Sunday, 27 March 2011

The people marched ... and the Coalition ignored

Hundreds of thousands of people descended on the London this weekend to march in protest at Government plans and to call for an urgent re-think ... and the next day Vince Cable* says the Coalition is going to carry on regardless!

They want us to believe they are listening to the people ... but clearly they are not! 

They'll point to their change of plan with regard to selling off the forests, after supposedly listening to the people (because a change of heart here was not a big issue for them), but when it comes to everything else, including tuition fees and reforms to the NHS (bribing GP's with bonuses to ration healthcare), they'll listen to no-one and will not budge!

No wonder people are becoming more cynical, annoyed and frustrated, and for a small minority this clearly boiled over. If the coalition continue not to listen to the people, IMHO things will unfortunately only get worse. It appears you can march all you like, but it won't make any difference to what they do ... so people will now have to hit these people hard in the forthcoming May elections too (forcing thousands of their rank and file supporters to get kicked out of local councils).

When students marched about tuition fees being tripled they were ignored and the Government were quick to tell us only a small number of Universities would actually charge the maximum £9k per year. In reality, virtually every university to date has announced it will be charging the £9k per year! The Government is also scrapping EMA for 16-18 year olds too, when youth unemployment has risen to an all time high (1 in 5 and rising). 

IMHO the Government need to remember, those with nothing ... have nothing to lose! 

* NB Vince Cable has also said today he wants to see the 50p tax cut for the rich! Shame on the man ... a man with no morals who has clearly lost all credibility and trust ... a man quickly corrupted by Power.

Saturday, 19 March 2011

Selfishness - a Recipe for Failure

For many years "The Apprentice" has offered UK viewers the unedifying sight of desperate contestants fighting it out to become Lord Sugar’s next business protege. However, the show’s celebration of selfishness and ruthlessness as the keys to success in the world of commerce has been debunked by one of the country’s leading businessmen.

Newly-departed Tesco boss Sir Terry Leahy said getting on with others and a work ethic of giving ‘more than you take’ were far more valuable assets – and ones that schools should be instilling in children.

Sir Terry, 55, who left Tesco earlier this month after 14 years at the helm during which he took the supermarket’s annual pre-tax profits from £750million to more than £3billion, said that the show was ‘not a very accurate reflection of business - The Apprentice is good entertainment but it’s got nothing to do with business or how to be successful in business'. 

‘If you’re ruthless and selfish, you won’t do well in business’, and went on to say, ‘Everyone wants a successful society, but to have a successful society you need a successful economy and to have a successful economy you want the best and the brightest wanting to go into business, into enterprise, and seeing it as worthwhile and noble work, which it is.' 

Sir Terry believes that schools should undertake ‘social skills training’ to equip pupils for the workplace as they must be able to work with other people. He said: ‘I think that employers need to be clearer with schools and universities that they also want teaching of values, of citizenship, of how as an individual it’s important to give more than you take. That’s what makes you effective in the workplace – that people like working with you and you’re a useful member of a team and you’re keen and happy to give service.’

Sir Terry left his chief executive role at Tesco three weeks ago, having built the supermarket into the UK market leader. It now has 30 per cent of the market, nearly double that of closest rival Asda.

Sir Terry Leahy speaks a lot of common sense (see my Book, Chapter 6), but unfortunately 'common sense' is not all that 'common', particularly in larger organisations ... where most 'leaders' fail to listen to anyone and enjoy telling people what to do. Flawed HR reward systems also drive people's selfishness and short-term self-interest (partly due to outdated/flawed practices still being taught in business schools), rather than promoting teamwork, listening to customers, and ensuring that everyone's intrinsically motivated and committed to continuously improving the value provided (i.e. through its products, services and solutions) to their customers (which engenders loyalty and creates long-term, sustainable success). 

Sir Terry is also right about the importance of getting things right with regard to creating a successful economy and a successful society ... however, unfortunately for Sir Terry, and the nation, selfishness and self-interest still rule, which is why we are where we are today. Put bluntly, if the UK were already doing what Sir Terry suggests, the UK would not be in the state it's in! 

... and things will have to change rapidly (and fundamentally) if the UK's going to not only survive but prosper. The real challenge faced is all the self-interest shown by current 'leaders', including politicians, the bankers, the landowners, the media and the judiciary, as well as the vast majority of 'leaders' of public bodies and large corporations, who profit heavily from how things currently are and who'll resist any change that's not in their own self-interest.

Indeed, if we look at major changes currently occurring, things are changing ... but change is going in totally the wrong direction! For instance the Government, rather than improving 'leadership practice'*, is currently trying to bribe GP's, using lucrative personal bonuses/deals, to ration healthcare and destroy the NHS, whilst creating fundamental conflicts of interest and destroying the trust between doctor and patient ... contrary to society's best interests ... which is now dividing the GP community ... between the 'good' and the 'greedy'.

Selfishness, self-interest and greed are all around us ... and are destroying this once great nation ... a nation previous generations died in order to protect! Will we see the people of this once great nation once again stand up and be counted ... we shall see! The 'good' GP's/doctors are trying to ... and thousands more besides (sign the petition and join the protests by clicking HERE).

* NB changing 'leadership practice' is currently transforming 'leading' hospitals out of all recognition (e.g. 50%+ improvement in performance, customer satisfaction and staff morale, all in less than a year - referred to in my book too), but this is being completely ignored (because Cameron/Lansley want to ration healthcare and privatise the NHS, not improve it, and prefer to use NHS money to bribe GP's to back their reforms, instead of using it to improve the health of the nation)!

Thursday, 17 March 2011

People Power ... Trying to Save Our NHS

Join thousands of people who have already told their MP's to "Save our NHS" and vote against the bill ... by clicking HERE.

Join the hundreds of thousands of people who have already signed the petition to "Save our NHS" being sent direct to the Government ... by clicking HERE.

Remember ignorance blinds but apathy kills ... so act now ... and get your friends to do the same!  

The fightback: by the honorable doctors ... and by citizens telling their MP's

Dr Jacky Davis explains why it's wrong ... but the greedy GP's [enticed/bribed by £300k+ salaries], supported by the BMA chief, ensured such opposition fell short of total rejection [as the greedy GP's want the money]!

By clicking here you can join the thousands of people already telling their MP's to vote against this bill ... and tell all your friends to do this too ... as ignorance blinds, and apathy kills (quite literally if this health bill is passed)!

Wednesday, 16 March 2011

NHS reforms - a nice little earner for GP's

Exposed further - GPs could be earning around £140,000 extra each if they set up a private commissioning company – on top of their basic salary and bonuses. Have a read of the article below, written by Kieran Walshe (professor of health policy and management at Manchester Business School), and published in the Guardian:

GPs have always had an ambiguous position in the NHS. On the one hand, they are self-employed entrepreneurs, employing their own staff, owning their own premises and providing services for a fee, just like a solicitor or estate agent. Indeed, many GPs have diversified into owning private clinics, nursing homes and other businesses.
On the other hand, they are seen by patients as part of the NHS. They get a final salary pension just as NHS employees do, most of the services they provide are funded directly by primary care trusts through a nationally negotiated contract which GPs do not have to compete to get or keep, and once appointed it is almost impossible for PCTs to remove them. GPs have always been pretty hard-nosed about negotiating that contract with the Department of Health, and using it to maximise their income.
Will they be equally good at profiting from the NHS reforms? They could do so in four main ways:
• They will be paid to set up and run GP commissioning consortiums – a "management allowance" of about £55,000 per GP. This money could be spent on employing other people to do the work of the consortium, or they could pay their existing staff or themselves with this money.
• They will be paid a new "quality premium" for taking on commissioning, which the government says will be based on outcomes and efficiency. No one knows how much it will be, and GPs fear it will come out of existing income and will be intended to incentivise them to refer fewer patients to hospital.
• GPs could start to provide services which their own consortium commissions from them, often instead of patients having to go to an NHS trust or another provider. This already happens in services such as minor surgery but it could dramatically expand. For example, GPs who set up and own their own diagnostics centre could send patients there for ultrasounds and X-rays, instead of sending them to the local hospital.
• GPs in a consortium could set up a private company which they own, and then get the consortium to contract out the commissioning of healthcare to that company. If that company can make savings by spending less than it gets from the consortium, the surplus could then be distributed to the shareholders – the GPs – as profit. This is where the big money is: if they can save 5%, the surplus for redistribution would be about £140,000 per GP.
The NHS reforms envisage a much bigger role for the private sector in both commissioning and providing NHS-funded healthcare. Once NHS money flows out of public bodies such as PCTs and the new GP commissioning consortiums into the private sector, it's very hard to work out how it's being used and who is profiting from it. The Freedom of Information Act does not apply to private companies, the National Audit Office has no powers to require data from them, and past experience suggests that NHS bodies will claim that the details of contracts with private companies are commercially confidential. So we may never know who makes how much money from these reforms.

As highlighted yesterday, this is the real reason the BMA find themselves caught between two stools - between greedy GP's who are looking forward to profiteering ... and the concerned/honorable GP's (as well as hospital doctor's and consultants) who disagree with this and want to ensure that NHS money is channelled into caring for patients and not GP's bank balances (thereby avoiding any conflicts of interest).

However, as the BMA makes its stand, alongside the Liberal Democrats (who are part of the coalition government!) as well as the Royal College of Surgeons, the Royal College of Physicians and the Royal College of Nursing,  it appears David Cameron is looking to ignore them all and press ahead ('what was that about listening to the people David? ... oh yes! ... and what about listening to your own party Nick Clegg? ... oh yes

Entirely predictable, both of them ... we'll have to see whether a little bit of 'real people power' emerges now to stop them!

UPDATE: and just to show not all GP's are greedy, here's a post from one GP:

16 March 2011 12:50PM
I am a GP.
I think this is a well argued article that explains why the profession is split in two by these reforms. One group of GPs 'the Pathfinders' are the entrepreneurs who will set up limited companies to cream money off the NHS. The others like me simply aren't interested, because we have enough work to do just seeing patients, and regard ourselves as already well paid for what we do.

Tuesday, 15 March 2011

'Patient Care' vs 'GP Greed' - the real battle within the BMA

Doctors have today called upon the government to put a halt to its overhaul of the NHS in England, but stopped short of opposing the plans outright [nb due to GP greed]!

An emergency meeting of the British Medical Association - the first of its kind for nearly 20 years - urged ministers to withdraw the health bill so the plans could be looked at again -  plans the union did describe as "dangerous and risky".

The emergency meeting was called by the BMA leadership after concerns from its grassroots membership about the plans. The motion voted in favour of by delegates says withdrawing the health bill is needed so that the controversial and more radical elements of the legislation can be considered again. But a motion calling for outright opposition of the plans was narrowly rejected [nb a key moment, and again the result of greedy GP's].

This emergency meeting was called because those members want the BMA to go further and harden its stance following discussions by the leadership on Wednesday. The result could force union's leaders taking a tougher line with government.

However the 'government' - and in particular No. 10 - is 'fully committed' to the plans [even though the Liberal Democrat party - who are part of this coalition government - rejected the plans themselves only two days ago]! The bill is already well on its way through parliament [nb a bill created without a mandate from anyone and which is being forced though by No. 10] and pilots are starting across the country [nb they had no problem bribing a few greedy GP's to try it].

BMA leader Dr Hamish Meldrum said he would rather see the NHS as the preferred provider instead of having a level playing field with the big health companies, and said "We want to put more pressure on the government to change what are flawed and very risky proposals for the NHS" [nb he has deliberately avoided referring to the fundamental conflicts of interests, and GP profiteering, that these current plans create].

More than 300 doctors attended the meeting with many supporting Dr Meldrum's stance. Dr Layla Jader, a public health physician, said: "The NHS needs evolution not revolution - these reforms are very threatening to the future of the NHS. If they go through, our children will look back and say how could you allow this to happen?" [Well said - I couldn't have put in better myself].

Members voted not to support a "damaging and unjustified" shake-up, which will see GPs get control of much of the NHS budget along with the scrapping of primary care trusts and strategic health authorities.

A Department of Health spokesman said: "We are disappointed the BMA has decided to take this step rather than work constructively with us to improve services for patients. The reality is over 5,000 GP practices, covering two-thirds of the country, have already signed up and have started to implement plans to give patients better care" [nb those not voluntarily signing up are being forced to as no alternative is being given].

What they fail to highlight is the moral battle going on in the BMA, where on the one hand there are greedy GP's who see a fantastic opportunity to profiteer  [and who do not want the BMA to intervene] ... and on the other there are all the trustworthy and honorable doctors who are strongly against the plans due to the clear/fundamental conflicts of interest they create [but who have until now had little/no support, as the BMA has till now tried to play a 'passive role' in order to support the greedy GP's).

By 'bribing' greedy GP's, this Government is trying to push through it plans and it has effectively split the BMA [a clear 'divide and conquer' strategy]. But will it work ... IMHO I unfortunately think it will ... though I obviously hope it does not!

This Government is trying every trick in the book and if they do succeed, they will, without any mandate from the people, dismantle the NHS and destroy the trust a patient should have in their GP in the process.

Saturday, 5 March 2011

The banks are to blame ... and King's surprised people aren't more angry!

In an interview with the Daily Telegraph, Mervyn King has urged high street banks to take a better, longer term view towards their customers and to stop focusing on the need to “simply maximise profits next week”.

He accused them of routinely exploiting their millions of customers, stating “If it’s possible for them to make money out of gullible or unsuspecting customers, particularly institutional customers, they think that is perfectly acceptable.” [More evidence highlighting that ignorance is not bliss, and that those misusing power think it's perfectly acceptable to exploit it!]

The Governor also criticised the “weight put on the importance and value of takeovers” and raises concerns that companies with good reputations have been “destroyed” in the search for short-term profits.

Mr King expressed regret for not sounding a louder warning over his concerns before the last banking crisis [NB Is this an apology? IMHO he should have been sacked for this!]. The Governor’s remarks are a warning to George Osborne, the Chancellor, as a government commission considers whether to force high street banks to sell off their investment banking arms [NB IMHO this is a must and a no-brainer!]

Mr Osborne is thought to be against such a plan [NB as he's trying to look after his friends in the City!], but Mr King is due to ultimately become responsible for banking regulation and his views are, therefore, critical. In the interview, the Bank Governor said: “We allowed a banking system to build up which contained the seeds of its own destruction. We’ve not yet solved the 'too big to fail’ or, as I prefer to call it, the 'too important to fail’ problem. The concept of being too important to fail should have no place in a market economy.”

When asked whether there could be a repeat of the financial crisis, Mr King said: “Yes. The problem is still there. The search for yield goes on. Imbalances are beginning to grow again.”

Mr King suggested that the culture of short-term profits and bonuses within the banks may ultimately be responsible for the problems. He says that traditional manufacturing industries have a more “moral” way of operating [i.e. banks have few(er) morals!] They care deeply about their workforce, about their customers and, above all, are proud of their products. With the banks there isn’t that sense of longer term relationships. There’s a different attitude towards customers. Small and medium firms really notice this: they miss the people they know”.

The Governor added that good businesses “keep a clear vision of who their customers are, and are run by people who don’t think they should simply maximise profits next week.” He said that the payment of bonuses is part of this cultural problem. “Why do banks in general want to pay bonuses? It’s because they live in a 'too big to fail’ world in which the state will bail them out on the downside.”

Over the past 30 years, he says, “we changed Britain away from a sclerotic economy with inefficiencies and problems in labour relations. Everyone got to the point where we no longer expected government to bail us out. Everyone bought in to market discipline. We were all better off. It was working very successfully.” But now, people have every right to be angry, because “out of what seems to them a clear blue sky”, the crisis comes, they find they lose their jobs and there’s the sharpest fall in world trade since the 1930s. “But, surprise, surprise, the institutions bailed out were those at the heart of the crisis. Hedge funds were allowed to fail, 3,000 of them have gone, but banks weren’t”.

The comments will embarrass the Chancellor, who recently concluded a deal with the banks under which they would be able to resume the payment of bonuses in return for boosting lending [IMHO this is yet another act of treachery, from a Tory millionaire looking after his friends in the City, and who also fund his party].

So why aren't people more angry? ... well there's Ignorance of course ... but there's also a great deal of Apathy! Apathy is a disease in Britain ... a disease that will result in millions of lives being blighted!

Captain of a sinking ship ... or mutiny on the Bounty?

Nick Clegg faces potential defeat over the government's planned NHS reforms at his spring party conference, as a heavyweight group of Liberal Democrat figures tables an amendment opposing the "damaging and unjustified market-based approach".

Evan Harris, a doctor and former MP and vice-chair of the party's ruling federal policy committee, will table the amendment, supported by the former cabinet minister Lady Williams (Shirley Williams), registering their concerns that the current legislation will lead to a widening of UK health inequalities if left unchecked.

Defeat at his own conference on a central plank of the government's public service reform agenda would mean Clegg would have to choose between ignoring a vote by his grassroots and negotiating concessions from the prime minister.

The amendment complains that some of the proposed changes in the health bill "have never been Liberal Democrat policy, did not feature in our manifesto or in the coalition agreement, which instead called for an end to large-scale top-down reorganisations".

The changes sought by Harris and Williams include:

• No decision about the spending of NHS funds to be made in private and without proper consultation, as can take place by the GP consortiums proposed by Andrew Lansley, the health secretary.

• Restoration of the NHS as the preferred provider, only allowing new private providers where there is no risk of "cherry-picking" that would destabilise the existing NHS. At the moment, the legislation brings an end to the NHS as preferred provider.

• NHS commissioning retained as an entirely public function, rather than the subcontracting of commissioning to private companies. At present primary care trusts are democratically accountable and open to public scrutiny.

• Continued separation of the commissioning and provision of services to prevent conflicts of interest.

• Healthcare commissioning to be carried out by locally elected health boards or local authorities, with the ability to vary a fair local tax in order to invest in local healthcare services.

Given the fundamental conflicts of interest already raised by numerous well-respected healthcare bodies (as well as Channel 4) and the additional flaws contained within current reforms now raised by his own MP's, will Nick Clegg  decide to do a 'U turn' and fight to defend the NHS ... or will he bury his head, soldier on regardless and talk to David Cameron about securing himself a safe Converative seat to fight in the next election? Trust, honor, respect ... Nick Clegg appears to have abandoned all of these in pursuit of power ... e.g. look at tuition fees for instance, and what he wants to do with the NHS now ... with no mandate whatsoever from his party or the electorate.

IMHO the Liberal Democrats will rue the day they allowed their leader to put aside any moral values and renege upon all their elections promises, as many voters will not forget ... and they will not vote for them again! The Liberal Democrats are already getting worried about the future (e.g. in the recent by-election they were pushed into sixth place and also lost their deposit).

Interestingly, despite pushing for it, and despite the clear benefits/importance of electoral reform, one of the biggest risks to a YES vote in the referendum has been the actions of the Liberal Democrat leader himself! Since gaining office he has traded moral principles for power in an attempt to secure electoral reform. Having gained agreement for a referendum, Clegg's now hoping people will vote YES as this will give "him more power" ... however, wasn't he meant to be giving "people the power"! 

IMHO this appears to be yet another example of a 'leader' corrupted by Power and who, in their desire to gain more of it, has abandoned their moral compass as well as the people they're supposed to represent. There is no point striving to become captain of the ship (with the intention of steering it into better waters) if in the process of doing so you have to throw away your compass ... which causes the entire ship to sink!

By jumping ship, and the promise of a 'safe' Tory seat, I am sure Nick Clegg's lifeboat is at the 'ready' ... as the Liberal Democrats start to sink ...

In my humble opinion the referendum on electoral reform will be the point Nick Clegg will know whether he's going to need it or not ... as without a vote to change the electoral system (i.e. a YES vote) the Liberal Democrats are now almost certainly dead!

Wednesday, 2 March 2011

Conflict of Interest: 'Profit for Doctors' v 'Your Care'

Following my post in January entitled "NHS Reforms: Patient Choice or Doctor's Choice?" I exposed the fundamental flaws in the reforms planned for the NHS, as well as the conflicts of interest they create. As they stand GP's will be able to profiteer in many different ways, destroying the trust between patient and GP. 

Well Channel 4 has today also gone on the offensive, exposing the fundamental flaws in the proposed bill and challenging politicians/providers. They highlight how the current bill is almost devoid of any legislation focused on tackling fundamental conflicts of interest and stopping GP's from being able to profiteer from such reforms (at the expense of patient care). Channel 4 pointed out numerous ways GP's will be able to profiteer (e.g. referring work to providers they are 'partners' in, being given a share of the profits created by reducing the amount spent on care for patients etc), and went further by exposing the plans of some of the groups involved (e.g. Integrated Health Partners).

Will the Government now start to listen and avoid this potential catastophe?  Let's hope so, though they haven't listened to date (e.g. to the concerns of the Royal College of Surgeons, the Royal College of Physicians and the Royal College of Nursing). It's interesting the BBC and Nick Robinson are nowhere to be seen when it comes to challenging these NHS reforms ... I wonder why!

Tuesday, 1 March 2011

Monetary rewards - a recipe for success ... or failure ?

Are monetary rewards the passport to 'success' or a recipe for 'failure' ... should a company incentivize its people to innovate? 

This great 10 minute clip does a fantastic job at answering the above questions ... 

The clip successfully highlights the fundamental flaws in traditional enterprises and economies, as well as the fallacy of "incentivizing" people using monetary reward too* ...

It also goes on to explain what really motivates people ... nb the idea that money is not a motivator is well known and has been for some time (well over half a century in fact) ... as Maslow, Herzberg, Deming (and myself) have all pointed out!

So why is it not prevalent in enterprises and communities all around the world today?

Is it down to ignorance? ... well partly, for instance most mainstream business schools are still teaching flawed and outdated practices! 

Is it down to apathy? ... well partly, given many of those who know better chose not to do anything about it. 

Whilst ignorance and apathy are partly to blame, IMHO the main reason for it is that those currently in power (and who apply Poweromics) like to use monetary reward as a way to 'control people' and to get them to do what they want them to do (whether it's best for customers/company/country or not). Politicians/bankers also deliberately use debt to control people and create compliance too (see 'debt slavery')! 

So it's not hard to see why it's not prevalent yet ... it's because those abusing power like to use it to control people for their own personal gain ... despite the fact that it destroys motivation, the performance of enterprise and the long term success of the country.   

* NB the City's drive to profit from speculation and their ability to profit from the buying and selling of shares are also problematic too. For instance, city bonuses drove 'fraudulent' types of 'innovation' and the creation of 'toxic' financial 'products' (e.g. C.D.O's, C.D.S's and Self-certificated mortgages). City bankers profited heavily from gambling using these products (e.g. creating pyramid schemes using other people's money) ... and left taxpayers to pick up all the losses (resulting in massive Government debt, tax rises and cuts to public services). The City also speculates with shares and profits heavily from the process of buying and selling shares too (nb with bankers again not risking any of their own money). This speculation results in the entire share stock of most publicly traded companies being bought and sold in less than a year, and   results in most executives being incentivized by substantial cash bonuses for creating short-term profit/results too (at the expense of long term sustainable success) - just like the bankers themselves!