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We need more bureaucracy – politicalbetting.com

SystemSystem Posts: 11,736
edited March 12 in General
imageWe need more bureaucracy – politicalbetting.com

The State of Process – The Process State – Maybe politicians read PB. I do wish they would read @Cyclefree’s headers, though.

Read the full story here

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  • Options
    Daveyboy1961Daveyboy1961 Posts: 3,404
    First or test
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    DecrepiterJohnLDecrepiterJohnL Posts: 24,753
    In America some old geezer has made a speech without, apparently, showing any signs of dementia.
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    CleitophonCleitophon Posts: 260
    I have an executive role in a large organization and I concur. Change is forever. You are constantly adapting to changing circumstances and change is hurt, because you cannot rely on routine but have to rethink basic assumptions. Scale and complexity challenges go hand in hand. Legacy IT systems that won't interact gobble up your admin staff for back office work rather than creating value for end users. Get yourself a contemporary IT system that does good data linking. If you are drowning you cannot make long term plans and you enter a death spiral. In bad organizations poor leadership begins with outward looking top management that doesn't provide guidance to their staff... this has knock on effects all the way to the bottom, leading to uncoordinated action. When the left hand doesn't know what the right hand is doing you get highly inefficient replication or tugs of war or diverging action. Ultimately coordination, consultation and communication between top and bottom collapse in these situations and make for very unpleasant workplaces... and ultimately the nhs has belligerent leadership that destroys these processes in the politicians who operate with a permanent eye on externalities and stakeholders in the electorate.
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    ydoethurydoethur Posts: 67,650

    I have an executive role in a large organization and I concur. Change is forever. You are constantly adapting to changing circumstances and change is hurt, because you cannot rely on routine but have to rethink basic assumptions. Scale and complexity challenges go hand in hand. Legacy IT systems that won't interact gobble up your admin staff for back office work rather than creating value for end users. Get yourself a contemporary IT system that does good data linking. If you are drowning you cannot make long term plans and you enter a death spiral. In bad organizations poor leadership begins with outward looking top management that doesn't provide guidance to their staff... this has knock on effects all the way to the bottom, leading to uncoordinated action. When the left hand doesn't know what the right hand is doing you get highly inefficient replication or tugs of war or diverging action. Ultimately coordination, consultation and communication between top and bottom collapse in these situations and make for very unpleasant workplaces... and ultimately the nhs has belligerent leadership that destroys these processes in the politicians who operate with a permanent eye on externalities and stakeholders in the electorate.

    I see you are also acquainted with Susan Acland-Hood.
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    bondegezoubondegezou Posts: 8,089
    NHS England had been undergoing a major reorganisation, including the merger into it of NHS Digital and Health Education England. There have been massive job cuts. The result of all this is that staff have been focused on re-applying for their own jobs and surviving the changes. The broader result is that nothing has got done. It should be a scandal.
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    JosiasJessopJosiasJessop Posts: 39,327
    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.
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    JosiasJessopJosiasJessop Posts: 39,327
    What rugby and cricket look like to me:

    https://www.youtube.com/watch?v=E_6d3JBBo4s

    "And they're going for the threesome..."
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    CleitophonCleitophon Posts: 260
    ydoethur said:

    I have an executive role in a large organization and I concur. Change is forever. You are constantly adapting to changing circumstances and change is hurt, because you cannot rely on routine but have to rethink basic assumptions. Scale and complexity challenges go hand in hand. Legacy IT systems that won't interact gobble up your admin staff for back office work rather than creating value for end users. Get yourself a contemporary IT system that does good data linking. If you are drowning you cannot make long term plans and you enter a death spiral. In bad organizations poor leadership begins with outward looking top management that doesn't provide guidance to their staff... this has knock on effects all the way to the bottom, leading to uncoordinated action. When the left hand doesn't know what the right hand is doing you get highly inefficient replication or tugs of war or diverging action. Ultimately coordination, consultation and communication between top and bottom collapse in these situations and make for very unpleasant workplaces... and ultimately the nhs has belligerent leadership that destroys these processes in the politicians who operate with a permanent eye on externalities and stakeholders in the electorate.

    I see you are also acquainted with Susan Acland-Hood.
    🤣🤣🤣

    Just to be clear, I am a business school researcher and Associate Dean. I am not associated with the civil service.
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    nico679nico679 Posts: 5,112

    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.

    I thought she handled the Brexit negotiations terribly but events since have shown her in a better light. The Lib Dems will certainly go after her seat now .
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    CleitophonCleitophon Posts: 260
    Wow the first poll after the budget has the tories 28% behind at 18% I wonder if discipline can be maintained in the tory party or if events overtake Sunak and the conservatives just crumble before summer. I mean if I were an MP I would begin to think about defection to save my skin.... they are clearly holed below the waterline.
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    nico679nico679 Posts: 5,112

    Wow the first poll after the budget has the tories 28% behind at 18% I wonder if discipline can be maintained in the tory party or if events overtake Sunak and the conservatives just crumble before summer. I mean if I were an MP I would begin to think about defection to save my skin.... they are clearly holed below the waterline.

    I’m a bit dubious of People polling so will wait and see what the others report but the wheels do seem to be coming off the budget . And today’s DM headline from the normal arse licking Tory paper will come as a shock to no 10.
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    FishingFishing Posts: 4,566
    Government needs to do things better but it also needs to do less, since it cocks up so much of what it touches, and then refuses to acknowledge it has cocked up until some celebrity complains or the BBC runs a drama series about it.
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    mwadamsmwadams Posts: 3,159
    Couldn't agree more. And the basis of any change is an honest understanding of where we are now - the current chain of needs. Tools exist to make it less challenging and confrontational to develop that understanding, but it is a huge barrier to "getting started".
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    JosiasJessopJosiasJessop Posts: 39,327
    nico679 said:

    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.

    I thought she handled the Brexit negotiations terribly but events since have shown her in a better light. The Lib Dems will certainly go after her seat now .
    My own view is that she handled the Brexit negotiations with the EU reasonably well, given the bad hand she had been dealt. What she did terribly at were the Brexit negotiations with the Europhobic madmen in her own party. And that was partly because it is hard to negotiate with one-eyed madmen, but mostly because those madmen wanted their 'own' person, Boris, to be in her job.
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    DavidLDavidL Posts: 51,589
    edited March 8
    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.
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    OnlyLivingBoyOnlyLivingBoy Posts: 15,245
    Labour's Brenda Dacres wins the Lewisham mayoral byelection with more than half of the vote, albeit on a low turnout. One of her key priorities will be pushing for the Bakerloo Line extension to Lewisham via the Old Kent Road and New Cross Gate.
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    ThomasNasheThomasNashe Posts: 5,024

    nico679 said:

    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.

    I thought she handled the Brexit negotiations terribly but events since have shown her in a better light. The Lib Dems will certainly go after her seat now .
    My own view is that she handled the Brexit negotiations with the EU reasonably well, given the bad hand she had been dealt. What she did terribly at were the Brexit negotiations with the Europhobic madmen in her own party. And that was partly because it is hard to negotiate with one-eyed madmen, but mostly because those madmen wanted their 'own' person, Boris, to be in her job.
    Yes, hospital pass from Cameron - who still has not been called to account for the egregious irresponsibility of his resignation at the point his country needed him most.
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    JosiasJessopJosiasJessop Posts: 39,327
    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    "Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better. "

    Coming from a tech background, not an NHS one, I'd argue the problem with that is that everyone who does the work *knows* how to do it better. The problem is that they all have different opinions on what that 'better' is, and how to get there. Which do you choose?
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    numbertwelvenumbertwelve Posts: 5,562
    nico679 said:

    Wow the first poll after the budget has the tories 28% behind at 18% I wonder if discipline can be maintained in the tory party or if events overtake Sunak and the conservatives just crumble before summer. I mean if I were an MP I would begin to think about defection to save my skin.... they are clearly holed below the waterline.

    I’m a bit dubious of People polling so will wait and see what the others report but the wheels do seem to be coming off the budget . And today’s DM headline from the normal arse licking Tory paper will come as a shock to no 10.
    I’ve said it before and I’ll say it again. The Tories have really got to hope that Reform don’t get their act together / capture the headlines. They could really face a challenge on the right.

    Working in the Tories’ favour is that Reform is filled with people not particularly well known for being able to get their act together….
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    bondegezoubondegezou Posts: 8,089

    Labour's Brenda Dacres wins the Lewisham mayoral byelection with more than half of the vote, albeit on a low turnout. One of her key priorities will be pushing for the Bakerloo Line extension to Lewisham via the Old Kent Road and New Cross Gate.

    Comfortable win, but Labour vote share down 6.5%. Best ever Green vote, second on 16.3%. Worst ever Conservative vote in position (falling to 4th) and vote share (9.1%, first time in single figures). The biggest “gain” was Galloway’s party, standing for the first time and getting 5.7%.
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    ThomasNasheThomasNashe Posts: 5,024

    nico679 said:

    Wow the first poll after the budget has the tories 28% behind at 18% I wonder if discipline can be maintained in the tory party or if events overtake Sunak and the conservatives just crumble before summer. I mean if I were an MP I would begin to think about defection to save my skin.... they are clearly holed below the waterline.

    I’m a bit dubious of People polling so will wait and see what the others report but the wheels do seem to be coming off the budget . And today’s DM headline from the normal arse licking Tory paper will come as a shock to no 10.
    I’ve said it before and I’ll say it again. The Tories have really got to hope that Reform don’t get their act together / capture the headlines. They could really face a challenge on the right.

    Working in the Tories’ favour is that Reform is filled with people not particularly well known for being able to get their act together….
    Signs are good so far, as far as the Tories are concerned. Piss poor performances by Reform in Rochdale and Wellingborough - the latter being a seat where they had a real opportunity.
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    RochdalePioneersRochdalePioneers Posts: 27,479

    Wow the first poll after the budget has the tories 28% behind at 18% I wonder if discipline can be maintained in the tory party or if events overtake Sunak and the conservatives just crumble before summer. I mean if I were an MP I would begin to think about defection to save my skin.... they are clearly holed below the waterline.

    Its a Goodwin poll so shrug your shoulders. BUT - its not absurd, its not putting ReFUK ahead of them and it fits the trend shown in all polls.

    Reportedly the Tory internal polls are not anywhere near as bad. So the question is whether Sunak is going to use the momentum from their "meh" budget and massive polling turnaround to go for an early election? As that was the obsession debate on here for the last few days.

    Forget the "go now it will only get worse" argument. This is Sunak's Tory party, so they have neither the nous or the brain to understand such concepts. If as reported their own polls are better, and if as they claim their budget and autumn statement are genuinely good and things will turn around, you would wait.

    And wait. And wait. And wait. And wait, when did we model things would turn around?
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    ThomasNasheThomasNashe Posts: 5,024

    Labour's Brenda Dacres wins the Lewisham mayoral byelection with more than half of the vote, albeit on a low turnout. One of her key priorities will be pushing for the Bakerloo Line extension to Lewisham via the Old Kent Road and New Cross Gate.

    Comfortable win, but Labour vote share down 6.5%. Best ever Green vote, second on 16.3%. Worst ever Conservative vote in position (falling to 4th) and vote share (9.1%, first time in single figures). The biggest “gain” was Galloway’s party, standing for the first time and getting 5.7%.
    And that 5.7% in such a favourable area would seem to suggest they don't have much future beyond Galloway himself.
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    OldKingColeOldKingCole Posts: 32,170

    Labour's Brenda Dacres wins the Lewisham mayoral byelection with more than half of the vote, albeit on a low turnout. One of her key priorities will be pushing for the Bakerloo Line extension to Lewisham via the Old Kent Road and New Cross Gate.

    Labour win, Green second, then LibDem, then Conservative. I know it’s not a good area for the Tories, and there was a low turnout, but this isn’t good for them.
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    OldKingColeOldKingCole Posts: 32,170

    nico679 said:

    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.

    I thought she handled the Brexit negotiations terribly but events since have shown her in a better light. The Lib Dems will certainly go after her seat now .
    My own view is that she handled the Brexit negotiations with the EU reasonably well, given the bad hand she had been dealt. What she did terribly at were the Brexit negotiations with the Europhobic madmen in her own party. And that was partly because it is hard to negotiate with one-eyed madmen, but mostly because those madmen wanted their 'own' person, Boris, to be in her job.
    A lot to be critical of in her handling of immigration when she was Home Secretary!
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    StuartinromfordStuartinromford Posts: 14,744

    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.

    Nah, she did tremendous harm. By laying out her needless Lancaster House red lines, she shaped the chaos to come.
    They were deffo a mistake. I think Phil Hammond (remember him?) described it as a massive hole which she dug for herself and spent the rest of her premiership trying to fill in with a teaspoon.

    But even without that speech, any Brexit deal she arranged would have had two flaws:

    1 It would have disappointed the nutters. Declaring war on Belgium would have disappointed the nutters. And the Conservative Party contained a lot of nutters-still does.

    2 It meant that Boris wasn't PM and that would never do.

    Sometimes bad things are just written in the stars, and no statesman can change them.
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    ThomasNasheThomasNashe Posts: 5,024

    Labour's Brenda Dacres wins the Lewisham mayoral byelection with more than half of the vote, albeit on a low turnout. One of her key priorities will be pushing for the Bakerloo Line extension to Lewisham via the Old Kent Road and New Cross Gate.

    A big part of me doesn't want to see any modernisation of the Bakerloo Line. The ancient trains give me cosy vibes, recalling my childhood travelling on the Underground for the first time.
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    nico679nico679 Posts: 5,112
    May over compensated as she was seen as a Remainer. This was part of the problem . She’s not though a pathological liar and does still believe in standards in public life .

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    JosiasJessopJosiasJessop Posts: 39,327

    nico679 said:

    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.

    I thought she handled the Brexit negotiations terribly but events since have shown her in a better light. The Lib Dems will certainly go after her seat now .
    My own view is that she handled the Brexit negotiations with the EU reasonably well, given the bad hand she had been dealt. What she did terribly at were the Brexit negotiations with the Europhobic madmen in her own party. And that was partly because it is hard to negotiate with one-eyed madmen, but mostly because those madmen wanted their 'own' person, Boris, to be in her job.
    A lot to be critical of in her handling of immigration when she was Home Secretary!
    Who was the last Home Secretary who handled immigration well? And ignoring issues is not 'handling'...
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    ThomasNasheThomasNashe Posts: 5,024

    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.

    Nah, she did tremendous harm. By laying out her needless Lancaster House red lines, she shaped the chaos to come.
    They were deffo a mistake. I think Phil Hammond (remember him?) described it as a massive hole which she dug for herself and spent the rest of her premiership trying to fill in with a teaspoon.

    But even without that speech, any Brexit deal she arranged would have had two flaws:

    1 It would have disappointed the nutters. Declaring war on Belgium would have disappointed the nutters. And the Conservative Party contained a lot of nutters-still does.

    2 It meant that Boris wasn't PM and that would never do.

    Sometimes bad things are just written in the stars, and no statesman can change them.
    What was needed was an immediate announcement of say three main options for departure and the promise of widespread consultation. The failure - and an absolutely massive one - was the total absence of any contingency planning by Cameron's government.
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    Scott_xPScott_xP Posts: 33,329
    @lara_spirit
    Labour lead at 27 points in latest YouGov poll for The Times

    CON 20 (=)
    LAB 47 (+1)
    LIB DEM 9 (+2)
    REF UK 13 (-1)
    GRN 7 (=)

    Fieldwork 6 - 7 March
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    nico679nico679 Posts: 5,112
    I think a vote for Reform is a vote for Labour mantra will be quite powerful by the Tories come the GE . So I’d be surprised if Reform even manage 5% on the day . Similarly I see the Greens shedding half their current polling to Labour .
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    StuartinromfordStuartinromford Posts: 14,744
    And bravo @Malmesbury. Though with one important caveat.

    Simplism says "front line staff = good, admin = bad". We love our nurses. We respect our doctors, even when we resent paying them so much. We may think teachers are ghastly, but we recognise the need for them and if pushed acknowledge that we couldn't do their job.

    But administrators are money wasting pen pushers. Get rid. Even if it means you have people being paid a fortune spending their time being really expensive secretaries to themselves or wasting valuable time while their wheezy old PC boots up.
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    FoxyFoxy Posts: 45,052
    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    Pretty much all innovation comes from the shop floor rather than management or management consultants.

    Personally, I am not convinced that more IT spending should be a priority. I work from electronic notes, use digital imaging systems and letter writing software. Admittedly these systems don't communicate well with each other, but that just means opening a half dozen applications when I switch on.

    The limitations on my productivity are mostly more straightforward. Physical space and beds to put people in, not enough Band 2 or 3 admin staff to book patients into gaps in clinics, not enough imaging capacity to keep pace with modern treatments etc.

    There isn't much point in digitalising booking software for operating theatre's to increase utilisation when the major reason for gaps is patients being cancelled because the beds are full of medical admissions waiting for social care.

    Tech Bros gonna Tech Bro. The real problems are just too boring and prosaic.

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    OldKingColeOldKingCole Posts: 32,170

    nico679 said:

    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.

    I thought she handled the Brexit negotiations terribly but events since have shown her in a better light. The Lib Dems will certainly go after her seat now .
    My own view is that she handled the Brexit negotiations with the EU reasonably well, given the bad hand she had been dealt. What she did terribly at were the Brexit negotiations with the Europhobic madmen in her own party. And that was partly because it is hard to negotiate with one-eyed madmen, but mostly because those madmen wanted their 'own' person, Boris, to be in her job.
    A lot to be critical of in her handling of immigration when she was Home Secretary!
    Who was the last Home Secretary who handled immigration well? And ignoring issues is not 'handling'...
    Roy Jenkins?
    May’s ignoring of the developing Windrush problem, and her overt hostility to the problem didn’t help at all!
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    FF43FF43 Posts: 15,897
    edited March 8
    nico679 said:

    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.

    I thought she handled the Brexit negotiations terribly but events since have shown her in a better light. The Lib Dems will certainly go after her seat now .
    Theresa May went very hard on Brexit at the start, rather than aiming for some kind of accommodation or transition, and spent the rest of her premiership trying to undo her mistake. Ultimately she failed to square the Brexit circle. I am not sure anyone was capable of that and her successor didn't bother to try.
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    nico679nico679 Posts: 5,112
    Scott_xP said:

    @lara_spirit
    Labour lead at 27 points in latest YouGov poll for The Times

    CON 20 (=)
    LAB 47 (+1)
    LIB DEM 9 (+2)
    REF UK 13 (-1)
    GRN 7 (=)

    Fieldwork 6 - 7 March

    That’s a shocker .
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    BenpointerBenpointer Posts: 31,967
    Scott_xP said:

    @lara_spirit
    Labour lead at 27 points in latest YouGov poll for The Times

    CON 20 (=)
    LAB 47 (+1)
    LIB DEM 9 (+2)
    REF UK 13 (-1)
    GRN 7 (=)

    Fieldwork 6 - 7 March

    Budget bounce.
  • Options
    FF43FF43 Posts: 15,897

    nico679 said:

    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.

    I thought she handled the Brexit negotiations terribly but events since have shown her in a better light. The Lib Dems will certainly go after her seat now .
    My own view is that she handled the Brexit negotiations with the EU reasonably well, given the bad hand she had been dealt. What she did terribly at were the Brexit negotiations with the Europhobic madmen in her own party. And that was partly because it is hard to negotiate with one-eyed madmen, but mostly because those madmen wanted their 'own' person, Boris, to be in her job.
    A lot to be critical of in her handling of immigration when she was Home Secretary!
    Hostile immigration policy should be engraved on her heart.
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    Casino_RoyaleCasino_Royale Posts: 55,869

    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.

    That's actually surprised me.

    I thought she had the same attitude to her vocation as the late Queen.
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    EabhalEabhal Posts: 6,118
    edited March 8
    There is a bigger problem with Hunt's plan. Even if you improve productivity in IT and project management, It would take a brave Health Secretary to use it to cut costs rather than save lives.

    That's the problem with public services, and health in particular. The savings could be used for dementia research, which will mean people will live with dementia for longer. Or for cancer research - my grandparents survived several bouts of cancer at massive cost, when 50 years ago the first bout would have had them.

    My shoulder surgery was only possible because of capital investment and innovation - MRI scans and keyhole surgery. But it cost the NHS a surgical team, a bed, months of physio, GP follow ups. That's why health spending is growing so much faster than what demographics would suggest.

    The only productivity improvement I can see that would actually reduce costs in the NHS would be a pervasive state intervention in how people live their lives - exercise, alcohol and diet most obviously. And even then, the saved cash would just be funnelled towards social care or mental health rather than say defence.

    Current health spending is a political choice and no one is brave enough to face up to that.
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    FF43FF43 Posts: 15,897
    Scott_xP said:

    @lara_spirit
    Labour lead at 27 points in latest YouGov poll for The Times

    CON 20 (=)
    LAB 47 (+1)
    LIB DEM 9 (+2)
    REF UK 13 (-1)
    GRN 7 (=)

    Fieldwork 6 - 7 March

    Curious about the Reform share. Very high and not indicated by any recent election.
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    Dura_AceDura_Ace Posts: 13,126
    Scott_xP said:

    @lara_spirit
    Labour lead at 27 points in latest YouGov poll for The Times

    CON 20 (=)
    LAB 47 (+1)
    LIB DEM 9 (+2)
    REF UK 13 (-1)
    GRN 7 (=)

    Fieldwork 6 - 7 March

    2nd May nailed on. 🥴🔫
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    williamglennwilliamglenn Posts: 48,355
    Seat projection from the Goodwin/GB News poll:

    image
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    OnlyLivingBoyOnlyLivingBoy Posts: 15,245

    Labour's Brenda Dacres wins the Lewisham mayoral byelection with more than half of the vote, albeit on a low turnout. One of her key priorities will be pushing for the Bakerloo Line extension to Lewisham via the Old Kent Road and New Cross Gate.

    A big part of me doesn't want to see any modernisation of the Bakerloo Line. The ancient trains give me cosy vibes, recalling my childhood travelling on the Underground for the first time.
    Yes I agree on that, the Bakerloo line is the last place in Britain that's completely unchanged from my childhood. The extension will be very good news for this area though, unlocking a load of housing and development down the Old Kent Road.
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    BenpointerBenpointer Posts: 31,967
    Interesting header Malmesbury, thanks. Fits with my experience of successful and unsuccessful major IT changes.

    Key for me is buy-in at the top - constant ministerial shuffles undermine that, as you point out.
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    BenpointerBenpointer Posts: 31,967
    Apols if already posted:

    @BritainElects

    📊 Labour lead at 28pts
    Westminster voting intention:

    LAB: 46% (+1)
    CON: 18% (-2)
    REF: 13% (+1)
    LDEM: 10% (-)

    via @PeoplePolling , 07 Mar
    Chgs. w/ Jan



    https://x.com/BritainElects/status/1766003924299895100?s=20
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    CarnyxCarnyx Posts: 40,193
    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    You'll definitely need more capacity if you want weekend working. When I hear politicians chunder on about weekend working, I'm reminded of a boss I once had who wanted a colleague to add a new job to her existing work and told her to take time off in lieu when she asked how she was going to find the time. Not to mention their insistence on insane inefficiencies in the conduct of Parliament at Westminster.

    On the other hand, quite a bit of hospital work is already on a 7-day basis.
  • Options
    MalmesburyMalmesbury Posts: 44,975

    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    "Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better. "

    Coming from a tech background, not an NHS one, I'd argue the problem with that is that everyone who does the work *knows* how to do it better. The problem is that they all have different opinions on what that 'better' is, and how to get there. Which do you choose?
    Which is why you need to join their thinking to experts in IT, OR and the like. Many times people will see, then, that similar problems were solved elsewhere.

    At the moment, you probably have lots of isolated groups of people trying to do the right thing. Join them up and give them help and knowledge.
  • Options
    BenpointerBenpointer Posts: 31,967
    Dura_Ace said:

    Scott_xP said:

    @lara_spirit
    Labour lead at 27 points in latest YouGov poll for The Times

    CON 20 (=)
    LAB 47 (+1)
    LIB DEM 9 (+2)
    REF UK 13 (-1)
    GRN 7 (=)

    Fieldwork 6 - 7 March

    2nd May nailed on. 🥴🔫
    I wouldn't put it past this bunch of turkeys to vote for Christmas but, yeah, that probably stuffs a May GE.
  • Options
    bigjohnowlsbigjohnowls Posts: 21,935

    Labour's Brenda Dacres wins the Lewisham mayoral byelection with more than half of the vote, albeit on a low turnout. One of her key priorities will be pushing for the Bakerloo Line extension to Lewisham via the Old Kent Road and New Cross Gate.

    Comfortable win, but Labour vote share down 6.5%. Best ever Green vote, second on 16.3%. Worst ever Conservative vote in position (falling to 4th) and vote share (9.1%, first time in single figures). The biggest “gain” was Galloway’s party, standing for the first time and getting 5.7%.
    And that 5.7% in such a favourable area would seem to suggest they don't have much future beyond Galloway himself.
    Good momentum for the Greens.

    Potential to win this after a couple of years of even worse austerity under SKS/ Playmobil haircut Reeves
  • Options
    mwadamsmwadams Posts: 3,159

    "Theresa May to stand down as MP at next election"

    https://www.bbc.co.uk/news/uk-politics-68509239

    Sad to see her go, but 27 years is a good innings as an MP.

    Nah, she did tremendous harm. By laying out her needless Lancaster House red lines, she shaped the chaos to come.
    They were deffo a mistake. I think Phil Hammond (remember him?) described it as a massive hole which she dug for herself and spent the rest of her premiership trying to fill in with a teaspoon.

    But even without that speech, any Brexit deal she arranged would have had two flaws:

    1 It would have disappointed the nutters. Declaring war on Belgium would have disappointed the nutters. And the Conservative Party contained a lot of nutters-still does.

    2 It meant that Boris wasn't PM and that would never do.

    Sometimes bad things are just written in the stars, and no statesman can change them.
    Until Cassius makes a proposal...
  • Options
    Morris_DancerMorris_Dancer Posts: 61,052
    Good morning, everyone.

    In happy news, Dragon's Dogma 2 has released the character creator as a demo, so I'll spend a few hours playing with that later.

    F1: Alonso flying in practice, though I'm wary as his great qualifying in Bahrain proved no guide to lacklustre race pace. On the Mercedes' front, if they were overheating in a cooler than usual Bahrain they're perhaps going to suffer in Saudi Arabia. Temperatures at qualifying/race start times will be 26C or so.
  • Options
    DavidLDavidL Posts: 51,589
    Foxy said:

    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    Pretty much all innovation comes from the shop floor rather than management or management consultants.

    Personally, I am not convinced that more IT spending should be a priority. I work from electronic notes, use digital imaging systems and letter writing software. Admittedly these systems don't communicate well with each other, but that just means opening a half dozen applications when I switch on.

    The limitations on my productivity are mostly more straightforward. Physical space and beds to put people in, not enough Band 2 or 3 admin staff to book patients into gaps in clinics, not enough imaging capacity to keep pace with modern treatments etc.

    There isn't much point in digitalising booking software for operating theatre's to increase utilisation when the major reason for gaps is patients being cancelled because the beds are full of medical admissions waiting for social care.

    Tech Bros gonna Tech Bro. The real problems are just too boring and prosaic.

    Yes I completely agree. The idea that some tech is the answer has failed too many times to count. Focus on what stops people like you from doing your job more efficiently, see where the blockages are and deal with them.

    And try to build a culture that that is the way things will go with iterative growth and improvement.
  • Options
    RochdalePioneersRochdalePioneers Posts: 27,479
    You can't read anything into the Rochdale result and ReFUK polling. Their candidate was Simon Danczuk...
  • Options
    StuartinromfordStuartinromford Posts: 14,744
    Scott_xP said:

    @lara_spirit
    Labour lead at 27 points in latest YouGov poll for The Times

    CON 20 (=)
    LAB 47 (+1)
    LIB DEM 9 (+2)
    REF UK 13 (-1)
    GRN 7 (=)

    Fieldwork 6 - 7 March

    OK, still a bit early to say there won't be a Budget Bounce- isn't the rule that news usually takes a couple of weeks to filter through?

    But if the government has borked the public finances to the tune of 40 billion a year (4 p off NI in total) and has bought approximately zero votes with that...

    Is that the biggest waste of government money ever? (And it is government money, given the current borrowing figures.)
  • Options
    TheuniondivvieTheuniondivvie Posts: 40,436
    edited March 8
    Nothing on the Biden SOTU address? I find all that whoopy self praise thing a bit cringe but even on those terms JoBi sounded pretty coherent.

    I think I heard ‘liar’ bellowed out at one point, I wonder which of the gross Trump loonballs was responsible?
  • Options
    MexicanpeteMexicanpete Posts: 25,553
    ...

    Apols if already posted:

    @BritainElects

    📊 Labour lead at 28pts
    Westminster voting intention:

    LAB: 46% (+1)
    CON: 18% (-2)
    REF: 13% (+1)
    LDEM: 10% (-)

    via @PeoplePolling , 07 Mar
    Chgs. w/ Jan



    https://x.com/BritainElects/status/1766003924299895100?s=20

    I don't believe this polling, but Sunak is surely toast.

    Good performance from the photogenic sword wielding Catherine Deneuve yesterday, defending Michelle Donelan.
  • Options
    EabhalEabhal Posts: 6,118
    DavidL said:

    Foxy said:

    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    Pretty much all innovation comes from the shop floor rather than management or management consultants.

    Personally, I am not convinced that more IT spending should be a priority. I work from electronic notes, use digital imaging systems and letter writing software. Admittedly these systems don't communicate well with each other, but that just means opening a half dozen applications when I switch on.

    The limitations on my productivity are mostly more straightforward. Physical space and beds to put people in, not enough Band 2 or 3 admin staff to book patients into gaps in clinics, not enough imaging capacity to keep pace with modern treatments etc.

    There isn't much point in digitalising booking software for operating theatre's to increase utilisation when the major reason for gaps is patients being cancelled because the beds are full of medical admissions waiting for social care.

    Tech Bros gonna Tech Bro. The real problems are just too boring and prosaic.

    Yes I completely agree. The idea that some tech is the answer has failed too many times to count. Focus on what stops people like you from doing your job more efficiently, see where the blockages are and deal with them.

    And try to build a culture that that is the way things will go with iterative growth and improvement.
    That's not going to cut costs though - it will probably mean increased costs as Foxy will be able to help more people. This is not a bad thing.

    You would need a political directive to say any productivity gains must be converted into savings, not improved health outcomes.
  • Options
    DavidLDavidL Posts: 51,589

    Labour's Brenda Dacres wins the Lewisham mayoral byelection with more than half of the vote, albeit on a low turnout. One of her key priorities will be pushing for the Bakerloo Line extension to Lewisham via the Old Kent Road and New Cross Gate.

    A big part of me doesn't want to see any modernisation of the Bakerloo Line. The ancient trains give me cosy vibes, recalling my childhood travelling on the Underground for the first time.
    Yes I agree on that, the Bakerloo line is the last place in Britain that's completely unchanged from my childhood. The extension will be very good news for this area though, unlocking a load of housing and development down the Old Kent Road.
    Low value property though. What, £2 and £4 rent on the light browns? Hard to get a return on that.
  • Options
    TheuniondivvieTheuniondivvie Posts: 40,436

    Labour's Brenda Dacres wins the Lewisham mayoral byelection with more than half of the vote, albeit on a low turnout. One of her key priorities will be pushing for the Bakerloo Line extension to Lewisham via the Old Kent Road and New Cross Gate.

    Comfortable win, but Labour vote share down 6.5%. Best ever Green vote, second on 16.3%. Worst ever Conservative vote in position (falling to 4th) and vote share (9.1%, first time in single figures). The biggest “gain” was Galloway’s party, standing for the first time and getting 5.7%.
    And that 5.7% in such a favourable area would seem to suggest they don't have much future beyond Galloway himself.
    Good momentum for the Greens.

    Potential to win this after a couple of years of even worse austerity under SKS/ Playmobil haircut Reeves
    Your party (or rather sister party) did ok in Glasgow.


  • Options
    CarnyxCarnyx Posts: 40,193

    ...

    Apols if already posted:

    @BritainElects

    📊 Labour lead at 28pts
    Westminster voting intention:

    LAB: 46% (+1)
    CON: 18% (-2)
    REF: 13% (+1)
    LDEM: 10% (-)

    via @PeoplePolling , 07 Mar
    Chgs. w/ Jan



    https://x.com/BritainElects/status/1766003924299895100?s=20

    I don't believe this polling, but Sunak is surely toast.

    Good performance from the photogenic sword wielding Catherine Deneuve yesterday, defending Michelle Donelan.
    Not impressed by their insistence on blaming civil servants.

    Civil servants for whom they are *responsible* in the first place.
  • Options
    Scott_xPScott_xP Posts: 33,329

    OK, still a bit early to say there won't be a Budget Bounce- isn't the rule that news usually takes a couple of weeks to filter through?

    As others have noted, everything in the budget was known for a week in advance. How much longer does it need...
  • Options
    AverageNinjaAverageNinja Posts: 1,169
    My 30 point lead prediction is looking very good at this point.
  • Options
    DavidLDavidL Posts: 51,589
    Eabhal said:

    DavidL said:

    Foxy said:

    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    Pretty much all innovation comes from the shop floor rather than management or management consultants.

    Personally, I am not convinced that more IT spending should be a priority. I work from electronic notes, use digital imaging systems and letter writing software. Admittedly these systems don't communicate well with each other, but that just means opening a half dozen applications when I switch on.

    The limitations on my productivity are mostly more straightforward. Physical space and beds to put people in, not enough Band 2 or 3 admin staff to book patients into gaps in clinics, not enough imaging capacity to keep pace with modern treatments etc.

    There isn't much point in digitalising booking software for operating theatre's to increase utilisation when the major reason for gaps is patients being cancelled because the beds are full of medical admissions waiting for social care.

    Tech Bros gonna Tech Bro. The real problems are just too boring and prosaic.

    Yes I completely agree. The idea that some tech is the answer has failed too many times to count. Focus on what stops people like you from doing your job more efficiently, see where the blockages are and deal with them.

    And try to build a culture that that is the way things will go with iterative growth and improvement.
    That's not going to cut costs though - it will probably mean increased costs as Foxy will be able to help more people. This is not a bad thing.

    You would need a political directive to say any productivity gains must be converted into savings, not improved health outcomes.
    No we need the opposite. Better health outcomes save money in both the long and the short term as well as doing better for the patients!
  • Options
    Scott_xPScott_xP Posts: 33,329

    Nothing on the Biden SOTU address? I find all that whoopy self praise thing a bit cringe but even on those terms JoBi sounded pretty coherent.

    I think I heard ‘liar’ bellowed out at one point, I wonder which of the gross Trump loonballs was responsible?

    The Republican Stepford wife response team briefed journalists in advance about how they should report it

    Meanwhile...

    @elizaorlins
    Someone is having fun with Katie Britt’s Wikipedia page tonight…

    #SOTU rebuttal


  • Options
    MexicanpeteMexicanpete Posts: 25,553
    Scott_xP said:

    @lara_spirit
    Labour lead at 27 points in latest YouGov poll for The Times

    CON 20 (=)
    LAB 47 (+1)
    LIB DEM 9 (+2)
    REF UK 13 (-1)
    GRN 7 (=)

    Fieldwork 6 - 7 March

    Before we get too excited can we just wait for one of the more mainstream polling organisations. Oh...
  • Options
    MalmesburyMalmesbury Posts: 44,975

    On topic, I've seen terrible examples of bureaucracy in some private firms as well - particularly the large partnership consultancies.

    There's always a reason to add more to a process, "just to be sure", and a real fear of taking anything away.

    It’s not a public or private problem. The worst version in the private sector is one of the major causes of “creative destruction”

    i.e. going out of business.

    Since the public sector can’t go out of business, we can’t wait for the DfE to collapse.
  • Options
    LostPasswordLostPassword Posts: 15,699
    Scott_xP said:

    @lara_spirit
    Labour lead at 27 points in latest YouGov poll for The Times

    CON 20 (=)
    LAB 47 (+1)
    LIB DEM 9 (+2)
    REF UK 13 (-1)
    GRN 7 (=)

    Fieldwork 6 - 7 March

    5 out of 11 YouGov polls this year with a Tory share of 20% including all of the last three.

    Nothing has changed.
  • Options
    TheuniondivvieTheuniondivvie Posts: 40,436
    Oh dear.
    No blacks, no Irish, no dogs, no immigrants.

    https://x.com/lbc/status/1765825818091991501?s=61&t=LYVEHh2mqFy1oUJAdCfe-Q

  • Options
    FoxyFoxy Posts: 45,052
    DavidL said:

    Foxy said:

    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    Pretty much all innovation comes from the shop floor rather than management or management consultants.

    Personally, I am not convinced that more IT spending should be a priority. I work from electronic notes, use digital imaging systems and letter writing software. Admittedly these systems don't communicate well with each other, but that just means opening a half dozen applications when I switch on.

    The limitations on my productivity are mostly more straightforward. Physical space and beds to put people in, not enough Band 2 or 3 admin staff to book patients into gaps in clinics, not enough imaging capacity to keep pace with modern treatments etc.

    There isn't much point in digitalising booking software for operating theatre's to increase utilisation when the major reason for gaps is patients being cancelled because the beds are full of medical admissions waiting for social care.

    Tech Bros gonna Tech Bro. The real problems are just too boring and prosaic.

    Yes I completely agree. The idea that some tech is the answer has failed too many times to count. Focus on what stops people like you from doing your job more efficiently, see where the blockages are and deal with them.

    And try to build a culture that that is the way things will go with iterative growth and improvement.
    The other drag on NHS productivity is the lack of senior decision makers on the front line. Juniors, Physician Associates, Specialist Nurses all tend to lack confidence, so err on the safe side, over-investigating, over referring , bringing back for unnecessary reviews etc. This is both a training issue and a lack of continuity issue, as I am often working with unfamiliar staff, so they want and need to check everything with the boss.

    At the moment there is a real problem of over referral by non-medical staff in primary care for problems easily managed in General Practice previously. As each hospital attendance costs the NHS as much as a years percapita GP budget it is a waste of both time and resources, and a major cause of long waiting lists and patient anxiety.

  • Options
    LostPasswordLostPassword Posts: 15,699

    Scott_xP said:

    @lara_spirit
    Labour lead at 27 points in latest YouGov poll for The Times

    CON 20 (=)
    LAB 47 (+1)
    LIB DEM 9 (+2)
    REF UK 13 (-1)
    GRN 7 (=)

    Fieldwork 6 - 7 March

    5 out of 11 YouGov polls this year with a Tory share of 20% including all of the last three.

    Nothing has changed.
    I remember when people used to suspect YouGov of having a pro-Tory bias.
  • Options
    felixfelix Posts: 15,125
    nico679 said:

    I think a vote for Reform is a vote for Labour mantra will be quite powerful by the Tories come the GE . So I’d be surprised if Reform even manage 5% on the day . Similarly I see the Greens shedding half their current polling to Labour .

    Not so sure about the Green vote. Few think Labour can lose and the Greens could well gain votes from anti-Semitic Labour voters on the left.
  • Options
    RochdalePioneersRochdalePioneers Posts: 27,479
    edited March 8

    Scott_xP said:

    @lara_spirit
    Labour lead at 27 points in latest YouGov poll for The Times

    CON 20 (=)
    LAB 47 (+1)
    LIB DEM 9 (+2)
    REF UK 13 (-1)
    GRN 7 (=)

    Fieldwork 6 - 7 March

    5 out of 11 YouGov polls this year with a Tory share of 20% including all of the last three.

    Nothing has changed.
    I remember when people used to suspect YouGov of having a pro-Tory bias.
    Suspect??? They were screaming about it when Jezbollah was Labour leader. You can't trust YouTory. Look at who founded it! Look at who runs it! Its Tory polling for Tories!!!!

    I also remember snide attacks on Starmer that "any other leader would be 20 points ahead" - from BJO mainly. Would Starmer want to *only* be 20 points ahead now?
  • Options
    MexicanpeteMexicanpete Posts: 25,553
    edited March 8

    Oh dear.
    No blacks, no Irish, no dogs, no immigrants.

    https://x.com/lbc/status/1765825818091991501?s=61&t=LYVEHh2mqFy1oUJAdCfe-Q

    What a Rotten thing to say.

    I heard it last night on Marr. Pro-Brexit, lived in the USA for forty years, bemoaning the decay of seaside towns and attributing that to immigration.

    Johnny W*n*er, more like.
  • Options
    EabhalEabhal Posts: 6,118
    DavidL said:

    Eabhal said:

    DavidL said:

    Foxy said:

    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    Pretty much all innovation comes from the shop floor rather than management or management consultants.

    Personally, I am not convinced that more IT spending should be a priority. I work from electronic notes, use digital imaging systems and letter writing software. Admittedly these systems don't communicate well with each other, but that just means opening a half dozen applications when I switch on.

    The limitations on my productivity are mostly more straightforward. Physical space and beds to put people in, not enough Band 2 or 3 admin staff to book patients into gaps in clinics, not enough imaging capacity to keep pace with modern treatments etc.

    There isn't much point in digitalising booking software for operating theatre's to increase utilisation when the major reason for gaps is patients being cancelled because the beds are full of medical admissions waiting for social care.

    Tech Bros gonna Tech Bro. The real problems are just too boring and prosaic.

    Yes I completely agree. The idea that some tech is the answer has failed too many times to count. Focus on what stops people like you from doing your job more efficiently, see where the blockages are and deal with them.

    And try to build a culture that that is the way things will go with iterative growth and improvement.
    That's not going to cut costs though - it will probably mean increased costs as Foxy will be able to help more people. This is not a bad thing.

    You would need a political directive to say any productivity gains must be converted into savings, not improved health outcomes.
    No we need the opposite. Better health outcomes save money in both the long and the short term as well as doing better for the patients!
    Not necessarily. From 1995 - 2009, average change in health spending in the UK was 4.6% per year in real terms. Only 0.2% was demographics. 1.5% was income effect.

    The residual, 2.8%, was things like technological innovation and the increased prevalence of chronic conditions. No one will face up to this inconvenient truth.
  • Options
    UnpopularUnpopular Posts: 789
    Eabhal said:

    DavidL said:

    Foxy said:

    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    Pretty much all innovation comes from the shop floor rather than management or management consultants.

    Personally, I am not convinced that more IT spending should be a priority. I work from electronic notes, use digital imaging systems and letter writing software. Admittedly these systems don't communicate well with each other, but that just means opening a half dozen applications when I switch on.

    The limitations on my productivity are mostly more straightforward. Physical space and beds to put people in, not enough Band 2 or 3 admin staff to book patients into gaps in clinics, not enough imaging capacity to keep pace with modern treatments etc.

    There isn't much point in digitalising booking software for operating theatre's to increase utilisation when the major reason for gaps is patients being cancelled because the beds are full of medical admissions waiting for social care.

    Tech Bros gonna Tech Bro. The real problems are just too boring and prosaic.

    Yes I completely agree. The idea that some tech is the answer has failed too many times to count. Focus on what stops people like you from doing your job more efficiently, see where the blockages are and deal with them.

    And try to build a culture that that is the way things will go with iterative growth and improvement.
    That's not going to cut costs though - it will probably mean increased costs as Foxy will be able to help more people. This is not a bad thing.

    You would need a political directive to say any productivity gains must be converted into savings, not improved health outcomes.
    I did an analysis once on the healthcare costs associated with a particular underfunded disease to see where the gaps are to try and refocus research efforts towards them in the hopes of finding some economic benefits to the research. Focusing on NHS costs, it quickly became apparent that I was actually looking at NHS spend on the condition rather than the actual cost, and actually the NHS would be a lot cheaper if we didn't bother with things like in-patient treatment and Doctors...
  • Options
    CarnyxCarnyx Posts: 40,193
    https://www.theguardian.com/film/2024/mar/07/dune-movie-part-two-book-messiah

    O/T but perhaps of interest to our melange addicts.

    "‘Completely unfilmable’: the Dune universe is about to get weird"
  • Options
    MalmesburyMalmesbury Posts: 44,975
    DavidL said:

    Eabhal said:

    DavidL said:

    Foxy said:

    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    Pretty much all innovation comes from the shop floor rather than management or management consultants.

    Personally, I am not convinced that more IT spending should be a priority. I work from electronic notes, use digital imaging systems and letter writing software. Admittedly these systems don't communicate well with each other, but that just means opening a half dozen applications when I switch on.

    The limitations on my productivity are mostly more straightforward. Physical space and beds to put people in, not enough Band 2 or 3 admin staff to book patients into gaps in clinics, not enough imaging capacity to keep pace with modern treatments etc.

    There isn't much point in digitalising booking software for operating theatre's to increase utilisation when the major reason for gaps is patients being cancelled because the beds are full of medical admissions waiting for social care.

    Tech Bros gonna Tech Bro. The real problems are just too boring and prosaic.

    Yes I completely agree. The idea that some tech is the answer has failed too many times to count. Focus on what stops people like you from doing your job more efficiently, see where the blockages are and deal with them.

    And try to build a culture that that is the way things will go with iterative growth and improvement.
    That's not going to cut costs though - it will probably mean increased costs as Foxy will be able to help more people. This is not a bad thing.

    You would need a political directive to say any productivity gains must be converted into savings, not improved health outcomes.
    No we need the opposite. Better health outcomes save money in both the long and the short term as well as doing better for the patients!
    Process re-engineering is not necessarily about IT.

    It comes down to :

    1) Is this necessary?
    2) If it is, make sure the people doing it are not doing extraneous tasks. Automate them or hand them off to other specialists.

    The classics of OR date from the days when IBM was predicting 5 computers worldwide. The story of how lathe work was gradually streamlined is 19th/early 20th.

    A major part of it is realising that a lot of organisations work as a series of queues. When keys ones back up, the organisation slows to a halt. So you put time, effort and money into those. Then you find the next thing slowing the system down.
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    TOPPINGTOPPING Posts: 41,607
    Good header.

    Not that I more than speed-read it but it seemed to include "NHS" and "fucking useless" in sentiment rather than explicitly so I applaud it wholeheartedly.

    I expect precisely nothing to change at the NHS for precisely the reason given by @Malmesbury - people have become subservient to the system.
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    RochdalePioneersRochdalePioneers Posts: 27,479
    Call the election now, Labour are toast:

    https://twitter.com/Daily_Express/status/1765866468065837561?ref_src=twsrc

    "BREXIT IS A GREAT BRITISH SUCCESS STORY WORTH BILLIONS" screams the front page. Then a quote from BadEnoch - "Britons are Better Off"

    So there. Cut over to GBeebies where their impartial panel of Lee Anderson and Jacob Rees-Mogg review the Express story then interview Ester McVey about why Labour would destroy our land of plenty.
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    FF43FF43 Posts: 15,897
    On topic I suspect this suggestion wouldn't fix the NHS. Which raises the entirely reasonable riposte, what would you do differently, when I really don't know. Getting rid of the NHS entirely isn't an answer either. Sometimes I think you just have to work with what you've got and try to make it better.
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    eekeek Posts: 25,147
    Scott_xP said:

    OK, still a bit early to say there won't be a Budget Bounce- isn't the rule that news usually takes a couple of weeks to filter through?

    As others have noted, everything in the budget was known for a week in advance. How much longer does it need...
    The child benefit taper changes weren’t known about - that should have an impact but it probably won’t last long
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    MexicanpeteMexicanpete Posts: 25,553

    My 30 point lead prediction is looking very good at this point.

    Come off it. I am not expecting parity until autumn, so just a small lead by January 23rd. Certainly no Tory landslide.
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    OnlyLivingBoyOnlyLivingBoy Posts: 15,245
    DavidL said:

    Labour's Brenda Dacres wins the Lewisham mayoral byelection with more than half of the vote, albeit on a low turnout. One of her key priorities will be pushing for the Bakerloo Line extension to Lewisham via the Old Kent Road and New Cross Gate.

    A big part of me doesn't want to see any modernisation of the Bakerloo Line. The ancient trains give me cosy vibes, recalling my childhood travelling on the Underground for the first time.
    Yes I agree on that, the Bakerloo line is the last place in Britain that's completely unchanged from my childhood. The extension will be very good news for this area though, unlocking a load of housing and development down the Old Kent Road.
    Low value property though. What, £2 and £4 rent on the light browns? Hard to get a return on that.
    I work by the most expensive property on the Monopoly board and live just off the cheapest one. I must be doing something wrong...
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    kinabalukinabalu Posts: 39,539
    Good article @Malmesbury

    Yes, get the right people and just keep on improving things, no 'targets'. That's the way to go.

    This 'internal consultancy' you mention (focussed all the time on better processes) existed in some of the banks I worked for. A central Business Analysis Group - its employees somewhat inevitably known as the BAGs.

    Did it work? Yes, sometimes. They key is making such a role an aspirational career choice, which means high pay and power, this latter coming from buy-in from senior management and a reporting line straight to the top.

    For the NHS? I don't see why not. But you do need the above criteria to be met. Otherwise what you get is the function soon falls into disrepute - "Oh no the BAGs want a meeting" eyeroll etc - and becomes just another overhead, and nothing changes.
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    JohnLilburneJohnLilburne Posts: 6,034
    DavidL said:

    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    "Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better. "

    Coming from a tech background, not an NHS one, I'd argue the problem with that is that everyone who does the work *knows* how to do it better. The problem is that they all have different opinions on what that 'better' is, and how to get there. Which do you choose?

    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    "Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better. "

    Coming from a tech background, not an NHS one, I'd argue the problem with that is that everyone who does the work *knows* how to do it better. The problem is that they all have different opinions on what that 'better' is, and how to get there. Which do you choose?
    You measure results. This does, as the thread header suggests, require some more bureaucracy and a standardised system. Secondly, and I agree with the thread header on this too, you make changes incrementally over time. You don’t throw everything up in the air as past reorganisations have done. And the incremental process should never stop.

    What you don’t do is have expensive outsiders coming in, telling you that you are doing it all wrong and then swanning off again.
    The Civil Service measures inputs, not outputs.

    For example, the DWP's grant from the treasury is based on how long it spends talking to its "customers" . Not on how many people it helps get into work.
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    RochdalePioneersRochdalePioneers Posts: 27,479

    My 30 point lead prediction is looking very good at this point.

    Come off it. I am not expecting parity until autumn, so just a small lead by January 23rd. Certainly no Tory landslide.
    Is that the scenario where the Tory score first goes negative, then collapses so fast that it goes all the way round the clock so that they are back in the lead?
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    SelebianSelebian Posts: 7,603
    Great thread @Malmesbury

    This is very true. Good admin is key. We also have oddities in some parts of the NHS where only doctors are permitted to do things that do not require someone with the knowledge and pay grade - e.g. some research sites will insist that doctors extract purely demographic data from health records (probably has to be someone in the care team for ethics/confidentiality, but theres no need for it to be a senior clinician - the care team administrator who accessed the records for other purposes such as booking appointments and adding results is perfectly qualified).
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    OldKingColeOldKingCole Posts: 32,170
    Foxy said:

    DavidL said:

    Foxy said:

    DavidL said:

    The sheer size of the NHS creates many challenges and also some opportunities. It employs many capable people. Some will have good ideas of how to improve things. For example we had the stories of the hospitals who had weekends entirely focused on a single procedure, massively increasing through put and reducing waiting times. Learn from this. Replicate it across the organisation.

    I am sure that there will be multiple examples of good practices across such a huge organisation and that there will be many examples of poor performance too. Before spending a lot of money on consultants real effort needs to be made to listen to the people who already do the work and how to do it better.

    This will require a culture shift. Less defensive, more open to new ideas, more focused on change than just coping. It may require an NHS with a bit more capacity than we have now. But personally, I think it’s the way ahead.

    Pretty much all innovation comes from the shop floor rather than management or management consultants.

    Personally, I am not convinced that more IT spending should be a priority. I work from electronic notes, use digital imaging systems and letter writing software. Admittedly these systems don't communicate well with each other, but that just means opening a half dozen applications when I switch on.

    The limitations on my productivity are mostly more straightforward. Physical space and beds to put people in, not enough Band 2 or 3 admin staff to book patients into gaps in clinics, not enough imaging capacity to keep pace with modern treatments etc.

    There isn't much point in digitalising booking software for operating theatre's to increase utilisation when the major reason for gaps is patients being cancelled because the beds are full of medical admissions waiting for social care.

    Tech Bros gonna Tech Bro. The real problems are just too boring and prosaic.

    Yes I completely agree. The idea that some tech is the answer has failed too many times to count. Focus on what stops people like you from doing your job more efficiently, see where the blockages are and deal with them.

    And try to build a culture that that is the way things will go with iterative growth and improvement.
    The other drag on NHS productivity is the lack of senior decision makers on the front line. Juniors, Physician Associates, Specialist Nurses all tend to lack confidence, so err on the safe side, over-investigating, over referring , bringing back for unnecessary reviews etc. This is both a training issue and a lack of continuity issue, as I am often working with unfamiliar staff, so they want and need to check everything with the boss.

    At the moment there is a real problem of over referral by non-medical staff in primary care for problems easily managed in General Practice previously. As each hospital attendance costs the NHS as much as a years percapita GP budget it is a waste of both time and resources, and a major cause of long waiting lists and patient anxiety.

    When I was involved in these things I used to worry that the then insistence on monitoring (aka cutting) the prescribing budget, which I was doing, was sometimes achieved by referring expensive patients to hospital.
    Hospital costs, per GP practice, were not monitored, and AFAIK, not even established.
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    SelebianSelebian Posts: 7,603
    Anyway, NHS anecdote: after about 15 minutes in a queue I've booked two same day GP appointments this morning.

    Services around here are pretty good, but of course it varies.
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    MalmesburyMalmesbury Posts: 44,975
    Carnyx said:

    https://www.theguardian.com/film/2024/mar/07/dune-movie-part-two-book-messiah

    O/T but perhaps of interest to our melange addicts.

    "‘Completely unfilmable’: the Dune universe is about to get weird"

    Messiah is pretty filmable -

    He’s not the Messiah, he’s a very naughty boy. 62 billion and all. Why even uber competent tyrants with perfect foresight of the future are a bad plan.

    It’s God Emperor that would be fun.
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    CarnyxCarnyx Posts: 40,193

    Carnyx said:

    https://www.theguardian.com/film/2024/mar/07/dune-movie-part-two-book-messiah

    O/T but perhaps of interest to our melange addicts.

    "‘Completely unfilmable’: the Dune universe is about to get weird"

    Messiah is pretty filmable -

    He’s not the Messiah, he’s a very naughty boy. 62 billion and all. Why even uber competent tyrants with perfect foresight of the future are a bad plan.

    It’s God Emperor that would be fun.
    First the NHS and now Dune ... plenty of scope for argument today. Actually, some very good and sometimes unexpected points on the NHS from you and many comers today.
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    AverageNinjaAverageNinja Posts: 1,169

    Scott_xP said:

    @lara_spirit
    Labour lead at 27 points in latest YouGov poll for The Times

    CON 20 (=)
    LAB 47 (+1)
    LIB DEM 9 (+2)
    REF UK 13 (-1)
    GRN 7 (=)

    Fieldwork 6 - 7 March

    5 out of 11 YouGov polls this year with a Tory share of 20% including all of the last three.

    Nothing has changed.
    I remember when people used to suspect YouGov of having a pro-Tory bias.
    Was always one of the dumber things about the Corbynites even when I was one of them. It was co-founded and run by a Labour Peer from recollection.
This discussion has been closed.