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”.

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 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 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!

The Conservative Business Imbalance

I work in the NHS, more specifically in community healthcare as a Leader in Information Governance and Information Technology. Standard practice involves getting to work, firing up the laptop, turning on the work mobile and checking emails. I produce policy, guides, documents, research law blah blah blah!

This style of working practice is alien to humans. When did you normal start to be antihuman? So here I am, living in another time. This morning I am building a new central building for celebrations. Tomorrow I will be painting the interior with incredible colour. Next week I will be discussing how we will make and plan the rest of the build with others in the village. Once it is all finished I, and all the villagers who worked on the project will step back and say “we did that”. Ok back to reality.

I know this is romanticised and life would have been hard for our ancestors. But the point is, as a society we have lost the element of the big picture. As we as a culture have become over populated and taken over more of the world, our communication has increased. We work together far more but, we only see part of the big picture.

Imagine being locked in a room for years. All day you forge a piece of metal to an identical specification. You get paid but you never know what the piece of metal is for. Your morale will be low and you may work quite slowly and lose interest which could affect the finished piece. Now lets mix it up a bit. This room is now an aircraft hangar. Others are working around you on other parts. Then in the middle, is a plane. You can see the part you have made being placed onto the plane with other parts. Once completed you can see the customer pick up the plane and see its test flight. You learn that the component you make is a safety feature that has saved 20 lives each year it has been fitted. You have purpose, you feel inspired and even take interest in others work and how the plane was designed. Put in simple terms, you have a village.

So whats this got to do with my mental health? I have needed to force myself into a world based on how people think things should be, not on how humans are used to being. Through school we learn through play up until we are 5-6. Then the tables, chairs and looking forward at a board starts. Straight away preparing us for work at a desk. By the time we reach secondary school, we are trained very well at sitting at a desk and looking at books and computers. By college, we naturally turn to books and computers to carry out all our work, revision and tests. Then there is university with its large auditoriums and, you guessed it, books and computers.

I’m not saying that books and computers are not required, but is this really the best way to learn? Do we need to sit at desks? Are we teaching everyone a conservative approach to work? Are we subduing the natural tendencies of humans to innovative and discover to survive?

For me, academic learning is a nightmare. Sitting at a desk with a book or computer and with a test at the end is hell to me. So my qualification scores are average but my practical results are excellent. In truth is it not the practical results that employers need? Don’t we need people to ask questions and challenge the way we think?

For me certain things at work agitate my mental health problems. Meetings are not really useful, more specifically, formal meetings. The constant non stop overload of information and people talking, the need to make notes and the sitting at a desk in a room that was designed by Mr Conservative himself. The bombardment of questions expecting instant answers to every question with immediate timescales. Documents that must be in a consistent, conservative, black on white format with no sign of being interesting other than the business logo in the corner if you are lucky. And last but not least the inspirational, overload of information known as the spreadsheet. Full of numbers, stats and columns of confusion, unless you have hours to look over the sheets.

Again, I’m not saying this is wrong just that this is based on a specific type of person that thrives on the detail. One decimal place is not enough and nor is a top level plan. We must have every little thought and plan for every possible scenario, even the impossible!

Me and many others thrive on colour, diagrams, logical interpretations, pictures, inspirational spaces and everything beautiful. Yet the environments in most offices are as inspirational as a cowpat in the sun. Without an image of the bigger picture you may as well be throwing your work in the bin after you finish.

A work environment should mimic the natural world as much as possible. What’s wrong with plants, art work and comfortable chairs? Why can’t a work space be flexible to adapt to how the employee wants to work? We always feel better when we are in a nice environment with flexibility and the best innovation thrives on it. Check out the Google HQ or Moshi Monsters or Apple. These environments encourage play and innovation.

So in conclusion, your work environment can have an impact on your mental health. Businesses need to adapt to enable happier work spaces and to reduce stress. I tend to look at two screens all day. Turn to the left, cream coloured wall. Turn to my right, storage units, desks and other employees. No breathing space, nothing inspirational and constantly feeling out of place. Come on businesses of the world, innovate, become more human and help us to help you!