Re-shuffle cafuffel

[LJS]

I don't really want choice I want my local services to match the best, if there was more emphasis on quality of service rather than choice we wouldn't need to choose.

Who really wants to go travelling to see consultants and have treatment if they are ill, I can't imagine anyone wanting that as a first choice they'll want quality local services. It's the same with schools.

We then complain there's too much traffic and pollution so in the scheme of things it is not economical or environmentally good to have all these people on journeys, we'd be better off putting "that spend" ( I know it's an abstract cost as far as the Gov. is concerned but you get my point) into the NHS pot.

There is huge emphasis on quality of services. No decision is ever made without considering what is best for patients, and patients themselves are increasingly asked their views and they are increasingly being acted upon. Everything is about achieving the best possible clinical outcomes and providing the best possible 'patient experience' (NHS term for customer service).

You're correct to say that everybody would want high quality local services as a priority. I certainly would; I'm a patient as well as being an NHS employee. And by and large people do get that (although the Leicester hospitals are struggling at the moment both financially and in terms of providing excellent care). But there will always be variation. Why? I work in Coventry, where we have one of the best hospital facilities in Western Europe. Walk around the place. It really is brilliant, and gives you a completely different feeling to the one you get walking around LRI. But it doesn't matter, because the best consultants don't want to come to live and work in Coventry. Or Leicester. Or anywhere else other than the really big cities. That doesn't mean that provincial hospital consultants are rubbish. Many of them are excellent. They just aren't the best. There's nothing much we can do about that short of forcing consultants to work in places they don't want to work in. Given that consultants are by far the most powerful staff group in the NHS (a no confidence vote from your consultants would be the end of even the most powerful chief executive) we won't be forcing them to do anything any time soon.

[breadandcheese]

I don't really want choice I want my local services to match the best, if there was more emphasis on quality of service rather than choice we wouldn't need to choose.

Who really wants to go travelling to see consultants and have treatment if they are ill, I can't imagine anyone wanting that as a first choice they'll want quality local services. It's the same with schools.

We then complain there's too much traffic and pollution so in the scheme of things it is not economical or environmentally good to have all these people on journeys, we'd be better off putting "that spend" ( I know it's an abstract cost as far as the Gov. is concerned but you get my point) into the NHS pot.

The problem comes with, for example, a school, where if you're not happy with the quality, what can you do about it? If you have choice, you can take your child out of the school and move, rather than wait for the slow wheels of bureaucracy to catch up and remedy the situation.

That's the theory anyway, and as theories go, it's not terrible.

[Captain...]

The problem comes with, for example, a school, where if you're not happy with the quality, what can you do about it? If you have choice, you can take your child out of the school and move, rather than wait for the slow wheels of bureaucracy to catch up and remedy the situation.

That's the theory anyway, and as theories go, it's not terrible.

The problem is then everyone will move schools, and the good schools will not be able to handle it and become overcrowded and then shit, likewise with hospitals, going back to DavieG's comment, it is not always a tangible thing that makes a hospital or a school good or bad, you can have 2 identical hospitals with identical resources, but if one is in bigger city than the other then it will be busier and therefore not as good to go to because waiting lists are longer.

Or there is just the human aspect, some doctors and nurses will be better than others, and this you cannot control this, you can throw as much money as you want at a local hospital, but some hospitals will be better than others.

[hairy]