Something Sinister
I work in the NHS. I have done the same job, albeit with several promotions along the way, for over twenty years. I started under a Tory government, worked my way through thirteen years of New Labour, and now find myself once more at the mercy of the Conservative party and its contempt for public services. Yes, yes, I know that technically it’s a coalition, but we all know what the truth is. The truth is that we’re now at the mercy of a hideous chimera, neither of whose constituent parts mentioned anything about dismantling the NHS in their manifesto – in fact one of whom specifically said this: “there will be no top-down reorganisation of the NHS” – but who now seem hell-bent on tearing it limb from limb and feeding it to a profit-hungry private sector.
My job is based very much in the backroom. You won’t see me mentioned in the headlines about nurses’ pay, nor in the British Medical Journal. But I am a qualified professional, with a degree and hard-earned postgraduate qualifications. On my more self-aggrandising days, I award myself a total of 12 post-nominal letters (9 of which have cost me approximately £1500 to date) in all written communications. And my job is not one of those middle-management bureaucrat positions that the popular press love to mock; the work I do impacts directly on patient care and helps families to make – literally – life-or-death decisions. I care deeply about my job. I work many hours of unpaid overtime, because I want the service I provide to be as good as it can be.
Anyway. Enough of the thinly-disguised martyrdom.
In the light of today’s latest public-sector-bashing announcement from our mandateless puppet-masters, I had a conversation with someone on Twitter which made me think. He works in the private sector, though not in healthcare, and often likes to accuse me of being a ‘lefty’. If that means that I believe in fairness and equality, and doing the right thing, then: yes, guilty as charged. But if it means that I’m an anti-Tory, anti-capitalist knee-jerker, then: no. Wrong. Nothing in life is ever that simple.
There is nothing wrong with trying to save money in the NHS, or in any other public sector organisation. Entrusted with the hard-earned money of millions of UK taxpayers – and let’s not forget that, unlike the corporate behemoths cosying up to HMRC, we are taxpayers too – we have a moral duty to provide the best possible service at the least possible cost. But the taxpayer also has a right to expect that he / she is not paying tax so that private companies can profit from running services less well than their public sector predecessors did. To allow public money to go straight into the back pocket of big business, as a reward for providing services driven by cost-effectiveness (aka profit) rather than quality, is a moral crime far greater than that of paying a nurse with 40 years’ dedicated service a slightly better pension than someone who works in the private sector.
In the last two years, the department in which I work has been subject to multiple ‘efficiency reviews’ by multiple highly-paid management consultants, none of which has achieved a single useful thing – not due to unwillingness or lack of engagement on our part, but due to a lack of understanding of the specialised nature of our work on theirs. One company, paid thousands of pounds to conduct an in-depth review, has not even managed to produce a report at the end of the process. It just pocketed the cash and went away, having used up hours of staff time that could have been spent doing something productive. Ultimately, the people best placed to deliver efficiency are the people who understand the job. We do, we can, and we are.
And we, the people who work in the public sector, also have a right to expect that we will not be treated with contempt by our blue and yellow chimeric overlords. Of course the country is in dire financial straits. Of course we need to save money. But it is beginning to feel as though the Government will not stop until it has salami-sliced every public sector worker’s pay and pension down to the absolute bare minimum it can get away with, while it continues to cut taxes for the rich and to waive them altogether for the super-rich. If thinking that this is unfair makes me a lefty, then I’m going to have to change my name to Vladimir.
Something Blonde 
I think you’ve identified part of the problem when you refer to your friend in the private sector. People forget that things like the NHS are a service rather than a business.
The most financially efficient business doesn’t necessarily mean that it offers the best service. When those in the private sector apply their business standards to a service, they aren’t comparing like with like.
Unfortunately, the Tories with their privatisation agenda, want us to view everything as a business, and to convince us that this is the normal way to view things (and that it was always that way).
Another great post, to be expected.
My response will probably get some backlash, but I feel it’s worth getting my point over, as a small business owner and former civil servant, (ex Royal Navy).
To All, I am the person on Twitter referred above.
The private sector sells a product or provides a service. It only does this if someone takes a gamble and risks something of themselves and their families to do the job/sell the product.
The bi-product of my business is to make money. There is no security, no guaranty of employment and in my case, when my company that turns over about £1.1m wanted an overdraft of £20K – for just one month whilst waiting for cheques to arrive, (mainly from government agencies), I was told that I had to put my house down as collateral.
My aim in business is to enjoy my work, provide an excellent service to my customers, provide an enjoyable place to work for my staff, (14), pay them a fair salary, give them a good package – and to make some money. I don’t have a company car, I do get paid better than the average, (but I have 15 years of business behind me).
An example:
In my business, I provide a service to the police that is cheaper that if the police do the same job. For some reason, police forces think it’s a good idea to train police officers to do this particular job. I would rather they stayed being police officers. It seems pointless training up a member of staff in a totally new job to me. You end up losing their resource in the job that they were trained for.
The argument from LE, (Law Enforcement), is that they are cheaper that sending the job to an outsourced company. They don’t take into consideration that when they retire at 50, (after completing 30 years service), they get a BIG lump sum, then they also get their pension. Now call me old fashioned, but I think that’s a shit hot deal? At 50, most of them then go on to ‘consult’ or take on new careers, meaning that they are still getting paid by me and my fellow tax payers until they die. If you pro-rata this, the average life of an adult these days is about 85, so they have 35 years of pension, which means that their average pay then goes up to something around £60 – 70K per year, (I don’t have any actual figures, I am guessing them – but i am sure you get the gist).
I believe that this is an extreme, but it hopefully shows my point. What people get paid isn’t necessarily the whole deal.
For the record, I have some great friends that are police officers. I also believe that they do an excellent job.
There was a big fuss recently about the Forensic Science Service being shut down by the police. I was delighted! I lost out on business to them. The difference between my company and the FSS being that my company wasn’t 51% owned by the government – who just happened to be funding them to the tune of £2m a month, (the loss they made per month). This is why we lost business – the FSS were undercutting us.
Ironically, I employed one of their forensic scientists. A really nice chap who had worked for them for over 10 years. He was earning £16K. We took him on. He now earns 26K, doing the same job, just a year later. He also has BUPA, an extra weeks holiday than the legal requirement and gets another day off for each years service. To me, this says that my company is more efficient the government owned FSS. The reason we are better is because the money is ‘mine’. It matters. I can’t just put it down to a bad decision or just one of those things – unlike civil servants. If I make a mistake, it could mean that I lose my home and that would likely mean that colleagues would be in a really bad place financially too. My business has accountability. I don’t see that from civil servants. I see the occasional scape goat, but the senior managers don’t seem to lose anything, just get retired on full pensions.
My wife is a civil servant. A couple of years ago, she got a new director of services. After 18 months, the director decided her position wasn’t required and took a £250K pay-out and pension. Who the hell employed her and why did she get the pay-out? Why wasn’t the person responsible sacked? (another example of civil service anonymity.
Politically, I have voted tory, (remember I was in the Royal Navy just after the Falklands), I have also voted Lib Dem and for an independent, so I try to be fair. I haven’t voted for Labour because I think they are weak. They gave into to everyone’s moaning, (especially the unions), and paid everyone more, gave everyone better everything. A bit like communism, it’s a great idea, but it can’t work. It just doesn’t work. We have proof of this now in that financially, we are in the shit as a country. I believe that the lot that are in now are genuinely trying to sort problems out, and the way they are doing it is to get everyone to contribute more. By not giving everyone in the civil service pay rises, (which it can’t afford) and getting rid of lots of civil servants. The reason civil servants are going is, like the police, the cost of employing them is incredible, (taking pensions and other perks in to consideration). The private sector will be doing the same job, (probably more efficiently, therefore cheaper), but it’s the job of the company, not the government to sort out the perks like pensions etc.
I could not have any respect for any party that thinks that if they are in debt, the best thing to do is to go shopping, spending more money that we have borrowed. That’s sheer lunacy. I understand that by spending on capital infrastructure, you are employing people that spend money and pay taxes, but even taking that into consideration, it’s not viable. Greece, Ireland and Portugal have proved this.
I don’t want you to all agree with me, just to be open minded enough to hear another point of view.
This was meant to be a short response to Something Blonde. It isn’t. Sorry.
PS I am not a writer – as I am sure you can see.
Hi Simon,
Thanks for taking so much time to write your response -and thanks for being the person who inspired me to write the post in the first place 🙂
You and I both know that we seldom agree politically, but I hope that I’m open-minded enough to see both sides of most arguments, and so I’m thinking about what you’ve said.
The first thing to say is that I’m sure you’re a great boss. You obviously care about your job and you are obviously respected by your employees, and I have nothing but respect for anyone who is willing to risk the roof over their head for their business. That’s one thing a public sector employee will never be expected to do, unless you count those who can no longer afford to pay their mortgage because of the constant pay freezes and regradings. But you and I both know that the kind of private sector company I’m talking about when it comes to NHS outsourcing isn’t a small business with 14 employees providing a highly-specialised service with a relatively low demand. No. The kind of company I’m talking about is the kind of company that makes an operational profit of £123m, yet pays only £1m a year in tax (http://www.guardian.co.uk/politics/2012/mar/17/nhs-shakeup-health-firms-tax-havens). An organisation which is willing to operate in the murky waters of offshore tax avoidance is, to me, an organisation that puts profits, not quality of service or employees’ welfare, at the beginning, middle and end of its business plan, and on all the pages in between. And I don’t want any organisation with that kind of agenda to be running the NHS. As I said in my original post, we as NHS employees have a moral duty not to waste taxpayers’ money; but the flip side of that is that any corporation which becomes involved in the running of the NHS has an equal moral duty not to divert the taxpayers’ money to the Cayman Islands where it will never be seen again. That would be as much of a waste as the public sector ‘inefficiencies’ that politicians love to beat us about the head with.
Secondly, believe it or not, I agree with you about the police. Mr SB used to work as civilian staff for a large UK police force, and told me pretty much the same things as you mentioned in your comment. Police officers would retire at 50 on a 2/3 final salary pension, then apply for another job within the same force and be re-employed – while still drawing their pension. They’d also be allowed up to 90 days a year on sick leave. Now, I’m not suggesting that being a police officer is an easy job – of course it isn’t – but those seem like pretty generous terms of employment to me, too. But maybe we all think the grass is greener somewhere else. I know that many people would look at my salary and pension and think them outrageously high. I do myself, sometimes.
Unlike you, though, I can’t make myself believe that ‘the lot who are in now’ are genuinely trying to sort the problems out. I don’t deny that we’re in a financial mess – but I suspect that the Coalition is merely using that fact as a convenient excuse for lining the pockets of its friends in big business behind all our backs. I’m not anti-capitalist, but I am anti-lying.
And as for your employee who’d worked as a scientist for FSS for ten years and was only earning £16K – doesn’t that tell you something about public sector wages? 😉
Thanks again for commenting, and for stimulating a thought-provoking discussion.
No doubt you paint a colourful picture of a NHS as must
maintain a good public opinion of also its TITANIC loss.
The NHS is a financial disaster // money ever poured unto
a bottemless pit // the cost in running such a folly meaning
in reality there little gain for $trillions of its ongoing costing.
Let us also take to account the claimed qualifications of
a good percent of NHS staff are totally fraudulant / such
an dire situation having been allowed continue in having
brought direst results for many of their vulneable victims.
The birth of the NHS in itself being a total gigantic fraud.
The 2nd world war ( though in truth such was not a world
war but a war betwixt a USA and western EURO nations
as to whom had as held military domination / thus could
hold the rest of the world to ransom / THIS being won by
the USA with its lacky British Govts whom having always
bowed before their USA masters // in knowing the USA
(IF NEEDED) would bomb BRITAIN as they would BOMB
IRAQ AFGHANISTAN LIBYA V ITETNAM as any NATION
as people whom did not bow before them. The USA but
preaches democracy as freedom yet the reality the USA
MILITARY / GOVTS be the biggest terrorist organization
that the world having ever known // their brutality against
people is beyond words to describe / having butchered
millions worldwide/ man /woman /child / shown no mercy.
As said the birth of an NHS a gigantic fraud. Its birth was
not to serve the nation / people’s as portryed in the fairy
story of media brainwashing the reality t’was given birtht
in dealing with thethen ever growing proplem of tobacco
addiction // millions the victims of tobacco AS ITS ADDED
HIGHLY ADDICTIVE CHEMICALS. The 2nd world war but
used as cover flooding the USA as BRITAIN with Tobacco
and its highly addictive added chemicals /endless movies
that were nought but long adverts for tobacco // the dying
soldier having a cigg stuck in his mouth such shown as a
act of kindness /// how a cigg was siupposed to remove as
ease one’s stress or their worries // promoted as a act that
couples should share the joy of giving your partner a cigg.
By the wars end half the population of the USA as BRITAIN
ADDICTED UNTO TOBACCO AND IT ADDED CHEMICALS
within an few years doctors surgeries full of tobacco victims
as the realty of tobacco realized not as a joy / but an horror.
Thus the Govt no choice but to act // thus the birth of the
NHS where the people taxed to pay // the cost of the then
as now grave horror done by the TOBACCO COMPANIES.
The Tobacco companies were as now making $billions in
profit / thus to protect their profits as protect themselves
from from responsibility of their killer product // they but
funded the political parties to the tune of $MILLIONS / IN
turn political parties turned an blind eye to the death as
suffering of their own people // so protected were tobacco
companies that dispite the death suffering that tobacco in
having brought it was decades before a law could be put
in place that banned smoking in public places / rather
than politicians voting to protect the people / politicians
voted to protect the profits of the tobbaco companies / in
turn ensure their funding from tobacco profits continued.
Such being the world we live where money is power / as
able corrupt the highest in office / corrupt all politicians.
In returning to the NHS there no doubt it brings a much
needed service /as having brought great benifit to many
one should be grateful that it exists as being staff whom
give much in their field of learning // as must be praised
yat the NHS having its faults / as such must be treated
as if treating a ill person // in giving the best quality that
is affordable // that the vast amount of expense not be
wasteed on administratrion but being used in practical
aid to those in need // of course there must be limits as
to what one can expect // yet their must also be an true
accounting unto the vast resources that the NHS given.
My qualifications are not fraudulent, and neither are those of any of my colleagues. They cost me money because I had to pay £500 to sit four three-hour exams, and I must pay a Royal College an annual fee to keep the resulting letters after my name (incidentally, I also have to pay State Registration fees and separate fees for membership of my professional body.)
I’d write a longer reply, but I’m only having a five minute lunch break.
I like your sense of humour / your not the usual service
of NHS standard only “aving but the one flickering brain
cell ( thus the emplyment hopes reduced to that of NHS).
A internet site that may interest / a aid helping others as
unto yourself /being that of ( words of peace ) it an site
you’ll find a selection of videos (free) which Prem Rawat
talks /explains /meditation. In turning the senses inward
grants a unfolding of spiritual self. Not of ideas or belief.
Not an heaven a paradise beyond the clouds // but that
in having very practical spiritual experience / that grants
a clarity of understanding / as to the purpose of creation
one’s journey unto the ultimate which be Enlightenment.
Not being a great or even near great enlightened soul
but just the beginnings of giving a short period of time
a day ( even a HOUR) can give one a very balanced
outlook in going through the day / as in helping others
its not that one does’nt have their bad days / its being
that the strenght from the source of meditation / being
as a suit of armour that takes the blows as the insults
the abuse ( as such one can get in the NHS) WHERE
peoples expectations on staff as NHS being too much
as it the poor service of some NHS staff brings insult
thus a hours meditation a day would give benifit to all.
With meditation many would not have to be crippled in
living with extreme anxiety /as depressive states which
can be crippling // the effect of meditation is bringing a
balance that one can deal with the depression as deal
with the anxiety / thus to reduce its levels to being that
which more the norm / than at levels which are way of
the scales which have people reach for pills as potions
which with many rather than help / they end up where..
side effects of the medication bring physical problems
in many cases such physical problems in being severe.
Through the history of humanity there being spiritual
teachers // among such be the Teacher of Teachers
at such present time the teacher of teachers / Prem
Rawat // thus he is the best of the best // thus being
the recomendation // for those whom seek peace of
mind // more so those in having to deal with extreme
depression as high anxiety levels which crippling in
bringing little joy unto their lives / but excess misery
thus if any should seek a cure / meditation is a way
that will in practice bring its reward unto ones benifit.
Life is as the iceberg there’s more than one seeing
yet the answers are there // it’s not an hopeles task.
If one is at the stage the pleasures of the world still
leave one empty // then it simply means one needs
to go on a better diet // in this case a more spiritual
diet in restoring the joy of life / one’s purpose of life
if one’s content that the world offers all they desire
then so be it / every individual is unique / all vary in
their stages of development // we can but increase
our understanding as compassion to others needs.
In reality we are brothers sisters / one family upon
a journey of Spiritual Enlightenment // having come
a long way in learning in understanding our goal be
knowledge of the true self / in one knowing creator.
So you’re saying that if all NHS staff were to practise meditation for an hour a day, it would help them to deal with insults? So, for instance, if someone were to suggest that they all only had one brain cell and were thus incapable of any gainful employment more taxing than, say, transplant surgery, they’d just smile benignly and thank the person for their input instead of pulling out the sarcasm? Sounds great!
Just one thing, though: where do you suppose we might find a spare hour?
In response to your response:
The government should ensure that the contract states that all funds must be put in uk banks and no tax free havens should be used. They won’t of ourselves, stating Brussels this and Brussels that. I think you are unfair about this lot caring. I don’t think that there Ida politician that doesn’t want the best fr everyone – I certainly hope they do. It’s just a matter of how they do it. It’s a shame that they can’t agree. It’s also a shame that they can’t speak to each other and get a solution rather than just rubbishing each others ideas rather that may or may not work.
I don’t really know what this privatising will actually do, I just know that for the financial reasons stated in my first tome, they need to do something.
Regarding your comment about those that can’t afford their outages because they haven’t had a pay rise, I totally disagree with that. A pay rise is not a given, it’s a bonus. It’s not guaranteed. Those that base their living standards on it are rather naive. Don’t forget, we have tiny interest pay,ENTA at the moment, imagine if it went up to 7 or 8 % – would that be the governments fault? Would it be if it was Labour in charge?
Luckily……This is a short post – as I’m on my iPad and can’t type to well on it.
“It’s also a shame that they can’t speak to each other and get a solution rather than just rubbishing each others ideas rather that may or may not work” – Absolutely. I’m sick to death of playground politics; parties haranguing each other to change their policies, only to mock and cry “U-turn” on the rare occasions when they do. That’s not helpful, and it makes the whole thing look like a silly, childish point-scoring exercise.
And I don’t think we disagree as totally as you think we do about the relationship between salary and mortgage – the fact that the building society will let you have £400,000, doesn’t make it a good idea. Perhaps somebody should have pointed that out to Gordon Brown.
But I’m not just talking about a pay freeze that puts someone’s salary a bit further behind the RPI year-on-year, although that certainly isn’t nice for anyone. I’m talking about arbitrary regradings – and I’ve seen them happen, to people very close to me – that mean someone has to do the same job for 25% less pay, with a month’s notice.
I know what you’ll say. You’ll say, “ah, but that happens in the private sector, too. You lot in the public sector have just got too used to having too much job security and guaranteed pay rises every year; you need to wake up and smell the coffee.” And maybe you’re right. I’m prepared to accept that some things have got to change, but I’m not prepared to see patients and hard-working, dedicated staff suffer physically and financially while the boss of Spire Health buys himself another new yacht with money that could have paid for an MRI scanner. That’s all.
T’was not suggested that NHS staff having the one flickering brain cell betwixt them // such would have been totally off the mark as very rude
it accepted by the public / that to quallfy in working for the NHS / then
it be a necessity one in having the minimum of one flickering brain cell.
In regard to meditation an hour as a minimum being done before one attempts any other event on waking up ( exceptions ) be if one has a
baby to feed or one needs attend to the most obvious of one’s needs.
There be two forms of meditation // that in one sitting as relaxing
in turning all the senses inwards as in experience of XXXXX as of
xxxxx as of xxxxxx as of xxx xxxxxx. Alll of such explained more upon
one’s decision to take such a journey HOWEVER there aspects of
the meditation that one does constantly 24hrs One just not aware
in doing such. Meditation makes one tune into as experience that
which at present happens /yet which presently one not fully aware.
On becoming aware then one’s living a active life as still in a state
of meditation / where one is constantly tunning unto the source of
creation /in a constant state re-energizing one’s spiritual strength
thus one does not become tired as limit ones energy // when one
finished the night shift / one has a hour of deep meditation then
one can start work on the day shift // the benifits to the NHS but
astromonical in saving money / where the staff needed is halved.
Just Joking as to an level of energy as positive attitude one gain
through meditation one still needs a few hours good restful sleep.
Yet with meditation /the overall improvment unto ones well being
will greatly increase according unto each individuals needs / with
some // those in having high anxiety as depression of a crippling
nature // then improvement of mind as brains working activity /in
making improvement by leaps as bounds // in freeing them from
a life which be dire / of such torment that suicide be considered
as a solution // in being free. // No soul should have to deal with
such the heartbreaking burden that each day / but another day
of misery. Such creation of the universe having a clear purpose
that via heart brain in individual development comes a depth of
understanding as experience of one’s spiritual nature // that all
humanity via clarity of understanding in attaining Enlightenment.
Very interesting debate. My own two-pennies’ worth is to note that private and public organisations are rarely natural bedfellows. The former find the latters’ resistance to change stultifying, whilst the latter fully expect to be stiffed at the end of a plank by modern day pirates at any given moment. Both sides have horror stories enough to justify their viewpoints. And both, of course, only see half the story.
The degree to which change is necessary in the NHS is key here: are we looking at a potentially terminal patient, or one with a minor, transient health issue that could heal itself given time? To my mind, if it is the former, then any intervention is likely to be a form of radical surgery (and, no matter how loudly the patient complained, it might need to be seen through); if the latter, local running repairs might suffice.
As far as I can tell, through the veil of rock-throwing from either side, there is some general agreement, even among those who do not wish to see the Government’s proposals made substance, that the patient is potentially life-threatened. No matter what the appropriate solution is, therefore, it will be of a magnitude that will completely reshape the service. If so, will it too be hogtied and rendered impossible by patient resistance?
I suppose my challenge is this: is any big change going to be resisted to the hilt by definition? If so, should we give more credit to a Government that refuses to let the patient commit suicide. We may not agree with its methods, but might we agree with its objectives?
Beautifully put Captain.