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We need more bureaucracy – politicalbetting.com
We 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.
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We also need to separate development from support. One reason the same handful of firms win all the projects is that only they have the capacity to support a userbase of tens of thousands, whereas most successful software was originally developed by small teams.
https://www.bbc.co.uk/news/uk-politics-68509239
Sad to see her go, but 27 years is a good innings as an MP.
https://www.youtube.com/watch?v=E_6d3JBBo4s
"And they're going for the threesome..."
Just to be clear, I am a business school researcher and Associate Dean. I am not associated with the civil service.
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.
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?
Working in the Tories’ favour is that Reform is filled with people not particularly well known for being able to get their act together….
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?
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.
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
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.
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.
May’s ignoring of the developing Windrush problem, and her overt hostility to the problem didn’t help at all!
I thought she had the same attitude to her vocation as the late Queen.
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.
There's always a reason to add more to a process, "just to be sure", and a real fear of taking anything away.
Key for me is buy-in at the top - constant ministerial shuffles undermine that, as you point out.
@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
On the other hand, quite a bit of hospital work is already on a 7-day basis.
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.
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.
Potential to win this after a couple of years of even worse austerity under SKS/ Playmobil haircut Reeves
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.
And try to build a culture that that is the way things will go with iterative growth and improvement.
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.)
I think I heard ‘liar’ bellowed out at one point, I wonder which of the gross Trump loonballs was responsible?
Good performance from the photogenic sword wielding Catherine Deneuve yesterday, defending Michelle Donelan.
You would need a political directive to say any productivity gains must be converted into savings, not improved health outcomes.
Civil servants for whom they are *responsible* in the first place.
Meanwhile...
@elizaorlins
Someone is having fun with Katie Britt’s Wikipedia page tonight…
#SOTU rebuttal
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.
Nothing has changed.
No blacks, no Irish, no dogs, no immigrants.
https://x.com/lbc/status/1765825818091991501?s=61&t=LYVEHh2mqFy1oUJAdCfe-Q
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.
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?
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.
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.
O/T but perhaps of interest to our melange addicts.
"‘Completely unfilmable’: the Dune universe is about to get weird"
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.
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.
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.
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.
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.
What is needed is good management. What they used to call scientific management, back when punch cards were cool. Which means careful analysis of where the blockages are and removing them.
For example, an OR analysis might come up with the heresy that we could treat more by spending less on medical staff and more on hospice type facilities to get elderly “bed blockers” out of actual hospital beds.
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).
Hospital costs, per GP practice, were not monitored, and AFAIK, not even established.
Services around here are pretty good, but of course it varies.
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.