The Healthcare Experiment

The National Health Service. The most efficient health service in the world. Not a phrase you hear very often. Normally the headlines say ‘doctor errors’ or ‘ long waits’ or even ‘NHS wasting money’.

But over the years the NHS has grown from a basic service that focussed on minor problems to a nationally recognise healthcare system, free to all at the point of care. No matter your age, work status, back ground or health problem.

Healthcare in the United Kingdom achieves something all services want to deliver, equality and diversity. From its workers to the patients.

So why do politicians like to say ‘it’s the crown of the country’ while saying ‘it’s to inefficient and costly’? Why do politicians even get involved with the institution when the experts already work in the sector?

Many years ago while contradicting various statements they made, politicians decided that the American system made more sense. More specifically the idea that competition drives change and improvement. And they decided that the money in healthcare must be split between the people holding the money, and the organisation delivering the service who would be paid by the other organisation who would choose not only the organisation delivering the service, but are they doing the job properly.

This idea or concept or whatever it was called, oh yeah: world class commissioning. And so every area or Primary Care Trust as they were known, got to visit America to learn from them.

So, a few issues soon presented themselves. Firstly, America of all places to get advice about a healthcare system. Keeping in mind that the system is not equal for all in the states. In fact, it is separated between the have and have nots. Oh, you need surgery, are you insured. Your not, 80,000 please. You don’t have it, go home and die.

Secondly, we now have commissioners who hold the money and decide where it gets invested and for what reasons. The commissioners cost money and decide what cost saving is required of the provider.

Thirdly, healthcare is also overseen by the Department of Health, Care Quality Commission, NHS Digital, NHS England and it goes on. We have more people watching healthcare than providing it.

So why was this put in place? The reason given was to improve health services. The real reason was cost saving and off loading of responsibility. For example, if something goes wrong in a hospital, it’s their fault. Not the government or the commissioner. A new contract to cover the service goes else where. Which will include cost savings, reorganisation and lots of back slapping saying ‘good job’.

Meanwhile within the NHS, the staff are keeping things going with good will, poor conditions and constant belittling from news papers and news outlets.

The NHS has been in crisis for over 6 years now. I think it’s fair to say the experiment has failed and maybe, maybe, it’s time to let the NHS do what they do best.

Save money by removing commissioning and move to a holistic NHS approach across the country. Invest the saved money back into services. Let the CQC and NHS England do the job of keeping an eye on the services and research where money should be spent.

Let a consortium of professionals run the NHS from GP, Hospital, Mental Health, Community and Social Care. These people can ensure funding is spent properly and invest accordingly depending of evidence, not political or financial gain.

Currently the NHS is relying on good will and dedication by the people who bleed white and blue. Before long if we are not careful a do not resuscitate order will be put in place and we, the ones who care about the NHS will be arguing to save it’s life.

I leave you with this. If you can save a life save it, if you can help a living creature help it and most of all, if you can afford to buy a Costa coffee everyday you can afford to pay more tax to help the people who one day may save your life.

So why do politicians play about with the NHS and contradict themselves? The same reason people will follow rock stars or actors around like lost puppies. “They be famous, I could be too”.

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The Dog Particle

Some search for the tiniest of particles which may lead them on a journey over decades. Some adventure to dangerous places like in Netflix Dark Tourist. Others spend their days researching the details of a forgotten time.

Should we all have these ambitions or is any drive enough. Is the search of pleasure and contentment what is really about?

If your life starts and ends with a love of sun worshipping or rock climbing, who are we to judge.

But what if you don’t know what you want or how to feel about your life?

I recently lost a pet, should I say family member. This cat lived with me, sorry, my cat let me live in his house with my wife. I didn’t realise until he wasn’t there how much my mental health relied on him.

This got me thinking about our relationships with animals. Humans and animals have relied on each other for centuries. As food, allies and companions.

You would see paintings of explorers with there faithful dog by their side. Police with their four legged partner. Farmers with Shep, controlling the flock.

The farmers cat keeping down the rat population. But is this just a work relationship?

So when these people with the drive of discovery get home, do they need a dog to work for them. No.

But, what if it’s because of this relationship they are able to relax, concentrate and even let go from time to time. Our pets are more important then most give them credit. Would half of the discoveries made have even have happened without a way to switch off or unwind. And how many of those were due to animals being there for us at home.

Without my family friend I do feel life is a struggle. What discoveries or freedoms am I missing out on because he is no longer in my life. All I can be sure of is, they are not pets but family members, supportive friends, mental health support. Even if they don’t work for you, they help you every day, in their own little way.

Please support dogs for the blind, helper dogs, hospital dogs, reading dogs and mental health dogs whenever you can.

Please remember, cats don’t care, they put up with us, we have food. We are here for then. They are bastards, but we love them and them us in their own way.

The Quality Cascade

5 GCSE’s or equivalent qualification. PhD in astrophysics or equivalent experience. Team player with proven track record. Written reference from Sir Winston Churchill and at least 4 if his children.Is it me or are job specifications getting sillier by the day? I once applied for a job as AD of Business Development. I have 4 years experience as a change manager, a diploma in change management and worked in the relevant sector for over 15 years. I didn’t even get an interview because they wanted someone masters.I have moved on from this since but how does a person having a masters help in any topic.My mental health means I see things differently to others and have the ability to turn complexity into visual understanding. This in turn means I can explain and simplify for others. Is it because I have GCSEs or a diploma? No.If you take a job like coding or cyber security, I don’t want a university educated, theoretical computer science specialist. I would rather have people who are on the autistic spectrum. They analyse faster than others, see things others don’t and enjoy doing it. Will they have a degree or would they have built up years of practice on there home PC while hacking Curry’s PC World.Some Dyslexics have trouble writing or spelling, but are fantastic at seeing patterns or understanding visual elements of subjects. Their brains can work like a logic machine. But they would not even get to interview due to not having an English qualification.If organisations want the best, we need to start basing our need on those people. There is a shortage of cyber professionals, if we follow current ways of finding them. But organisations could find talented people by changing there recruitment procedure. Start workshops, adapt work environments for autistic staff, be flexible and most of all, don’t base everyone on an academic standard. Only around 15% of those on the higher end of the autistic spectrum have employment.How many more geniuses are stacking shelves who have excellent cyber skills, coding skills.And as for always putting team player in all job specs, do they really need to be to stop cyber attacks or code some new software. Food for thought. Check out a company called CyberSpace in Holland. They are doing great work with kids.

The Manic Dynamic

As with most, you have ups and downs. Moods that are good and moods that are, not so good. But at what point in this long spectrum does being not so good become depressed. And at what point does feeling good become manic.

My manic moods are easy to spot. Constant hyperactivity. Everything is a game and if it’s not it will be. A biscuit in a tin can be entertainment and laughter for hours. A squirrel in the park is the best thing ever and an excuse for acting like one. Walking like a penguin, because I can walk like penguin. Or chasing my wife acting like a monkey. Endless euphoria.

But with this manic episode comes the moment of realisation that I have been in an episode. By now I have already realised the euphoria is ending. Soon I will be normal again, if I’m lucky.

When I’m not lucky, my mood continues to go down beyond feeling a little down to the depths of depressed. Not that I recognise this at the time. My thoughts slow and become obsessive and paranoid. The world turns to being against me and darkness my new friend.

But sure enough, this also fades and I’m back to normal, hopefully. You get the idea. The recognition of either extreme is not accepted by me until after it ends.

At least each time you come out the other end. Sometimes as a monkey and sometimes as a paranoid obsessive. They are both me just to the extreme of the mood spectrum.

The Thoughts Vortex

The scene is set! You go up the stairs to the bedroom, your fortress of solitude. Brush your teeth, remove your contacts, check you don’t need to urinate. You lay down on the comfy bed, close your eyes then…

CD Player, I had one when I was younger. I have to go to that meeting tomorrow. What did she mean by I have missed some deadlines. I need to do more exercise. Am I getting fat. I hope my friend will be ok. I wonder how Kiefer Sutherland will survive this one. Can’t wait for Games of Thrones. Need to get the garden finished. Squirrel! I love dogs. I should listen to more music. Why do I need to attend that meeting. I didn’t realise I had missed many deadlines, we are very busy. Can’t wait to get out on my bike. I love chocolate. Its a minor surgery. I want to watch the next episode. Should I watch the whole series again. The pond needs to be bigger. Pheasant!

I focussed on going to bed but in truth these thought vortex can happen anytime. The worst part is it does not mean you are distracted. This can occur while in meetings, doing exercise or having a discussion. Its like trying to concentrate with constant noise around you or trying to speak in a loud night club.

While once a week may not produce any adverse affects, two or three times a day becomes wearing. You begin to show signs of fatigue and a general feeling of blur! Effect is moving and small things cause irritation. You become that snappy person that normally you would pretend to hold a handbag to your chest about a say “ohhhhh”.

Once, it became so bad while I was in a noisy supermarket, I held my head as I felt anger and frustration build up inside me. The extra noise around me was adding to the vortex, neither could be stopped. It would only have taken a tiny push to make me blow up.

Thankfully, getting to the blow up stage and moving beyond has only happened once in my life. I remember shouting “shut up” as I hit the floor with my fists before collapsing in a teary heap. The person who caused me to go over the edge hadn’t shut up, hence the finale of fist smashing. Better that than aggression towards a person. The worst part, is the constant head vortex didn’t stop, only the extra external irritation stopped. It took 3 hours before I got up off my kitchen floor. By then I was so tired I went to bed.

There are ways of coping but not controlling. There are ways of reducing the anger but not curing. When the vortex really whips up, concentration is the key. I’m not talking about forcing yourself you focus on something. I mean something you natural focus on. Games on the console, painting, spin classes, iPad games. Anything that naturally keeps your mind focussed without having to put any effort in. Or, as with me, multiple things. I’ll paint, may go for a cycle or play games on my iPad.

One more tip, explain the problem to people close by. They can always help when you need time away from others. I always have issues with particularly loud noises. My number one hated noise, hand dryers. Wet hands on my jeans every time. If I wanted the loud sound of a hover that’s gone wrong stuck in my ears, I would buy the album off iTunes. I’m sure that album exists, 101 special effects to annoy the whole family.

The Logic Cataclysm

Obsessive Compulsive Disorder. I like to use its full name from time to time to help me see it for what it is. I have an obsession, a compulsion that becomes uncontrollable. Hence the disorder part.

So I could understand it better I have tried to slow down the beginning of an obsessive episode. For me, the thought starts from something that I see as illogical. In this scenario lets use a process that is meant to make organisation restructures fair.

“Hello all”, a voice says from the depths of the HR cave. “We are restructuring the organisation to make it fit for purpose”. This for me was the start of an illogical process that will become an obsession.

The reason it was instantly illogical was I knew nothing about it as a mid level manager. Nor did the Assistant Director who is my line manage. Nor did any of the other managers or Assistant Directors. This means it was decided behind closed doors with a couple of people who have no idea what anyone does.

This is when I try and get answers to help my logic train get back on its logical tracks. “Is this to make it fit for purpose, or cost cutting”, I said calmly once I had a one to one with a director involved in the structure. Respect to the director when they answered “Its about saving money”.

Oh dear. My derailed logic train was now heading for a full blown crash. Other questions begin to form so I ask them. “How is cutting resources going to help you save money over the next few years, where is your strategy and what are you going to invest in to get there?”.

I must admit by this point my questions tend to extend to questions in questions. But this is due to the driver of my logic train trying to hold on for dear life. The answer to these questions will decide if there will be catastrophic multi pileup of logic trains or a last minute flick back on the logic tracks.

“This was decided by the board”. Oh hell, brace for impact, process failing, illogical sensors are firing. Questions begin to overlap, a feeling of dread builds as my mind begins to repeat the same process again and again. Like a malfunctioning robot, I repeat the process but get the same outcome each time.

My brain cannot process illogical things. If a straight line is the fastest route but we are going to go the long way, not to enjoy the view but just because I’ve decided its better, my mind briefly stops for milliseconds while it works out the logic.

But where logic does not exist, I am doomed, for a time at least, to obsess over the same thing. Control has a lot to do with it. I don’t have a voice to change the illogical nature of the thing that is happening. I may as well not be saying anything at all. But this leads to the obsession finding ways out through temper, sharp responses and tiredness.

Everything in nature makes sense to me from bacteria to the stars we see from earth. Yet making a decision based on a lack of knowledge,  lack on insight or forethought, perplexes me. All of us make silly decisions but wouldn’t you stop a train crash if you could, or stand by and watch it happen? This is the problem with my head. I can’t turn it off, or get over it, or distract myself.

The options I have are cycling, this helps. Painting, this helps. Or not being in the situations that cause my brain to have obsessive fuelled failures. I may as well stand up and repeat “cannot compute, cannot compute”.

So, off to distract myself. Oh and just so you know. My train drivers are fine they have great healthcare under the NHS. More to do with the amazing staff keeping it together, nothing to do with the conservative government gradually destroying it!

The Loudest Silence Philosophy

Something I have noticed people including myself struggle with is describing the feeling of severe depression. How do you describe a giraffe to a creature that has always lived in the ocean. “It has four legs…”, you start before the fish interrupts “what are legs?”. “They come out of the body and hold you upright…”, again an interruption of “why don’t they just swim?”. “OK, there is this force called gravity…”. You get the idea. I know it’s a little extreme but imagine, as I have to, that all you have felt in your life is sad!

Now I’m not playing the feeling of sad down. I hate being sad. But sadness and depression are two very different things. When my Mum died I was devastated. I was very sad and was grieving. But this felt very different to when I’m depressed. I fact, sometimes depression can make me sad. Trying to explain this to someone who has not had depression is to say the least, kind of impossible.

From my experience there has only been a few occasions that depression has been described brilliantly. One is the Black Dog video by The World Health Organisation (you can find this on YouTube). Others include descriptions by comedians who have suffered from depression or actors such as Jared Padalecki who promoted #AlwaysKeepFighting depression campaign. But do I understand and like these because I have and do suffer from depression?

My way of explaining depression is a little different. It may just be me but here goes.

Imagine a deep droning noise in your head, not really load or unbearable. But you can recognise it’s there. This is the start of your depression. At first the noise is low, quiet but still causing you to be a little irritable and angry. Now as the days go on it gets a little loader and things you could normally hear clearly become muffled. The irritability gets worse and loads places like nightclubs make it worse. People talking to you or being to load makes it worse so you start to avoid those situations. A few more days pass and the noise is constant, noticeable over everything else and you can’t control it. All you want to do is cover your head and avoid the noisy world. You feel angry, really irritated but now a new feeling arrives, one of exhaustion. But its not over, the noise gets loader still and brings with it another surprise. It’s the feeling of giving up on everything you know, the feeling of being numb and lifeless. The noise never stops.

The noise may get quieter and sometimes you may even feel it’s gone. The luckiest may have a one off noise for a few months while others it’s a ticking time bomb waiting the gain its volume again. It’s the loudest silence you will ever hear and for those who have it for life, just have to learn to manage it through medication, therapy, lifestyle and all of the mentioned.

Once I saw a doctor who said “you just need to do some exercise and get off these antidepressants”. I strange thing was he never checked my diagnosis or asked what exercise I do. I love cycling and train all year round. The day I saw him I had done a 100 cycle the day before.

I was also told to “man up” once and to “get over myself”. Someone even said “Cheer up a bit it’s not all bad”. I’m still waiting for the day they need a doctor and lose a limb so I can say “so you have lost a limb, just grow it back”.

There was a poet who normally I found to be very interesting until one day he released a video stating that anyone depressed should watch his video as it would “change their lives”. I watched the video and felt like slapping him up the side of the head. He compared people with depression to feeling a bit sad. He actually said “here is a cloud, but it passes you by. Like the sadness your feeling”. Oh yeah why didn’t I think of that. “I’m cured”.

Check out the Black Dog video and remember that depression is different for every person. There is no cure or magic or natural remedy that will make it go away. For some it will be a temporary illness. For others like me it is a lifelong fight that will have ups and downs like any illness. Make sure you have a support structure and have a code word for when you are suffering from symptoms, mine is “I’m feeling Heady”, so your support around you can know how you are feeling and help.

Keep strong and always listen to your doctors (unless they are useless and think mental illness isn’t real).

The Employee Deterioration

 

I wake up at random times of the night, wide awake. Decide to walk to the toilet, back again, get back into bed then wait to fall asleep. Yet the alarm sounds and I want it to stop. I’m so tired that my eyes barely remain open. “Just 10 more minutes”, I say to myself. Not that the 10 minutes will help.

Some mornings I get up on time and go on my indoor spin bike to do some interval training. This helps wake me up for the day. There is nothing like pushing yourself to the limit before you are properly awake. A protein bar, washing, dressing, tie tying, a Coke Zero and breakfast biscuits for the drive in.

As I join the manic metal road train of rushing parents and workers going about their day, BBC Radio Two provides a distraction. Cars travelling to close to others as they need to get somewhere faster than anyone else and we are all in their way. The occasional Nissan Micra or old beaten up Jaguar deciding that 47mph is plenty for a national speed limit road.

Finally I reach my destination. At this point my mood starts to go from determined to numbness. The building may as well be a precipice with no end. The light I use to hold for my work has faded and a shell which use to hold enthusiasm and enjoyment just gets out he car. Every footstep to the door is heavy like chains are pulling down my body. As I reach for my security fob all effort I have left is required to pull it to the door system. The door blips with enthusiasm. Why shouldn’t it, it has a task in life it succeeds at.

The door slams behind me as I make my way into the florescent lit room that resembles a battery hen farm which we are all so against. The keys of keyboards clatter, while phones buzz into life. Generic greetings can be heard before the first person walks towards me and says “sorry to jump on you before you are settled in”.

My body instantly reacts like Ironmans suit, automatically springing into action from head to toe. The smile appears on my face, shoulders go back and the words pour out like a dolly with a pull cord, “That’s ok, how can I help”.

Throughout the day I think, “there must be more than this”, and “I would rather be…”. These are probably normal thoughts that everyone has. But I didn’t use too. Before I was sent through the repeated NHS grinder made up of restructures, organisational changes and cut backs I was inspired to be in the NHS. I helped the clinical staff every day and made a difference. We were all a team, working to help people.

But my organisation has become deaf to the voices of its staff. Instead, external contractors are trusted above staff and patients. They would rather spend their money on an expensive suit than pay for up skilling staff. Mr and Mrs suit know best, they must do, we are paying them a fortune. What could the minions know, we don’t pay them properly.

Things in the NHS have become messy and cloudy. It’s like we are all islands and none of us have maps. If any of the experts who live and breathe healthcare speak up, a shout can be heard from government telling us how expensive it all is. And if there is a problem, it’s our fault, not theirs. We have been reduced from the largest employer to the messiest of commissioning led services, a postcode lottery of care.

But what if we asked the question of patients and experts, “what should the NHS look like?”, and then ask the government “how would you want to be treated by the NHS?” We could then logically state with certainty how much it will cost, how it should look and how it could be managed. Let’s go really crazy and protect the legacy of the NHS, healthcare for all, no matter what your background or nationality. Let’s protect the workers, the nurses, doctors, healthcare assistants, care staff, support staff.

Meanwhile, back to reality. The day is long and draining with little gaps for thinking. Due to restructuring my future is held in someone else’s hands again. The fact that I’m an IT professional does not matter in the eyes of executives and human resources, as long as I have some sort of job. Human resources will remain unchanged as always and the safety net of the directors specialties the same. If they know finance, the finance team will be fine. If they know quality the quality team will be fine. But if they don’t understand what you do, then you are the one that will pay for it in this structure.

Time to log off the computer, lock up the cupboards, turn off the lights as always due to everyone leaving on time except me. Walk to the car with the sound of the door closing behind me. You would think at this point I could take a deep breath and relax. No that would be too easy. Now the obsessions, the paranoia, the deep rooted depression really kicks in. The feelings of being alone and trapped while standing in the cold dark car park. The feeling of losing control of your future while executives switch off and enjoy life at the top. Maybe that’s my paranoia speaking, or is it!

You are told that working hard pays off but you are not told that some will take advantage of that. You are told to respect the hierarchy but never told that this respect doesn’t always come back. Your belief is based on doing good work to achieve an ultimate goal but what if that goal is hidden.

I guess work is a big part of every one’s life and everyone has difficulty with work sometimes. But I can’t help but think that my mental health hugely holds me back. Is it too much to ask a saviour to step in, tell me everything’s going to be alright and help me into a new job that I will feel inspired to be in again. They don’t need to be dressed as a super hero or anything (unless its Batman), but I feel I am being to hopeful. Quoting famous lyrics, Let’s see what tomorrow brings!