finally a href=”http://www.telegraph.co.uk/health/healthnews/5006037/Patients-died-due-to-appalling-care-at-Staffordshire-hospitals—Healthcare-Commission.html”barked/a on a href=”http://www.hsj.co.uk/news/acute-care/who-let-standards-fall-so-low-at-mid-staffordshire?/2007561.article%20″Staffordshire/a…and so is about to be abandonded and merged into the “Care a href=”http://www.cqc.org.uk/”Quality/a Commission” run by…the a href=”http://www.hsj.co.uk/news/acute-care/care-quality-commission-defends-cynthia-bower/5000279.article”former SHA chief/a exec for NHS West Midlands…who denies she could a href=”http://www.hsj.co.uk/news/acute-care/mid-staffs-was-off-sha-radar/2007598.article”possibly have realised /athere were problems at Stafford…as has the a href=”http://www.telegraph.co.uk/health/heal-our-hospitals/5106249/Coroners-records-will-be-examined-in-Stafford-Hospital-scandal.html”coroner/a…and a href=”http://www.telegraph.co.uk/health/heal-our-hospitals/5105991/Hospitals-granted-foundation-status-despite-a-plethora-of-failings.html”Monitor/a.br /br /GPs have their “a href=”http://www.civitas.org.uk/press/prcs83.php”Quality and Outcomes/a framework” which distorts their work, and purports to measure quality.br /br /Well as Dilbert puts it in a cartoon, “Nah, don’t bother with real quality. Just invent a meaningless metric and call it an industry gold standard.” Well our three star, green light, red rosette and gold swimming award foundation trust and their high quality Blue Riband Quality Medallion management manage to achieve this objective completely. The NHS must be a world leader in meaningless metrics. “World class” commissioning surpasses them all. Perhaps I should set up a Meaningful Metrics Consultancy and measure just how much money I could make in exchange for baloney.br //spanbr /br /6. The NHS will support and value its staffbr /The strength of the NHS lies in its staff, whose skills, expertise and dedication underpin all that it does. They have the right to be treated with respect and dignity. The NHS will continue to support, recognise, reward and invest in individuals and organisations, providing opportunities for individual staff to progress in their careers and encouraging education, training and personal development. Professionals and organisations will have opportunities and responsibilities to exercise their judgement within the context of nationally agreed policies and standards.br /br /span style=”font-style: italic;”I wish I felt valued by the NHS but I don’t. Staff now are disposable elements, who are motivated by vested producer interests, who need to be regulated, and if any of them speak out they should be struck off. The NHS is wonderful so anyone who points out any flaws in it is clearly deluded, wrong, and in need of re-education.br /br /Quite clearly all faults in the organisation are due to character flaws in employees. As one manager summed it up, his biggest fear for the NHS was that a href=”http://www.drrant.net/2007/06/deeply-unhappy-family-don-try-to.html”someone would try to improve it/a. I don’t think anyone as staff gets a particularly good deal out of NHS. (though in these recession times the available alternatives look rather worse)br /br /a href=”http://www.hsj.co.uk/news/workforce/bullying-permeating-patient-care-warns-healthcare-commission/2007581.article”Bullying is rife/a, with passive aggression the preferred option.br /br /But managers are so wonderful they need no regulatory body, and a quick golden a href=”http://www.hsj.co.uk/1631m-pay-off-for-former-sha-chief/57517.article”parachute/a out of trouble, and a sideways move sorts out any problems. From such attention to detail we get the a href=”http://www.hsj.co.uk/news/acute-care/care-quality-commission-defends-cynthia-bower/5000279.article”new chief exec/a of the Care Quality Commission from the SHA which a href=”http://www.hsj.co.uk/news/acute-care/mid-staffs-was-off-sha-radar/2007598.article%20″turned/a a blind eye to a href=”http://www.telegraph.co.uk/health/healthnews/5030012/Staffordshire-hospital-scandal-the-hidden-story.html”failings in Staffordshire/a.br /br /Expect floggings to continue till staff morale improves.br //spanbr /br /br /7. Public funds for healthcare will be devoted solely to NHS patients.br /The NHS is funded out of public expenditure, primarily by taxation. This is a fair andbr /efficient means for raising funds for healthcare services. Individuals will remain free to spend their own money as they see fit, but public funds will be devoted solely to NHS patients, and not be used to subsidise individuals’ privately funded healthcare.br /br /span style=”font-style: italic;”I wish we could describe the spending of taxpayers money on needless computer initiatives, bollocks management consultancy, ISTCs that don’t deliver, Darzi policlinics, dumbing up staff (nurse practitioners, GPwSI etc) redisorganisations, renaming failing organisations from Rantingshire PCT to NHS Rantingshire, chiropody to podiatry, fitness for purpose exercises, payment by results, world class commissioning, pathway redesign teams, PFI hospitals, LIFT(ing the budget deficit higher)primary care premises and other such wastes as “successful patient centred reform.” Sadly honesty forbids us from doing this…but new Labour apparatchiks will feel no such concerns.br /br /The NHS funding increase in the last ten years has largely been pissed away on government vanity projects, managerial conceits, and structural meddling in the NHS. The focus has been on internal objectives, not on delivering what patients need and want. /spanbr /br /br /8. The NHS will work together with others to ensure a seamless servicebr /for patients.br /br /The health and social care system must be shaped around the needs of the patient, notbr /the other way round. The NHS will develop partnerships and co-operation at all levels of care – between patients, their carers and families and NHS staff; between the healthbr /and social care sector; between different Government departments; between the publicbr /sector, voluntary organisations and private providers in the provision of NHS servicesbr /to ensure a patient-centred service.br /br /span style=”font-style: italic;”Don’t make me laugh. A carrier pigeon with a concrete block round its neck could get letters from hospitals to GPs quicker than the hospital mail and van systems. Letters from our local centre of excellence take over 4 weeks to arrive. Letters from a famous National Centre of Excellence take over 3 months to arrive. Interfaces of care are dangerous places for patients, and failures of communication here are legion. The issue isn’t on hospital star ratings yet, so no one is that bothered about it. The medical defence organisations are acutely aware of this as they defend (or more likely settle) the claims that arise from poor communication.br /br /Communications with social workers are rare and patchy.br /br /The battle over bed blocking geriatric patients and limited council funds for residential and nursing care are still huge. Care about the patient’s need for care? Who are we kidding? The game here is snag shifting of the old crumble and the budget cost from one agency to another.br /br /Patients do not experience a seamless service. Doctors are forced to work in their silos, and no one seems to have a grasp of the whole. I think that’s the kind of problem John Seddon’s systems thinking might address, but which therefore won’t be tried in the NHS./spanbr /br /br /9. The NHS will help keep people healthy and work to reduce healthbr /inequalitiesbr /The NHS will focus efforts on preventing, as well as treating ill-health. Recognising that good health also depends upon social, environmental and economic factors such as deprivation, housing, education and nutrition, the NHS will work with other publicbr /services to intervene not just after but before ill health occurs. It will work with othersbr /to reduce health inequalities.br /br /span style=”font-style: italic;”Health is a href=”http://www.amazon.co.uk/Impact-Inequality-Make-Societies-Healthier/dp/0415372690″proportional to wealth/a, and to a href=”http://www.amazon.co.uk/Spirit-Level-Societies-Almost-Always/dp/1846140390/%20″wealth distribution /aacross a society. This government has overseen and encouraged the biggest growth in wealth, education and class differentials in living memory.br /br /The NHS is like a pea shooter against a bazooka in fighting the ill effects of these increasing differentials. And fuck New Labour’s “Tory Toffs” game. The newly entitled twaterati are not old landed gentry but public sector managers, and their co-dependent a href=”http://www.amazon.co.uk/Rip-off-Scandalous-Management-Consulting-Machine/dp/1872188060″management consultants/a who between them siphon the a href=”http://www.amazon.co.uk/Plundering-Public-Sector-David-Craig/dp/1845293746″ public purse/a into their own pockets all the while talking the mantra of, “we (pretend) to care about health inequalities” and “opportunity for all.” (especially our own)br /br /Meanwhile New Labour has continued selling off public space such as school playing fields and old hospitals to builders, thereby reducing the opportunity for exercise in schools.br /br /Health and wealth inequalities a href=”http://www.spectator.co.uk/the-magazine/the-week/810976/glasgow-east-is-browns-dirty-little-secret-a-hideous-costly-social-experiment-gone-wrong.thtml”have grown /aas a result of New Labour’s economic policies./spanbr /br /10. The NHS will respect the confidentiality of individual patients and provide open access to information about services, treatment and performance. Patient confidentiality will be respected throughout the process of care. The NHS will be open with information about health and healthcare services. It will continue to use information to improve the quality of services for all and to generate new knowledge about future medical benefits. Developments in science such as the new genetics offer important possibilities for disease prevention and treatment in the future. As a national service, the NHS is well-placed to take advantage of the opportunities offered by scientific developments, and will ensure that new technologies are harnessed andbr /developed in the interests of society as a whole and available to all on the basis of need.br /br /span style=”font-style: italic;”Well, that’s all right then. It tells no one what it is up to and then Abracadra, wow, ker-bang, ker-plunk, all our medical notes are uploaded without personal consent onto the National Spine. So much for respecting confidential medical information, and the right of invididual patients to decide how their information will be used.br /br /This Labour government of control freak, micro-manager snoops wants to know everything about everyone. Well there’s enough evidence out there- we hate you- please fuck off. Get out of our light, and stop wasting our oxygen supplies you wasteful, hateful bastards.br /br /The only protection from New Labour’s database state is that it cannot get the a href=”http://www.drrant.net/2006/10/comrade-can-you-spare-20-billion.html”computers/a to a href=”http://www.e-health-insider.com/news/item.cfm?ID=2104″work/a. This government is less respectful of individual people and their right to privacy and confidentiality than any in recorded history. It is trying to make the NHS like this too, but is running into a href=”http://www.computerweekly.com/blogs/read-all-about-it/2009/03/doctors-letter-to-justice-secr.html”stiff opposition/a.br /br /So as we can see the NHS is failing to deliver on pretty well all of the ten principles of the NHS plan.br /br /span style=”font-weight: bold;”There is nothing patient centred about it. There is nothing in it, or any of New Labour’s reforms that a href=”http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2807%2960763-6/fulltext”really helps/a me to get patients seen and treated better./spanbr /br /Doctors and nurses saying this is a damning, and rather sad, indictment for anyone in the NHS to make in describing the effects of a huge cash injection into the NHS. This is New Labour at its best. It can produce a glossy brochure, and a nice newsletter, but it has no idea what is actually needed, or is happening, and even less wish to find out.br /br /span style=”font-weight: bold;”span style=”font-weight: bold;”The NHS plan is a failure on its own terms./span/spanbr /br /The Tories under Andrew Lansley seem to have no apparent specific plans about the NHS. Looking back at the failures of the Labour monsters this lack of a plan may be Mr Lansley’s most sensible decision of all!br /br /Happy 10th Birthday NHS plan./spanbr /br /a onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://1.bp.blogspot.com/_srKLQ9PUso4/Seelk1YofUI/AAAAAAAAAhg/fJ-uynI1bjo/s1600-h/Dr+Rant+Banner+Shit.jpg”img style=”margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 82px;” src=”http://1.bp.blogspot.com/_srKLQ9PUso4/Seelk1YofUI/AAAAAAAAAhg/fJ-uynI1bjo/s400/Dr+Rant+Banner+Shit.jpg” alt=”" id=”BLOGGER_PHOTO_ID_5325407136613170498″ border=”0″ //adiv class=”blogger-post-footer”img width=’1′ height=’1′ src=’//blogger.googleusercontent.com/tracker/28089527-6447868729165036254?l=www.drrant.net’//div
Posted in Other Ranters, Rants
Posted May 31st, 2009
by hsb10
div style=”text-align: center;”a onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://2.bp.blogspot.com/_srKLQ9PUso4/Se3pHcS9riI/AAAAAAAAAhw/_ivwjU–7fg/s1600-h/wistle.jpg”img style=”margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 293px;” src=”http://2.bp.blogspot.com/_srKLQ9PUso4/Se3pHcS9riI/AAAAAAAAAhw/_ivwjU–7fg/s400/wistle.jpg” alt=”" id=”BLOGGER_PHOTO_ID_5327170248313253410″ border=”0″ //aspan style=”font-size:85%;”span style=”font-style: italic;”Don’t even blow there!/spanbr //span/divbr /Alan Johnson is a href=”http://www.telegraph.co.uk/news/5051522/Mouse-droppings-found-in-hospital-operating-theatre.html”quoted/a as saying, span style=”font-style: italic;”“”I don’t understand why clinicians whose primary role is the safety of their patients are somehow concerned about whistle-blowing. I can’t understand it, quite frankly.”br //spanbr /Well let’s answer him.br /br /In the NHS the senior management of trusts now have the right to a href=”http://www.warwickcourier.co.uk/news/Specialist-doctor-sacked-by-hospital.4435536.jp”sack/a a href=”http://news.bbc.co.uk/1/hi/england/tyne/3701548.stm”doctors/a, and a href=”http://www.dailymail.co.uk/news/article-1055592/Heart-doctor-sacked-branded-fraudster-saving-elderly-patients-life-private-equipment.html”use this/a a href=”http://www.drrant.net/2006/08/dr-otto-chan.html%20″right/a freely. It happens a href=”http://www.canberratimes.com.au/news/local/news/general/hospital-bosses-blasted-over-doctors-sacking/418709.aspx”abroad /atoo.br /br /Senior management regards the bearers of bad news as unwelcome, disloyal, and untrustworthy. They are not “one of us” They are one of them, and dangerous. Trust managers fear the DH or exposure in the local a href=”http://www.guardian.co.uk/society/2006/jul/30/health.medicineandhealth”newspaper/a. Nothing else. The kindest term they will use for a whistle blower is “nuisance.”br /br /div style=”text-align: center;”a onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://static.guim.co.uk/sys-images/Money/Pix/pictures/2008/11/14/WhistleBlower460.jpg”img style=”margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 460px; height: 276px;” src=”http://static.guim.co.uk/sys-images/Money/Pix/pictures/2008/11/14/WhistleBlower460.jpg” alt=”" border=”0″ //aspan style=”font-size:85%;”span style=”font-style: italic;”Give a little whistle!/span/span/divbr /br /The default style of NHS senior management is span style=”font-weight: bold;”bullying/span (shut up), span style=”font-weight: bold;”bluster/span (talking is communicating) and span style=”font-weight: bold;”bravado/span (hope I don’t get found out before I get parachuted out of here).br /br /NHS senior management wants everything to look Ok, to get its foundation status, and not to get found out as incompetent. As all NHS management is incompetent maintaining the illusion of competence is difficult, but a top priority. Whistle blowers threaten this and must be eliminated.br /br /That’s why Dr Steve Bolsin ended up working in Australia.br /br /That’s why a href=”http://www.ward87.blogspot.com/”Dr Pal/a now cries in the wilderness.br /br /Whistle blowers are not welcome in the NHS, the no-blame culture means keep quiet and we won’t blame you…unless it’s convenient for us, and that patients continue to be harmed.br /br /The no blame culture, and the organisation with a memory, that makes amends, and learns from mistakes is a total fiction.br /br /In the NHS there are vicious blame games afoot, and shooting the messenger is one strategy the management use to get a href=”http://www.guardian.co.uk/society/2006/jul/30/health.medicineandhealth”unwelcome information/a off their patch.br /br /And professional bodies such as GMC and GTC will not stand up for whistle blowers, nor a href=”http://www.telegraph.co.uk/education/educationnews/5048998/Science-teacher-found-guilty-of-misconduct-for-Channel-4-undercover-filming.html”allow a public interest defence./abr /br /div style=”text-align: center;”a onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://www.seniorbrigade.com/health_care/images/abc_gma_elder_edit_071016_ms_000.jpg”img style=”margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 413px; height: 310px;” src=”http://www.seniorbrigade.com/health_care/images/abc_gma_elder_edit_071016_ms_000.jpg” alt=”" border=”0″ //aspan style=”font-style: italic;font-size:85%;” Smile: You’re on Candid Camera!br //span/divbr /It’s not just doctors is it? Anyone, who’s not spent the last week in contemplation of their own haemorrhoids, will have heard about thespan style=”font-style: italic;” /spana href=”http://news.bbc.co.uk/1/hi/england/sussex/8002559.stm”span style=”font-style: italic;”‘Panorama’/span nurse who got struck off/a. The irony is that her striking off has garnered more attention from the press than the disgusting abuse that she uncovered in the places where she worked.br /br /So, hidden camera work might not be listed in the ’span style=”font-style: italic;”professional duties/span’ of a nurse, and she might have jumped a few rungs of the ladder (perhaps the fact that she felt such a lack of confidence in the ‘proper pathways’ should be the most telling aspect of this sorry affair) , but sometimes the ends do justify the means. After all, isn’t that how modern politicians reconcile their nauseating, self-interested, subservience and lack of independent thoughts or actions?br /br /Alan Johnson wonders why whistle blowers are scared. Come on Alan. You are an ex-union man and you know the games employers play. The NHS shows all of them how to play at the highest level, and can rightfully revel in its status as one of the worlds most opaque, arbitrary and vindictive employers.br /br /Are you showing false naivete here? Or are you simply turning into another dissembling boss?div class=”blogger-post-footer”img width=’1′ height=’1′ src=’//blogger.googleusercontent.com/tracker/28089527-2381570571670075665?l=www.drrant.net’//div
Posted in Other Ranters, Rants
