Category Archives: Healthcare

Normal service will be resumed shortly

Are you a weekend warrior?  Or a daily doer?  Do you believe in the ‘no-pain, no-gain’ mantra?  Well, I have answered yes, to all of these questions in the past but now it’s confession time. If we listen to all of the opinion and advice, the exhortations and pleadings that are offered to us by the medical profession, the media and our political classes, then like good citizens we take our exercise and we believe it’s doing us good.  Some of us even grow to enjoy this pastime and indulge in multiple manifestations of the exercise thing.

Image courtesy

I hate to be a disappointment to all you good readers who have taken to turning to my blog in pursuit of truth, controversy, idle amusement or learned opinion but, sadly, I’m going to be out of action for some weeks.  This has come as something of a shock.

Over the years I have lifted weights, run, played squash, rowed, cycled, swum and hiked.  Whilst never in danger of actually winning anything other than self-satisfaction, I have derived great pleasure from all of these pursuits.  However, what they don’t tell us is that if we do all of this healthy stuff, then bits wear out; probably before they otherwise would have done.  First, I had to give up running due to recurrent problems with shin splints and ankle damage.  Then I had problems with my knees from cycling using the first generation of ‘Look’ pedals (no lateral movement).  Now I have learnt that my right shoulder has a rotator cuff tear and it also requires subacromial decompression.  I’m not sure what has caused this damage but I doubt that it was tapping away at the keyboard.

Having always been an early riser I have, as a consequence, enjoyed some extraordinary sights.  Sculling on a deserted Thames atHenley one late autumn morning the river was covered in a dense, low mist that just permitted my head and shoulders to break through into brilliant sunshine.  Completely lost in the magic of the moment and my exertions, I was brought back to reality by a shatteringly loud eruption behind me; glancing over my shoulder I found that I had sculled into a large flock ofCanada geese that were now rising into flight accompanied by a cacophony of beating wings and raucous honking.  Living now in the Yorkshire Dales, I have spent years cycling and hiking in this inspiring countryside.

During my business travels I have run in many parts of the world.  It’s so easy to pack your running gear and get out in the mornings and see something of the city or the countryside and sweat off the toxins from the inevitable prior night of overindulgence.  It was always fascinating to see the reactions of the locals at a time when running was not the mass pursuit it is today.  By far the most animated reaction I ever received was the whistling, gesturing and ribald comments from the morning commuters inRome.

High in the mountains above Nikko in Japan, a colleague and I collapsed into a small tea shop and pachinko arcade in search of refreshment after our exertions.  Sipping quietly on a wonderful cup of green tea and enjoying the surroundings, our tranquillity was interrupted by a group of young men bursting in, creating what seemed an amazingly authentic impersonation of Marlon Brando in The Wild One.  Catching sight of us strange gaijin, their noisy behaviour abruptly ceased, turning into furtive whispering amongst themselves with glances in our direction. Then, abruptly, the whispering ceased, they stood tall and strutted towards us with expressions as menacing as any I have seen.  With what appeared to be serious trouble looming, the real problem was not just that they heavily outnumbered us but that they had fanned out blocking the only exit.  I almost died with relief when the leader produced a large orange which he held out to me uttering in heavily accented English “Welcome Japan, please to enjoy our country.  Small gift for you”

Not only has exercise given me the space and timefor some of my best thinking but it has provided me with a store of energy that has exceeded that of almost anyone I have ever worked with, enabling me to keep focussed and relaxed when times got rough.  So, would I have changed my lifetime of exercise, if I had known that bits might wear out?  I don’t think so!  For me, nothing compares with the high from hard physical exercise (well, all right, maybe one exception).

Image courtesy of

However, I now have to put myself in the care of our medical profession and face the prospect of 6 weeks with my right arm in a very sturdy sling.  Regretfully, it seems that I’m not going to be able to tap away at the keyboard, producing my views of business life for all you faithful readers.  If you’re new to my blog, do have a browse in the archive and share your reactions.  If you’ve been following me for a while, why not leave a comment or two and start a lively thread?

Play nicely whilst I’m away!


No way to run a health service

In and amongst all of the fun I’ve had in business, I’ve had experience of our health service on many occasions.  Apart from boring personal ailments, I have also been through the life & death process with family loved ones (precious and humbling experiences) and was privileged to be married to a truly dedicated state registered nurse.  I’ve also had my life saved on 2 occasions by teams of dedicated professionals.  So, I can sing the praises of the best aspects of our National Health Service; but I have also seen at first hand the parts where it has never been put right from the very beginning, has gone astray and has been ruined by factional infighting, politicians and dogma.

Image courtesy of Business Leaders Learning


So, what’s this got to do with a business blog?  Where to start?  Over the second half of the 20th century business really learned to create and deal with mass markets.  It learned how to ascertain the needs of the customer and to meet those needs, invariably at lower and lower cost, whilst still providing value.  I know it isn’t always perfect but the progress that has been made is remarkable.  How is it that companies can get ever more profitable whilst selling at lower and lower real price levels?  It’s experience, constant learning and competition; if you have competitors snapping at your heels you get better or you go to the wall.

Now, consider our NHS; how many of you know that at its inception the cost of providing this comprehensive service free at the point of delivery was simply not known?  It was a leap of political faith and governments of the day have been trying to fund it ever since.  Demands made upon the NHS are growing exponentially, the costs of modern treatments are sky rocketing, people are leading more unhealthy lifestyles and simply living longer.  Not much of a business plan, was it?  And, since 1997 money has been lavished upon the NHS (more than doubling) but it has produced little or no net efficiency gains.  Not much of a management performance either.  Now, tell me about a business that was planned and run like this over 60 years ago, that still survives and is slavishly protected by government of all sides of the political spectrum?

One of the reasons many businesses succeed is that they are focussed upon a clearly understood goal; they may have a mission statement, a vision, a clearly understood strategy and a well-defined core process.  Take a look at the M & S plan on their corporate website ; fairly clear and concise, you know what they do and are going to do. Now try to find anything comparable on the multitude of NHS websites.  OK, you can find ‘NHS Choices’ which is filled with detailed information but the real key facts are opaque e.g. try finding out how to interpret Hospital Standardised Mortality Rates (HSMR).   In most businesses it is the core process that gets the attention; waste is eliminated, cost reduced, throughput speeded up, quality is improved and the customer satisfied.  Profits produce efficiency and satisfied customers

Teamwork is one of the real Achilles heels of the NHS – factionalism rules.  For example, even before the formation of the NHS, the Royal College of Nursing has been desperately attempting to raise the status of its members to compete on equal terms with doctors and consultants.  They have succeeded in part but at what cost to the patients they are supposed to be caring for?  Yes, the nurses have succeeded in raising their training, qualifications, status and salaries.  However, it has been a zero sum game with patients frequently losing the personal attention that used to be an essential part of the nursing role.

Targets are a concept borrowed from business (at the behest of politicians), clumsily applied and without an apparent thought as to the unintended consequences.  You want a maximum of four hour waits in A&E?  Simple; take resources from elsewhere where there are no targets, put patients into a medical ‘limbo’ and, if the timing is really critical, just keep them in the ambulances that are then prevented from hastening to other emergencies (and the ambulance service can worry about its own targets).

Of course, these are only a tiny few examples of what is bad in a vast organisation but our entire health system is neither operating in the patients’ best interests nor is it using efficiently the vast sums of our tax money poured into it.  It seems structurally incapable of focussing upon the needs of its customers and suffers too much from the continued central interference of our politicians.  What to do?  Outsource the lot.  Tesco Care, Your M& S Care anyone?