How to solve ‘The NHS Problem’ (2)

Wholesale engagement with charity sector

Last time, I discussed the need for the NHS to differentiate between ‘treatment’ and ‘care’. In the last week, three stories have emerged to support this view:

1. Families are being told they have seven days to find their relative a space in a care home – or risk being taken to court (Daily Mail)

Dr Paul Flynn, chairman of the British Medical Association’s consultant committee, said: ‘Pressure on NHS services is at a critical point and cracks are beginning to appear.’

2. Care for people with learning disabilities is ‘failing’, report says (BBC News)

Simon Stevens, NHS England Chief Executive, said: ‘radical changes are needed in NHS and social care.’

3. Private equity giant Terra Firma looking to break up Four Seasons Care Homes (City AM)

Terra Firma, a ‘private equity giant’, bought Four Seasons from Royal Bank of Scotland for £825million two years ago. Now: ‘The plan would see the company divided into three: an arm to deal with NHS patients; one to handle paying customers; and another to focus on brain injuries and mental health.’

I do not understand this. Why the distinction between ‘NHS patients’ and ‘paying customers’?

All in all, based this week’s news alone, I think we can say NHS care is a mess.

The NHS – ‘treatment’ and ‘care’

Society in the 21st Century has developed to the extent that ‘care’ is our fastest growing, and most expensive, social need.

As an issue, ‘care’ needs to be addressed far more radically and creatively than it is now.

Further, as discussed in my last post, the better the NHS is at ‘treatment’, the more ‘care’ it will create.

Is the role of the NHS to ‘care’ for all of us all of the time for all time?

Is this what it was set up to achieve?

There are people who think that, because it is called the National ‘Health’ Service, the NHS should focus on keeping people healthy – avoiding, rather than treating, illness. I have met people in the Department of Health who hold this view.

In one sense it makes sense. The healthier we are, the less likely we are to get sick.

But surely this misses the point? The NHS was not established to be some sort of national health club. The NHS is ‘doctors and nurses’ – not ‘fitness instructors’ and ‘nutritionists’.

In this interesting lecture, ‘The Origins of the NHS‘, by Professor Virginia Berridge, it is clear that the original aim of the NHS was pure and simple – ‘better access to hospital treatment':

‘Then came the Labour victory of 1945 and the NHS Act of May 1946. Bevan espoused the nationalization of the hospitals (state ownership and control under appointed local bodies) rather than local authority control which had been Labour Party policy until then.’

This is what we want the NHS for:

– when we feel sick, to see a GP (quickly and efficiently)

– if we need to go to hospital, to go to hospital (quickly and efficiently)

– in emergency, to get to A&E (quickly and efficiently)

The job of the NHS is to make sick people better – to provide ‘treatment’ – not to be some sort of all-encompassing health care advisor and provider.

The National Care Service (NCS)

So, what to do with patients who have needed ‘treatment’, but now need ‘care’?

We spend £110billion a year on the NHS but, when it comes to ‘care’, as the Chief Executive of NHS England said: ‘radical change is needed.’

I am calling for the launch of a new ‘National Care Service (NCS)’ in Britain.

And a wholesale engagement with the ‘charity’ sector.

How come?

Engagement with charities

We Brits are a very charitable people.

Charity UK‘ is an extraordinary thing. We have 164,097 charities. Total funds raised is over £60billion a year – enough to fill the hole in the NHS budget for the next ten years.

Here is a list of our top 1,000 charities. They are an eclectic bunch. Amongst them are Macmillan Cancer Support, the Alzheimer’s Society, the Stroke Association and Age UK.

If you had any of these illnesses – following your treatment by the NHS – wouldn’t you rather be cared for by specialists in the field and alongside other patients with the same problems as you?

For all the major illnesses – cancer, dementia, diabetes etc – I would like to see specialist centres of excellence – and care homes if necessary – managed by charities on a national and local basis.

These would be independent of the NHS and, like the NHS, not-for-profit but, unlike the NHS, with the professionalism and expertise of any top commercial organisation.

Funding? Please do not be put off. I will discuss funding in my next two posts.

I have bold, new, creative, society-changing ideas to reveal.

Charity in the UK

According to the Charities Commission, our top 1.2% of charities are responsible for 69.4% of funds raised.

Amazingly, the bottom 75% of all UK charities raise only 3.4% of total funds. Or, to put it another way, the smallest 123,179 charities raise £2.172billion.

Whereas the top 1,990 charities had an annual income to Sept 2014 of £44.68billion, no less.

These larger charities are managed by highly qualified professionals who would do a far better and more efficient job in managing ‘care’ than the mess we have now.

They are highly qualified professionals managing not-for-profit organisations.

This is what we need.

Funding? Please do not be put off. I will discuss funding in my next two posts.

I have bold, new, creative, society-changing ideas to reveal.

Department of Charities and Care (DOCC)

I propose a radical new initiative which, in its boldness and ambition, may be as great as the foundation of the NHS itself.

I am calling for the launch of a new Government Ministry to be called Department of Charities and Care (DOCC).

The new ‘National Care Service’ (NCS) would report in to DOCC, just as the NHS reports in to the Department of Health (DOH).

If this creates ‘competition’ and ‘tension’ between the two NHS and NCS services and the two DOH and DOCC departments, then so much the better. They won’t like it, but the DOH and the NHS need to be challenged by better organised, professionally managed ‘competitors’. From competition, accountability and improved performance must ensue.

Funding? Please do not be put off yet. I will discuss funding in my next two posts.

I have bold, new, creative, society-changing ideas to reveal.



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How to solve ‘The NHS Problem’ (1)

Isolate ‘care’ from ‘cure’

This is the first in a short series of posts about the NHS.

As a country, the NHS is the biggest issue we face. If we leave it to the politicians – you know, the people who don’t know that invoices for £1.7billion are coming through the door – the NHS could bankrupt us.

Bizarrely, we all know this could happen.

But no one knows what to do about it – or has the guts to take the decisions that need taking.

There are two irreconcilable forces: Continue reading

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The importance of customer service (2)

The man dozed.

For the first time in over a year, he could lie in late in bed. Time to rest from the hassles of home. Phew. Two weeks alone on the Greek Island he loved and

Bang! Bang! ‘Cleaning!’

Bang! Bang! ‘Cleaning!’

The man hauled himself out the bed and his day dreams. He grabbed his favourite kikoy from the bottom of the bed, wrapped it around the middle of his body and opened the door of his perfectly comfortable hotel room. Continue reading

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How an advertising agency could help defeat Islamic State

On 4 October, Lord Dannatt, who was introduced as a former ‘Chief of The General Staff and Head of the Army for several years and knows the Middle East well’, was interviewed on BBC Radio 4.

He said:

‘We are all united in the fact that the so called Islamic State, and these ISIL fighters, are an abomination and they have got to be confronted and they have got to be faced down….

This has to be looked at at several levels. Yes, of course there a military level…..

But there are other levels at which we have got to go at this. Continue reading

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A more creative approach to welfare reform could have saved lives

So, while the UK was talking about Scotland, someone has died:

David Clapson’s awful death was the result of grotesque government policies (9 September)

‘The DWP brags about ending the ‘something for nothing’ culture, but benefit sanctions punish the unemployed, disabled and poor in ways that are utterly inhumane.’

Family calls for benefit inquiry after David Clapson death

‘Diabetic David Clapson, 59, from Stevenage, died from lack of insulin, 18 days after his Jobseeker’s Allowance was suspended in July. He was found dead in his flat on 20 July, with £3.44 in his bank account.’

I have posted on this topic before: Continue reading

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Why the Scots would be mad to vote for independence (not that I care).

So, next week the Scots will decide if they want to be independent.

Let me start by declaring a lack of interest in this issue. A complete lack of interest. I think may be one-eighth Scottish but I really don’t care if I have Scottish blood coursing through my veins. It hasn’t affected my life either way.

I have been to Scotland a handful of times. I have watched a couple of rugby internationals in Edinburgh and stayed with some friends in the Borders which was good fun. I may have been to Glasgow once to be on local radio but I really can’t remember. Nor can I be bothered to find out. It really doesn’t matter either way.

I wonder how many Scots have heard of ‘ASEAN’? Continue reading

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When all you can do is play the ball that is bowled to you

To many of us, especially those of us who lived through those days, the TV series Mad Men has been essential viewing. We have come to know the character Don Draper, played by John Hamm, like a friend. And now, this week, Hamm’s new film Million Dollar Arm has come to London. And it’s about cricket! Wahaay! Have the Americans seen the light?

Now, if you don’t play cricket, I am sorry. Please bear with me. Who knows, the lesson in this post might change your life, just as a cricket ball can end it. Continue reading

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Long Lost Families and Masters of Sex

The most interesting thing in the world is people. And, talking about interesting, which we were, and people, which we are, there is a peculiar juxtaposition in two TV series currently on air.

For me, and anyone with personal experience of adoption, a must-watch TV programme is Long Lost Family where people separated by adoption at birth are reunited with the parents they have never met – usually their mother.

It is shocking to learn about the attitudes to pregnancy that prevailed in the lifetimes of two generations of people still living today. For, until the 1960s/70s, pregnancy represented a harsh and unforgiving world where babies of only a few weeks old were torn, literally ripped away, from the arms of their screaming, desperate mothers who, typically, were still teenagers. Continue reading

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It may be right. It may be good. But is it interesting?

David Ogilvy said this about advertising:

‘You can’t bore people into buying your product, you can only interest them into buying it.’

Here is the same mantra with the key word underlined by me:

‘You can’t bore people into buying your product, you can only interest them into buying it.’

As my advertising career began with Ogilvy, I have been interested in ‘interesting’ for a very long time.

In today’s world, is advertising interesting? Continue reading

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Debt collection: the shameful face of modern Britain

In free market economies, providers of products and services need customers.

In marketing, without customers, none of us are anything. Or, if that is too tortuous a double negative, without customers we are nothing.

Customers are the name of the game. They need to be identified, understood, targeted, persuaded, looked after, nurtured, retained. Continue reading

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