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C

CCFCSteve

Well-Known Member
stupot07 said:
My experience of consultancy firms in the public sector is they are extremely expensive and provide minimal benefit. But the government likes them.

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They are ridiculously expensive which is the point I’m making. If senior management were doing their job you wouldn’t need consultants, or far less of them. If you can get voluntary assistance from people on trust boards then they can bring external experience without the cost. Looking at systems and processes as an outsider usually brings challenges to the norm, plenty of which might well be rebutted on medical grounds but that doesn’t mean improvements won’t be found. If people are at board level they are more likely to oversee changes whereas consultants, from what I’ve heard, get bogged down by the inability of management to make decisions and drive through change

It’s strange that people are pushing back on suggestions like that. Group think amongst the medical profession can be dangerous and not listening to outside suggestions on how to improve processes in conjunction with additional funding/investment…I’m struggling to see the issue

Ps I think I said 2-3 years ago that people should check out a book called black box thinking about the culture within medical profession ie an inability to admit errors and effect change quickly which was driven by an arrogance of senior professionals unwilling to listen, acknowledge and address faults in the system. Yet people seem to think any outside challenge and involvement is a waste of time ?!
 
shmmeee

shmmeee

Well-Known Member
CCFCSteve said:
They are ridiculously expensive which is the point I’m making. If senior management were doing their job you wouldn’t need consultants, or far less of them. If you can get voluntary assistance from people on trust boards then they can bring external experience without the cost. Looking at systems and processes as an outsider usually brings challenges to the norm, plenty of which might well be rebutted on medical grounds but that doesn’t mean improvements won’t be found. If people are at board level they are more likely to oversee changes whereas consultants, from what I’ve heard, get bogged down by the inability of management to make decisions and drive through change

It’s strange that people are pushing back on suggestions like that. Group think amongst the medical profession can be dangerous and not listening to outside suggestions on how to improve processes in conjunction with additional funding/investment…I’m struggling to see the issue

Ps I think I said 2-3 years ago that people should check out a book called black box thinking about the culture within medical profession ie an inability to admit errors and effect change quickly which was driven by an arrogance of senior professionals unwilling to listen, acknowledge and address faults in the system. Yet people seem to think any outside challenge and involvement is a waste of time ?!
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No. They think management consultants are a waste of time. Because they are. In every industry. Culture change by all means, Blair professionalised teaching, it can be done, but handing dat checks to Tory donors isn’t the way.
 
C

CCFCSteve

Well-Known Member
shmmeee said:
No. They think management consultants are a waste of time. Because they are. In every industry. Culture change by all means, Blair professionalised teaching, it can be done, but handing dat checks to Tory donors isn’t the way.
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I don’t think I ever suggested getting more management consultants involved ?! I was trying to suggest ways to reduce the need for them ie trying to get very good, successful people from business to volunteer onto Trust boards. I do know consultants from a big four firm and they found the senior management at the nhs a nightmare to deal, however, that was a while back

Edit - I also personally think big consultancy/advisory firms should also offer up staff at low cost/free to help with nhs etc. they can afford to release people for a day or two a month (or secondments) and it would beneficial. If any are engaged normally fees should be heavily weighted toward delivery of very specific/targeted objectives
 
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shmmeee

shmmeee

Well-Known Member
CCFCSteve said:
I don’t think I ever suggested getting more management consultants involved ?! I was trying to suggest ways to reduce the need for them. I do know consultants from a big four firm and they found the senior management at the nhs a nightmare to deal, however, that was a while back
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I should be careful what I say because I’ve got an interview with PWC coming up 😂

But I’ve never seen a consultancy worth it’s salt. There’s this idea that “private good public bad” and all that’s needed is to get Mike Ashley and Alan Sugar in to run schools and hospitals and everything will be golden. I don’t buy it and have seen close up the disasters that can happen (Bob Edmiston at Grace for example).

The staff want what’s best for the service and know it the best and solution has to come from within. As I say culture can be changed. What changed teaching wasn’t a bunch of wankers in suits rocking up, it was a culture change from within.
 
fernandopartridge

fernandopartridge

Well-Known Member
CCFCSteve said:
They are ridiculously expensive which is the point I’m making. If senior management were doing their job you wouldn’t need consultants, or far less of them. If you can get voluntary assistance from people on trust boards then they can bring external experience without the cost. Looking at systems and processes as an outsider usually brings challenges to the norm, plenty of which might well be rebutted on medical grounds but that doesn’t mean improvements won’t be found. If people are at board level they are more likely to oversee changes whereas consultants, from what I’ve heard, get bogged down by the inability of management to make decisions and drive through change

It’s strange that people are pushing back on suggestions like that. Group think amongst the medical profession can be dangerous and not listening to outside suggestions on how to improve processes in conjunction with additional funding/investment…I’m struggling to see the issue

Ps I think I said 2-3 years ago that people should check out a book called black box thinking about the culture within medical profession ie an inability to admit errors and effect change quickly which was driven by an arrogance of senior professionals unwilling to listen, acknowledge and address faults in the system. Yet people seem to think any outside challenge and involvement is a waste of time ?!
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The consultants fill the gaps in management and administration staff that you think don't exist
 
B

Brighton Sky Blue

Well-Known Member
shmmeee said:
I should be careful what I say because I’ve got an interview with PWC coming up 😂

But I’ve never seen a consultancy worth it’s salt. There’s this idea that “private good public bad” and all that’s needed is to get Mike Ashley and Alan Sugar in to run schools and hospitals and everything will be golden. I don’t buy it and have seen close up the disasters that can happen (Bob Edmiston at Grace for example).

The staff want what’s best for the service and know it the best and solution has to come from within. As I say culture can be changed. What changed teaching wasn’t a bunch of wankers in suits rocking up, it was a culture change from within.
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Except what we have now are very well paid MAT executives who didn't exist before, who appoint their mates to very well paid MAT positions that also didn't exist before. Sucking money out of the budget for zero benefit to the front line service.

The Finham Park MAT is a classic example of this. The CEO gets a kick back for every new school he recruits into the MAT but in turn every new school that comes in dilutes the funding to all the others.
 
shmmeee

shmmeee

Well-Known Member
Brighton Sky Blue said:
Except what we have now are very well paid MAT executives who didn't exist before, who appoint their mates to very well paid MAT positions that also didn't exist before. Sucking money out of the budget for zero benefit to the front line service.

The Finham Park MAT is a classic example of this. The CEO gets a kick back for every new school he recruits into the MAT but in turn every new school that comes in dilutes the funding to all the others.
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Yeah academisation has been a massive Fucking failure. But not moving teaching to a more professional standing. Same as privatisation. Blair giveth with one hand and taketh with the other.
 
B

Brighton Sky Blue

Well-Known Member
shmmeee said:
Yeah academisation has been a massive Fucking failure. But not moving teaching to a more professional standing. Same as privatisation. Blair giveth with one hand and taketh with the other.
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I'm not sure how teaching has been made more professional by allowing teachers to work without QTS. But what the Blair government did do was enter into social partnership with the teaching unions and other bodies, which was a big success but not really applied to other departments and was dropped immediately in 2010. Some pretty good education secretaries during that time as well including a certain Cov based teacher in Estelle Morris.
 
shmmeee

shmmeee

Well-Known Member
Brighton Sky Blue said:
I'm not sure how teaching has been made more professional by allowing teachers to work without QTS. But what the Blair government did do was enter into social partnership with the teaching unions and other bodies, which was a big success but not really applied to other departments and was dropped immediately in 2010. Some pretty good education secretaries during that time as well including a certain Cov based teacher in Estelle Morris.
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It wasn’t that obviously. But how you work is I guarantee more professional than how your teachers worked. I technically only taught under Brown but pre and post 2010 there was a noticeable difference with education being taken in ideological rather than pedagogical directions.
 
stupot07

stupot07

Well-Known Member
CCFCSteve said:
They are ridiculously expensive which is the point I’m making. If senior management were doing their job you wouldn’t need consultants, or far less of them. If you can get voluntary assistance from people on trust boards then they can bring external experience without the cost. Looking at systems and processes as an outsider usually brings challenges to the norm, plenty of which might well be rebutted on medical grounds but that doesn’t mean improvements won’t be found. If people are at board level they are more likely to oversee changes whereas consultants, from what I’ve heard, get bogged down by the inability of management to make decisions and drive through change

It’s strange that people are pushing back on suggestions like that. Group think amongst the medical profession can be dangerous and not listening to outside suggestions on how to improve processes in conjunction with additional funding/investment…I’m struggling to see the issue

Ps I think I said 2-3 years ago that people should check out a book called black box thinking about the culture within medical profession ie an inability to admit errors and effect change quickly which was driven by an arrogance of senior professionals unwilling to listen, acknowledge and address faults in the system. Yet people seem to think any outside challenge and involvement is a waste of time ?!
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As I said before managers make up just 2% of the NHS, compared to 9.5% of the general UK workforce population. The reason deloitte, etc are brought in is because there isn't enough management support to really drive change, what they have is mostly dealing with firefighting. More investment is needed not just to support increase in clinical work but also increasing the number of managers to the required level. And as I mentioned in my experience they offer very little for the money they bring in.

Trusts already bring people in outside of Health to support with the management and governance of NHS, what you're suggesting is nothing new and is already happening.

The NHS and trusts are continually improving processes, working towards becoming leaner. Every manager in the NHS wants to drive change and improve services for patients.

There has been a lot of work around the duty of candour, admitting mistakes and looking to address them. The reason some decisions and changes take time to push through and get adopted it financial constraints within the NHS. Finance gets put above clinical need. Trusts are underfunded, understaffed, and struggling to recruit and retain staff (due to poor parades = finances), they are trying to juggle significant saving targets, alongside rising costs/inflation and trying to meet increasing clincial demands.

Peoples (and my) issue isn't your suggestion of getting more external input to support the NHS but more that you're (in line with general Tory rhetoric) are trying to scape goat NHS managers as being inept and unwilling to want to improve services. Which is just plain wrong.

On a side note let's compare the success of Test and Trace led by Private Sector expert Dido Harding, against the success of the coordination and delivery of the roll out of the Vaccine programme led by the NHS.

Interestingly my friend moved to Deloitte after 15 years in the NHS as a middle manager, his wages have gone up by 30% whilst his workload and responsibility has halved. He's gone from doing an extra 7-10 hours a week unpaid work in the NHS to doing his nice 8-4pm every day, always leaving on time.

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duffer

duffer

Well-Known Member
CCFCSteve said:
They are ridiculously expensive which is the point I’m making. If senior management were doing their job you wouldn’t need consultants, or far less of them. If you can get voluntary assistance from people on trust boards then they can bring external experience without the cost. Looking at systems and processes as an outsider usually brings challenges to the norm, plenty of which might well be rebutted on medical grounds but that doesn’t mean improvements won’t be found. If people are at board level they are more likely to oversee changes whereas consultants, from what I’ve heard, get bogged down by the inability of management to make decisions and drive through change

It’s strange that people are pushing back on suggestions like that. Group think amongst the medical profession can be dangerous and not listening to outside suggestions on how to improve processes in conjunction with additional funding/investment…I’m struggling to see the issue

Ps I think I said 2-3 years ago that people should check out a book called black box thinking about the culture within medical profession ie an inability to admit errors and effect change quickly which was driven by an arrogance of senior professionals unwilling to listen, acknowledge and address faults in the system. Yet people seem to think any outside challenge and involvement is a waste of time ?!
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The pushback is because you're coming from a completely false premise: The NHS isn't grossly inefficient, you're getting more or less what you're paying for.

Guess what, if you've spent years and years demanding efficiencies, then you might have exhausted where they can come from.

You can burn money on more consultants, you can do another top down re-organisation, or you can get someone who's made millions knocking out crap computers to go and have a look at it (if you think there's any real overlap between the biggest public service employer in the UK and making widgets), but the actual problem is not organisational, it is quite obviously long term underfunding.

It suits the Tories to paint the NHS as a hugely inefficient organisation because they'd rather not spend any money on it. But I'm afraid that doesn't make it true.
 
B

Brighton Sky Blue

Well-Known Member
duffer said:
The pushback is because you're coming from a completely false premise: The NHS isn't grossly inefficient, you're getting more or less what you're paying for.

Guess what, if you've spent years and years demanding efficiencies, then you might have exhausted where they can come from.

You can burn money on more consultants, you can do another top down re-organisation, or you can get someone who's made millions knocking out crap computers to go and have a look at it (if you think there's any real overlap between the biggest public service employer in the UK and making widgets), but the actual problem is not organisational, it is quite obviously long term underfunding.

It suits the Tories to paint the NHS as a hugely inefficient organisation because they'd rather not spend any money on it. But I'm afraid that doesn't make it true.
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Deep down they want the American system with people being charged for every little or major medical need.
 
Ian1779

Ian1779

Well-Known Member
P

PVA

Well-Known Member
Grifters gonna grift.

They won't split the Tory vote though, they 'graciously' step down most of their candidates to benefit the Tories
 
C

CCFCSteve

Well-Known Member
shmmeee said:
I should be careful what I say because I’ve got an interview with PWC coming up 😂

But I’ve never seen a consultancy worth it’s salt. There’s this idea that “private good public bad” and all that’s needed is to get Mike Ashley and Alan Sugar in to run schools and hospitals and everything will be golden. I don’t buy it and have seen close up the disasters that can happen (Bob Edmiston at Grace for example).

The staff want what’s best for the service and know it the best and solution has to come from within. As I say culture can be changed. What changed teaching wasn’t a bunch of wankers in suits rocking up, it was a culture change from within.
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You’ve obviously had bad experiences as have others but I know ex nhs who have then worked in advisory practices and they ‘get it’ and can definitely add value as can plenty of others with no direct previous experience

I’m not saying business people come in and run Trusts (I know you were half joking), I’m talking about encouraging different perspective and challenge, which is healthy in whatever you do. Noted stupots comments that this might already be happening, although I was talking about top people sitting on boards for free

I always think the best businesses or organisations (private or public) are the ones that ask, accept and act on external help, many of those will have minimal direct experience of that industry but that’s why it’s usually extra useful. For people to suggest the NHS/public sector doesn’t need that is maybe what leads to some of the culture issues

This isn’t an ‘everything in the nhs it’s shit’, it’s not at all, a majority of the direct care provided is exemplary. All I want is to see the front line better supported which as I’ve also said needs extra funding/investment..but this needs targeted and if done in the right way, value from that can be maximised.

There are things I’ve seen and heard from direct and indirect experiences that could easily be changed for little or no money though and if I’m seeing that, top quality external people sat on the board would spot a lot more stuff. I’ve also said previously the country’s mindset towards the nhs needs to change. These things don’t necessarily fit some peoples narrative though so I’ll leave it there


ps good luck with the interview
 
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skybluetony176

skybluetony176

Well-Known Member
Skybluefaz said:


Until they can start acknowledging basic facts how can we find a way forward?
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It’s not just them. Other political parties are afraid to bring it up. I’ve got a feeling that we aren’t going to have the grown up conversation required about Brexit until after the next GE. In the meantime it keeps doing damage on a daily basis.
 
D

Deleted member 9744

Guest
skybluetony176 said:
It’s not just them. Other political parties are afraid to bring it up. I’ve got a feeling that we aren’t going to have the grown up conversation required about Brexit until after the next GE. In the meantime it keeps doing damage on a daily basis.
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Absolutely. It's seen as unpatriotic to say it. The BBC are scared when anyone even suggests it.
 
W

wingy

Well-Known Member
PVA said:
Oh Hunt knows what a shit show Brexit is. He voted remain.

He just has to stand in front of the nation and pretend now that Brexit is wonderful, when he knows it isn't.
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Just like the Labour leader.
I'd imagine in reality the gov't would welcome someone of sufficient gonads stood up and drove it.
Trouble being it would just be used as a weapon,or self implosion if it happened to be one of their own.
That's what's required though, pathetic ideology.
 
W

wingy

Well-Known Member
clint van damme

clint van damme

Well-Known Member
wingy said:
As for this bloke he belongs in the Duma.
Might as well be an agent.
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How did wikileaks get hold of the podesta e mails?
Was it via Farage?
Was he Trumps 'friend in London'?
They were stolen by Russia so there's questions to be asked.
He definitely met with Alex Jones and Roger Stone to discuss the leaks, anyone keeping company with that pair is a wrong un.
 
David O'Day

David O'Day

Well-Known Member
JAM See said:
www.telegraph.co.uk

Nigel Farage-led party could attract more than a quarter of voters, poll reveals

Since leaving frontline politics, the former UKIP leader has become a host on GB News, a Right-leaning television channel
www.telegraph.co.uk www.telegraph.co.uk


Paywall removed link archive.ph

I know it's the Torygraph and anything they print must be taken with a pinch of salt.

But imagine this.
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It's nonsense if you actually read the article as, it's just people who say they may vote for something, the same data has 70% of people saying they may vote Labour.

It's an awful metric and an awful headline
 
shmmeee

shmmeee

Well-Known Member
David O'Day said:
It's nonsense if you actually read the article as, it's just people who say they may vote for something, the same data has 70% of people saying they may vote Labour.

It's an awful metric and an awful headline
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The Telegraph printing dubious shite to big up the far rights chances? Say it ain’t so!
 
C

CCFCSteve

Well-Known Member
Might not get much mainstream press but for those that are interested, some better news from US inflation data which may indirectly help us. Inflation was lower than anticipated last week. Now their producer prices increased lower than estimated. Hopefully this continues as it means the Fed might not raise rates as quickly/as much, therefore U.K./EU central banks won’t have to follow to protect currencies. Energy imports in dollars are also cheaper which will hopefully help our inflation a little. Pound is now $1.20. It bottomed around $1.04 after Truss/Kwarteng mini budget shambles.

Yields also significantly lower across the board (2, 5 and 10 yr all 3.1 - 3.4% they were all between 4.5 - 5% after mini budget) so should mean cheaper borrowing costs for government. I wonder if this might help Sunak/Hunt a bit more than expected in relation to their new budget/statement ? i know they want to demonstrate they’ve got control over finances after the Truss shitshow but my concern is they go too far with any cuts and tax rises just as the shits hitting the fan…also probably to give them flexibility to ‘offer a sweetener’ pre election. This would be a mistake

Fingers crossed for Thursday
 
shmmeee

shmmeee

Well-Known Member
As I was talking about the other day, Dawn Butler pisses me off at the best of times but this is a classic in the left “ooohhh scary data” stories that hold us back

 
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