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‘It’s the economy, stupid…’
… said by James Carville, Clinton’s strategist for the 1992, US presidential campaign.
Economic history...
... Dizzy Lizzy, Gordon Brown, Osborne, Sunak even Callaghan… who had to tackle a chronic balance-of-payments deficit and attacks on sterling.
It was 'the economy' then and it's still true today...
... as Rachel Reeves will find out. It's nothing like driving a car. More like skippering a sailing dinghy. Trimming, tacking and gybing.
'It’s the weather stupid…’
… global economic winds. It’ll be the economy that'll be the undoing of Charmer because…
… the quality of public services, their availability and responsiveness inextricably bound to the economy, is the only indicator we see of how well HMG is doing, or not.
‘It’s expectations, stupid…’
NHS expectations? All the public can judge by is waiting lists.
If all the people on NHS waiting lists were stood on top of each other, the pile would be more than 30 times the height of the International Space Station and about a third of the way to the Moon!
Fiddling with taxes for non-dom's and bit of overtime are the central planks of Labour's policies... plus the Darzi report, due any time soon.
I'd bet it'll be a rerun of the last one and Alan Milburn will have egged him on for the NHS to roll up its sleeves and 'be more business like'. The NHS is not a business, but running it in a business-like fashion is no bad thing. Creating a dilemma; are patients, customers? They could be…
… they, their family, society, pays for care in taxes. Not always a transaction. Mostly a down payment for the future.
Over the years the NHS narrative has edged towards a consumer role for the patient. We've never quite got there.
'It's capacity stupid...'
... there’s not enough people and kit in a paper driven system.
That's why various myths have emerged, to camouflage cuts in services and shortages. Kidding us they are in some way better.
Virtual wards? Only because we don’t have enough real wards.
'Care-navigators’ Only because we don't have enough care-givers.
‘It’s compromise, stupid...'
... and if the patient is a customer, they have no real say.
The CQC does not investigate individual patient complaints, yet unbeknown to the patient, true or false, it reports anecdotal evidence to condemn Trusts.
To start with the patient and work backwards is a good way forward but what about the people doing the job?
It was Harry Selfridge who's credited with the term, 'the customer is always right'. It stuck and we're stuck with it.
Is it true? Maybe not?
Where managers take the view the patient is never wrong, it's demoralising for staff who may know full well, the patient was wrong...
... pitting managers against staff is a culture killer
If staff are spread too thin, trying to meet unreasonable expectations, there's no headroom to create real improvements.
Staff with empathy, who are great listeners, with the time to dig into problems and speak the truth with kindness is key and that's why people like Branson says staff come first. Before customers.
He's right; care for the carers first, so they can care for the others.
‘It’s your people, stupid…’
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