UPDATED: Criticism mounts over ex UHMBT boss pay deal: £150k a year salary, car and benefits

REVEALED: Former UHMBT boss who stepped down 13 months ago still entitled to £150k a year salary, car and benefits REVEALED: Former UHMBT boss who stepped down 13 months ago still entitled to £150k a year salary, car and benefits

FORMER health chief Tony Halsall is still being paid his £150,000 a year salary from Morecambe Bay University Hospitals Foundation Trust - despite stepping down in February last year.

The details of the former chief executive's agreement with UHMBT trust bosses have been suddenly released today by incoming board chairman John Cowdall, who only took over at the start of March.

Mr Halsall, who stepped down in February 2012, will continue to get his salary until October this year and is also entitled to his lease car and the costs of career management advice up to the value of £5,000.

It means that since he stepped down, he will have been paid a total of £225,000 - a year's salary plus six months notice.

Just last week, the troubled trust told its nearly 5,000 staff it had to find £30 million by next April and it should turn computers off at night to save £60,000, while redundancies cannot be ruled out.

During Mr Halsall's tenure at the trust, it was criticised on several occasions by watchdog, the Care Quality Commission. A police inquiry into the deaths of mothers and babies at Furness General Hospital is still ongoing.

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On leaving the trust, Mr Halsall took up a secondment with the NHS Confederation where he remained on the same financial terms as his former post. 

The confederation describes itself as 'the membership body for the full range of organisations that commission and provide NHS services'.

It represents acute trusts, ambulance trusts, clinical commissioning groups, community health service providers, foundation trusts, mental health providers, primary care trusts and independent and voluntary sector healthcare organisations that deliver services within the NHS.

Mr Halsall was replaced at UHMBT by new chief executive, Jackie Daniel, in August last year and the trust has around 30 outstanding legal claims from hospital service users.

Details of the pay agreement were swiftly condemned by Lakes MP Tim Farron, who has been campaigning to end the secrecy of NHS deals.

Mr Farron said the amount was ‘too much for failure’.

He said: “I have repeatedly called on the trust to let us know the level of this severance package. I have said all along that taxpayers have the right to know.

"The level of this package will shock people. £225,000 is too much for the failure that he presided over.

“I really do welcome the move by the new management to release this information today. They have started to turn the corner and this should be acknowledged. I will keep working with them to improve services and health outcomes.”

“However, we should also recognise that despite the failings of the previous management, working with Tony Halsall helped bring chemotherapy to Westmorland General, and we would not have made as much progress on the campaign for radiotherapy without him."

Barrow MP John Woodcock branded the deal ‘inexcusable" and a 'shameful act unworthy of our National Health Service'.

Said Mr Woodcock: "The managers of the time may try to say that a secondment (to the NHS Confederation) was the easiest way to ensure a swift change could be made, but whether or not that is true, their failure to be straight with the public is inexcusable.

“And this attempt to bury the news on budget day suggests the new management team have not learnt the lessons of the past.

“Everyone involved in this sorry affair – including government ministers – should make clear what they knew, and when, and face the anger of local people who want their taxes spent on patient care not secret deals.”

Commenting on the announcement was Dalton-in-Furness dad, James Titcombe, whose baby son Joshua died nine days after he was born at Furness General Hospital's maternity unit.

An inquest found staff had failed to pick up the infection that claimed his life.

Mr Titcombe, who has been campaigning for improvements in the way the trust is run, said of the news: "This is completely unacceptable and an insult to the many families who are still suffering as a result of failures under Mr Halsall's leadership."

Mr Halsall is currently listed on the NHS Confederation website as one of its associate directors where his role is described as leading: 'our work on the Hospitals Forum and Outstanding Leaders programme."

The Confederation arranged a series of meetings between September and December last year to: 'Provide a safe and informative opportunity for our member chief executives and accountable officers to speak honestly and candidly about problems faced in the day to day running of organisations and the solutions that may be available'.

It session in London, called 'Resilience' looked at 'how chief executives deal with crisis situations and how those who have left have been able to bounce back either within or outside the NHS'.

Mr Halsall is also one of 18 members on the confederation's hospitals forum.

The Gazette has contacted Mr Halsall and the NHS Confederation to provide an opportunity to respond to criticisms of the deal.

Before joining UHMBT, Mr Halsall also held a chief executive role at Clatterbridge Centre for Oncology NHS FT. He joined the NHS in 1980 as a nurse, before moving into various senior management positions across the North West.

 

Darren McSweeney, of the FGH Cancer Care Campaign issued a statement in response to the announcement:

"As the FGH Cancer Care Campaign team prepare for tomorrow (Thursday 21) night's emergency public meeting around the UHMBT proposed removal of inpatient beds from the Oncology unit at Furness General Hospital, we are astonished that such a deal with Mr Halsall was agreed.

"A Trust trying to save every penny, should be ashamed that this "pay-off" was agreed.

"The fact the deal was hidden with a secrecy agreement, then finally released in the same week that we are discussing the impact of cost saving measures with the Trust is nothing short of shameful."

The full press release from UHMBT, which runs hospitals in Kendal, Barrow and Lancaster, reads as follows:

"The former Chief Executive, Mr Tony Halsall, stepped down from the Trust on 24 February 2012, in agreement with the Trust Board.

"In an agreement with the Trust, he then took up a secondment with the NHS Confederation. The agreement provided for him to be paid his salary by the Trust up to 5 October 2013.

"Under the agreement Mr Halsall also retained his existing benefits, including a lease car, and the provision of career management advice to the value of £5,000 + VAT.

"In signing the agreement, Mr Halsall not only resigned as Chief Executive but also waived his statutory employment protection rights and any claims he had, or may have had, arising from either his employment with the Trust or the termination of that employment.

It went on: "John Cowdall, who became Chairman of the Trust on 1 March 2013, said: “It has been decided at the end of the secondment with the NHS Confederation that the Trust will pay Mr Halsall for notice, which is due under the terms of the legal agreement concluded with him in February 2012.

"This will end his employment with the Trust. Mr Halsall is entitled under his existing agreement to six months’ notice or salary in lieu of notice.

“The compromise agreement that he and the Trust signed in February 2012 contained a confidentiality clause which is standard when these agreements are negotiated.

"Such a clause prevented both the Trust and Mr Halsall from revealing any details of the agreement.

“I am aware that this clause has caused a great deal of disquiet in the minds of many individuals, including representatives of the media.

“It is for this reason that I am making public the terms of the severance arrangements that have applied.

"I would like to stress that Mr Halsall has received no more than his contractual entitlement. Notice periods of six months are common for appointments at this level and enable employers to advertise for and recruit a successor.

“The financial arrangements under which Mr Halsall was seconded to the NHS Confederation may well attract criticism.

" I would simply state that those arrangements facilitated the departure of the former Chief Executive and avoided the potential for a long drawn out dispute that would have been expensive and time consuming and also, enabled the Trust to move quickly to restructure the Board and recruit a new Chief Executive.

"The arrangement was also of benefit to the NHS more generally through the work Mr Halsall was able to perform through the NHS Confederation.

“I would add that these arrangements are being made public because both the Trust and I are determined to have such matters dealt with in an open and transparent manner.

“The public interest arguments for making such information freely available are overwhelming and with that in mind, I can confirm that any compromise agreements that are entered into from now, will not be the subject of any confidentiality provisions or so called ‘gagging’ clauses."

 

Comments(34)

hemyfan says...
7:06pm Wed 20 Mar 13

So the does the NHS Confederation pay his salary? Who signed this deal off? How many "moved on" managers are advising other NHS managers in this NHS CONfed?
The temporary Chief Exec got paid a fortune; he is meant to have "turned around " the trust but but overspent by £30m and left maternity services still in chaos. Can I have a go please!

Whinfell says...
7:18pm Wed 20 Mar 13

When you next look at your wage slip look at your tax and national insurance deductions then weep.
Think about where your hard earned taxes are going to.
Might as well pour the money down the drain.
What is the point of ring fencing National Health service budgets and then just throwing away money on this scale?
Who is responsible for making these decisions?

zaney5 says...
7:46pm Wed 20 Mar 13

I think putting a smug looking photo of him is a real kick in the teeth to those people whose lives he ultimately ruined thanks to his poor management. Have a heart and remove it.

Cragrat1 says...
8:12pm Wed 20 Mar 13

Staff at MBHT have been forcibly downgraded, with no other reason except to "save money". To admitting to paying the incompetent Halsall even after he has left (thankfully) is a complete kick in the teeth to all current MBHT staff. Now they want £30 million in savings- why don't they start by sacking the current management- oh hang on that won't work because they will still get paid 13 months after they have left. No wonder staff morale is rock bottom and hold the current management in complete contempt.

wezzyk says...
9:15pm Wed 20 Mar 13

Not at all surprised about this. Most return at a later date when the money stops in a consultancy role earning more than before for less input.

nickjohn says...
11:14pm Wed 20 Mar 13

Why are people surprised at his package and pay off... Most of the top execs in these NHS Trusts get paid over £100k per annum and when paid off get at least a years salary and double that paid into their pension.

Its the system that is the problem and there are people out there more than happy to abuse the system and take what they can - wouldn't we all do the same thing if we thought we could get away with it.....

zaney5 says...
8:07am Thu 21 Mar 13

"...wouldn't we all do the same thing if we thought we could get away with it....."

Well I don't know about you but personally I have morals.

Kendmoor says...
11:04am Thu 21 Mar 13

I agree with nickjohn here.
Part of me thinks the system should probably change.

The other part of me feels that you should have higher paid jobs if the job demands it - that's why you work hard in school and continue to work hard afterwards. Hell, If I could get that kind of money I would...but there is no way I would be able to by doing what I want to do..it's all down to our choices.

Before people start salivating over what I just said I do refer you to my original comment that the bonus/payoff system should probably change with regards to a situation where our taxes are so directly involved.

WilliamT says...
11:53am Thu 21 Mar 13

There is no surprise about this- when you become a 'made man' on the Board, the DoH and NHS will always do whatever is necessary to look after you. If you look at the UHMB Board now, there are 3 longstanding executives still there from up to 7 years ago. The responses to the Francis Report are all talking about 'Board accountability', when there obviously isn't any.

The organised cynicism is astonishing- while the DoH testimony to the Mid-Staffs. Inquiry was full of statements that there must be no reward for failure, when it comes down to public money they will pay a lot to keep Halsall et al. quiet. It will be worse than has so far been admitted- while they're owning up to a car, they're slipping through massive payments into Halsall's pension. The payoff to Mid-Staffs CE Yeates was at least £400,000, and payments to managers are not subject to all these pay rise caps- they're just for the plebs.

gadgetgadget says...
1:35pm Thu 21 Mar 13

I agree with both sides of the posters on this.

Yes the system is at fault, but unless people start standing up the system and pointing out it's wrong then it won't change.

But what is scandalous about this is at a time when money is so much of an issue is

a) it was kept a secret until now
b) that money could have been spent saving lives or giving care to those who really need it.

The words I'd like to use to describe this would not be allowed on this website.

Add into this that Halsall is not the only one to leave recently and still be employed elsewhere within the NHS.

It's really all about responsibility though. No-one seems to actually LOSE their jobs - just shuffled into a different section of the NHS.

Only when heads properly roll will there be any chance of productive change and a mentality change in management of OUR National Heath Service. And we should all reflect really on that it is OUR money that is being paid in taxes etc that are funding Halsall and others mismanaging the NHS and lining their own pockets.

If he had any honour at all, he would have foregone some of his contractual obligations and walked. Key word there is honour.

Scots Guardsman says...
2:27pm Thu 21 Mar 13

The system is clearly unacceptable but frankly no different to what we have seen in the higher echeleons of the private sector except that taxpayers are directly paying for it - unlike the private sector (well except for the banks, railways, utilities, etc. etc.)

Bottom line, those at the top look after each other and demand constant "carrots" to reward "performance" whilst everyone has to be "motivated" with "sticks" like redundancy. The de facto privatisation of the NHS over the last 25 years by all parties is what has allowed these practices to take root and flourish.

Commenting specifically on Tony Halsall he seems to have actually been paid off with far less than some others in the NHS who have done far worse, e.g. Nicholson who has actually been rewarded with promotion....

There is also the scapegoat question.

Granted Tony Halsall was the man at the top - but there were an awful lot of others involved, some in privileged clinical roles who are just as culpable if not more so and nobody seems to have held any of them to account - yet.

Tony Halsall did good work at Clatterbridge - and as Tim Farron says helped bring oncology services to Kendal. It is well known that a covert "mafia" fiercely protective of "spanish practices" operates within UHMB - more on some sites than others - any Chief Executive who challenges that (and Tony did) will end up being stabbed in the back sooner or later.

WilliamT says...
2:54pm Thu 21 Mar 13

The point about being the accountable officer, as Halsall was, is that you are accountable. There was no gun held to his head when they lied to achieve FT status, when they distorted and misled about the UHMB mortality rates, when they withheld the Fielding Report and when they covered up 'serious untoward incidents'- Halsall was as accountable as a nine bob note- the fact that, unbelievably, Holt, Bennett and McGahon are still on the Board despite leading UHMB to destruction does not excuse Halsall. It just shows that the present Board is still bent.
You will note that the Health Ombudsman is now 'investigating' NW SHA for its failure overseeing UHMB- this is the same Ombudsman who refused to investigate the 'maternity and neonatal deaths' at FGH which brought UHMB down years later- this delay allowed UHMB to accumulate the worst mortality rates in England and hundreds of excess deaths. The Chairman of NW SHA at the time was Henshaw, who became Monitor's choice for UHMB chairman because he could be relied on to 'keep the lid on it', and who has only just left and was responsible for the fiasco of the aborted closure of the FGH maternity unit and SCBU. These people just investigate each other and find that no-one did anything wrong, no-one was responsible and they all deserve huge sums as 'pay for performance'.

gadgetgadget says...
3:13pm Thu 21 Mar 13

Sorry just spat my drink out ....

Halsall a scapegoat ?

Oh come on ...

Who presided over the farcical manner of obtaining Foundation Trust status ?

Who presided over the cutting of corners to achieve that ?

Who presided over the culture of gagging staff from speaking out ?

The real scandal here isn't just the pay-off but is that these people are allowed to continue to work within the NHS somewhere else.

Frankly the comparison with the private sector too is wrong - had this sort of thing happened in the private sector he would have been out of a job a long time before - perhaps with a similar payoff granted - but all the same he would have found it harder to get another job as a result.

Does the public sector care about that though ? It appears not. And that's the BIG difference between the two.

Kendal Jock says...
4:10pm Thu 21 Mar 13

Absolutely typical of the public services.
Nobody accepts the responsibility for failure nowadays. Private sector? he would be down the road, and rightly so.
Scandalous waste of our taxes on poor services and idiot pen and paper shufflers.

Cragrat1 says...
4:57pm Thu 21 Mar 13

What is also scandalous is the way the current management want plaudits for revealing the Halsall scandal, see "Fresh Thinking" web site (should be called "Fresh Spinning"), they were forced into revealing this information and if they had their way it would still be a dirty big secret. The whole Board and top level management of MBHT should be sacked with no recompense.

Scots Guardsman says...
5:35pm Thu 21 Mar 13

@gadgetgadget

Yes a scapegoat.

I have lived in the Bay for many years and been a patient a few times by now along with family & friends and also know people who used to work for the Trust.

If you read between the lines it's quite clear (although no one says it openly) that there are parts of the Trust that faced with a challenge or a change just get on with it - and there are other parts that go to great lengths including all sorts of maneuvers to keep things just the way they like them.

I am NOT saying Tony Halsall shouldn't be carrying the can - I just don't think he should be carrying it alone and there are people behind the scenes very glad he is in the spotlight.

The Truth is Out There

The politicians don't mind us knowing what happened, but they don't want us to know why.

Oh and the boardroom merry go round is extremely well known in the Private Sector - where good old boys mess up and shuffle down the road to someone else's remuneration committee and a couple of directorships - where do you think the NHS got the idea from in the first place.....

WilliamT says...
6:10pm Thu 21 Mar 13

SG is clearly part of the Revisionist Tendency- gradually they try to propagate the notion that it's all a bit of a fuss about nothing, that it was all a misunderstanding and that we should all have a good laugh about it.

Prof Ashton, former Director of Public Health for Cumbria (curiously, it's Cumbria that has led the way with UHMB- Lancashire was prepared to just let it lie) made the point that whenever people say that 'it was the system that was at fault, what they're really trying to arrange is that no-one is at fault'. Halsall was in charge of the system, nominally with dodgy Chairman Kane but NHS chairmen are front men who don't know anything about acute hospitals, Halsall was the one shown by James Titcombe's secret tape to be lying shamelessly and Halsall was the one writing the blog which proudly proclaimed 'the buck stops here' after he'd chiselled and cut the way to FT status.

Instead of campaigning for sympathy for Halsall, SG could profitably call for justice for board hangers-on, which is a payoff-less prompt exit.

Cragrat1 says...
6:47am Fri 22 Mar 13

The Halsall debacle is only the tip of the iceberg. The current crop of incompetents in management are making absolutely ridiculous decisions which cost not just thousands but millions of £. For example Consultants being paid for sessions that do not exist. I don't know about "Fresh Thinking" what MBHT needs is Fresh Management which is brought in from outside the cosy old boy network of the NHS.

Scots Guardsman says...
8:30am Fri 22 Mar 13

@WilliamT

I am not being revisionist or campaigning for TH.

I am saying the appalling events go far beyond the one man currently being (deservedly) criticised and there are reactionary and shadowy forces in the background both within the Trust and the Political Classes who are very happy to hang him out to dry publicly because while we are all looking at him we are not looking at THEM.

Why is it a succession of managers and board members - many with a track record of honourable success elsewhere in the NHS or in their own businesses - always end up unable to control events in UHMB?

The Truth Is Out There.

WilliamT says...
12:10pm Fri 22 Mar 13

Well, we can agree that not much change can be expected from the present Board and senior and middle management, because many of them are the same people and have been in their jobs for years. They are going to ensure that as much as possible from the past failures stays hidden. That's why they tried to fix yet another internal inquiry, and had to be overruled by Health Minister Poulter who substituted the presently planned 'inquiry in public'. We don't know what that means yet.

They won't say that it was the fault of Halsall- in fact he received only compliments about his abilities from Henshaw, and the system they worked out was that each departing board member received praise (and references no doubt) from Halsall until he went- the Henshaw did it. In fact, the praise was so effusive that you wondered how the trust could afford to lose such wonderful people.

Whinfell says...
1:49pm Fri 22 Mar 13

I have emailed Private Eye about this story.
Hopefully it will receive a national profile.
The more the hard pressed taxpayers of this counrty are aware of such use of public money the better

hemyfan says...
2:24pm Fri 22 Mar 13

Whinfell wrote:
I have emailed Private Eye about this story.
Hopefully it will receive a national profile.
The more the hard pressed taxpayers of this counrty are aware of such use of public money the better
The *aily *ail have a good write up today.
Reading it reminds you that clinicians have responsibility as well as the politicians, managers etc. It is too easy for incompetent and worse staff to hide behind the very obvious and correct anger directed at their bosses.
http://www.dailymail
.co.uk/news/article-
2297236/Sir-David-Ni
cholson-Who-Man-With
-No-Shame-blame-time
.html

gadgetgadget says...
5:41pm Fri 22 Mar 13

@ScotsGuardsman

Well aware that Halsall wasn't the only problem at UHMBT - and me ... I've been around in the area for over 40 years so have seen a lot of change in that time.

The problems with the NHS are deep running, but they are the same problems that are common throughout the public sector.

In my opinion, a lot of this started when the previous regimes started using client-provider unit scenarios in the public sector thus creating duplicated management posts, creating effectively "false" adminstrative posts as well. In the process however it became easier to pass the buck between departments and managers without responsibility being taken.

Yes some departments will tackle issues head on and others avoid - that's the same the world over BUT what is crucial is how those departments are dealt with for behaving in a manner that is unsuitable.

Whether you think Halsall is a scapegoat or not is not the real issue... he made so many mistakes and seemingly turned a blind eye whilst he was in charge that the use of the word scapegoat just doesn't seem to fit tbh.

Basically the buck stopped with Halsall, the bucks however didn't stop leaving Halsall when he left.

The issues about moving managers/directors around are MUCH more rift within the public sector than the private sector and not just the NHS. At the risk of being accused of the usual "council bashing" - you only have to look at the similar problems that exist within local government for example.

Until this culture is taken out of the equation and responsibility if not by committee and people start earning their salaries by taking decisions that they are paid for then it's not going to improve. That's just my opinion of course.

Scots Guardsman says...
7:56pm Fri 22 Mar 13

@gadgetgadget

The client-provider split was supposed to introduce the benefits of "competition" and the private sector ethos into public services at all levels thereby making them better and cheaper.

I think it fair to say that however monolithic the old District Health Authority model was at least you knew who was in charge and who the Matron was.

The same thing has happened in the utilities, the railways, councils etc etc

"Pretend" competition with a mass of external consutants all synergising delivery and the like.

The NHS is now a privatised health care system in all but name - and like the railways where ATOC and Network Rail bill each other for delays multiple sets of clinicians and managers are ticking boxes for the MPs not looking after patients

WilliamT says...
11:19am Sat 23 Mar 13

"Basically the buck stopped with Halsall, the bucks however didn't stop leaving Halsall when he left."

Or to put it more transparently (everything is said to be transparent in the NHS these days, even while they're fighting FoI requests with every public pound they can stuff into their tailored pockets) : the bucks stopped with Halsall, and stayed with him when he left.

The actual quote from our Tony's blog from June 2011 is "in terms of how the Trust performs, the buck stops here, with me....this applies to absolutely everything, not just the finances"

The problem is that no-one from the DoH down thinks this really applies to senior managers. They are not as other men- or women. Therefore, they award each other contracts that say 'when you leave, think of an amount of money and we''ll double it- we can easily get the money by sacking some staff'.

pixie55 says...
12:55pm Sat 23 Mar 13

The cuts have already begun - the sackings are next (or you come in to a letter telling you you have to reapply for your job on less banding/less pay while the ever increasing army of highly paid management goes from strength to strength.

nickjohn says...
2:38pm Sat 23 Mar 13

No matter what we all think of Halsall and how he managed things when he was in charge in six months time we will all have forgotten about him, someone new will be in charge and the same conversations will still be had.

There are problems with the NHS from the top to the bottom and it will take more than a few sackings at the top to sort it out.

In the age we live in everyone spends time watching their backs and passing the can, no one seems accountable and those that are never really pay the price.

Whilst I do not want to upset anyone within the NHS there are those that do a cracking job and put themselves out and there are also those in it for what they can get and do just enough so as not to get noticed.

As has been said before if it was a business it would have gone bust years ago but as it is financed from the public purse it just rambles on and on and on and on.

It really does need a top to bottom shake up, IMO this will never happen as those at the top have a vested interest in keeping things the way they are and those below with influence are given nice contracts so they too have an interest in agreeing with things at the top....

Scots Guardsman says...
5:39pm Sat 23 Mar 13

@nickjohn

If it was a "business" it would be based on the ability to pay and the cost-effective delivery of services.

There would be a single hospital located close to the majority population in the area to provide customer footfall and supply the necessary workers and areas like Kendal and Barrow would have been downgraded years ago.

There certainly wouldn't be any chance of a brand new Radiotherapy Unit stuck in a market town with a small poulation, Barrow maternity would have been midwife-led years ago.

Oh wait they DID privatise the NHS and look what's happening....

The only thing left is to start charging for access - and guess what they were talking about last week - £8.50 for every visit to the GP and a "hotel" charge for all hospital patients.

I wonder if all those people who despised the concept of treatment according to need and the provision of a universal SERVICE will still be happy when the full implications of the last 20 years finally come home to roost and US firms make big bucks from their illness?

No doubt the well-heeled will be thrilled at not having to share facilities with the common folk - who can be left to a "basic" service centralised either at Preston or Carlisle.

nickjohn says...
6:52pm Sat 23 Mar 13

Scots Guardsman wrote:
@nickjohn

If it was a "business" it would be based on the ability to pay and the cost-effective delivery of services.

There would be a single hospital located close to the majority population in the area to provide customer footfall and supply the necessary workers and areas like Kendal and Barrow would have been downgraded years ago.

There certainly wouldn't be any chance of a brand new Radiotherapy Unit stuck in a market town with a small poulation, Barrow maternity would have been midwife-led years ago.

Oh wait they DID privatise the NHS and look what's happening....

The only thing left is to start charging for access - and guess what they were talking about last week - £8.50 for every visit to the GP and a "hotel" charge for all hospital patients.

I wonder if all those people who despised the concept of treatment according to need and the provision of a universal SERVICE will still be happy when the full implications of the last 20 years finally come home to roost and US firms make big bucks from their illness?

No doubt the well-heeled will be thrilled at not having to share facilities with the common folk - who can be left to a "basic" service centralised either at Preston or Carlisle.
It does not necessarily have to be run on an ability to pay basis, it just needs to be run within its budgets and run efficiently. Private businesses run efficiently so the NHS should be no different, as said before one of the problems is accountability for budgets, when public money is used people see it as a bottomless pit and keep going back for more.

By running things efficiently the requirement for smaller localised hospitals could be met with larger centralised units offering specialised services.
Ultimately there may not be the ability to service a radiotherapy unit in Kendal but in the real world you cannot satisfy all of the people all of the time, what would be the sense in funding a service which will have small scale use when you could fund something which would be of better use to the community.

They were talking about charging for GP visits back in 2009 along with charging for procedures such as removing tonsils, fixing varicose veins and plastic surgery so that’s nothing new.

If when all the figures are stacked up and it shows there is a way for an independent operation (such as the Americans) to do the same job and make a profit then it just supports the argument that it is the current management structure and business model which is totally inadequate and it is that which needs reforming….

gadgetgadget says...
7:24pm Sat 23 Mar 13

Scots Guardsman wrote:
@gadgetgadget

The client-provider split was supposed to introduce the benefits of "competition" and the private sector ethos into public services at all levels thereby making them better and cheaper.

I think it fair to say that however monolithic the old District Health Authority model was at least you knew who was in charge and who the Matron was.

The same thing has happened in the utilities, the railways, councils etc etc

"Pretend" competition with a mass of external consutants all synergising delivery and the like.

The NHS is now a privatised health care system in all but name - and like the railways where ATOC and Network Rail bill each other for delays multiple sets of clinicians and managers are ticking boxes for the MPs not looking after patients
@ScotsGuardsman

Yes I know all of that - having worked in both the private and public sectors.

However, there is one fundamental difference between real competition in the private sector and "pretend" competition in the public.

A lot of money is wasted as a result, the real "places" where money should be spent are often bypassed and as you say masses of external consultants effectively ripping off the taxpayer.

However, there is a fundamental duty amongst all public sector services - and that is to ensure value for money. It is one of the root principles of their codes of conduct.

In a private sector organisation also if budgets aren't spent at the end of a financial year they are often allowed to be carried forward thus removing the need to borrow more in the next year. Compare that to the public sector and the difference is stark.

Again at the risk of council bashing, just have a look around Kendal at the number of sudden roadworks and pavement repairs occurring (it's the same EVERY year), spending money from this year's budget so can have same amount next year, instead of carrying money forward and borrowing less from the public purse.

What continues to amaze me is that the local and central government politicians haven't woken up to this travesty of wasted money.

Again as you alluded to : at least in the old DHA structure there was a much simpler organisational structure and a clear line of responsibility defined. The creation of "trusts" blurred that - and some have milked that for their own ends. It's a national disgrace really.

@nickjohn

Spot on - definitely needs a top to bottom overhaul - not just the NHS though.

Cragrat1 says...
9:09am Sun 24 Mar 13

pixie55 wrote:
The cuts have already begun - the sackings are next (or you come in to a letter telling you you have to reapply for your job on less banding/less pay while the ever increasing army of highly paid management goes from strength to strength.
Could not agree more. Several clinical departments have already gone through a "re-structure" (management speak for-" you lot cost too much so we are going to downgrade you and dramatically cut your salary but expect you to do the same job, with no right of appeal"). They seem to find the money to employ loads more management types who wander around MBHT with coffee cups in hands or purposefully stare at computer screens emailing each other about when to have the next meeting and who is bringing the biscuits. They are planning to close 10 beds on one of the wards but open 10 beds on a very expensively re-equipped ward (that was left empty by the failed experiment of Ramsey Healthcare providing expensive NHS operations), go and work that one out. There is no doubt compulsory redundancy letters will be going out soon, (obviously only to clinical and clerical staff I.e. those who actually see patients or help to keep the place running) there will be no redundancies in management, no doubt they will create a job to oversee all the redundancies, they will need an assistant obviously, probably a car and a coffee and biscuit budget. For a laugh watch the "staff briefings" videos on YouTube, perfect opportunity to come clean and transparent about the Halsall debacle, but no, choose to put up 3 speakers who said basically, "we have got a Bridging Loan from the government, and we all need to pull together" how patronising. A good example could be set by top management if they all took at least a 25% pay cut, ideally 50%.

gadgetgadget says...
10:00am Sun 24 Mar 13

Those would probably be the same management types who take out a water dispenser from one waiting room and leave others in place. Supposedly because of infection risk ... errrr... isn't bottled water LESS of an infection risk ?

Those would probably be the same management types who also remove other working facilities without notice or on flimiest excuses.

Those would probably be the same management types who think that centralized printing saves money - err but what about the amount of time it takes people to walk from their desks to the centralized printer ? Time and money lost.

Couldn't agree more with Cragrat1 & pixie55

gadgetgadget says...
1:54pm Tue 26 Mar 13

From http://www.bbc.co.uk
/news/health-2192299
8 - today

"Meanwhile, managers who fail in their jobs will be barred from holding such positions in the future."

Cannot happen soon enough.

WilliamT says...
2:50pm Tue 26 Mar 13

I hope no-one thinks for a moment that this is either true or intended to become true in the future. Halsall went off to the NHS Confederation, Yeates (Mid-Staffs.) was allowed to evade questioning at the public inquiry due to ill health (the giving of testimony lasted 9 months!), but rapidly got better when it finished, and 3 members of the UHMB Board remain, having all been on this 'accountable and responsible Board' over 5 years.

click2find

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