The rather amazing David Pendleton and myself have a conversation about the NHS, this is something that is dear to David's heart and he really has a deep understanding of the topic. This is David's article on Linked In, on the topic: Click here.
It is no secret that the National Health Service, or NHS, is facing numerous challenges in recent times.
One major issue is the shortage of funding and resources. The NHS has been struggling to keep up with increasing demand for services, rising costs of medical supplies and treatments, and an aging population. This has led to overcrowded hospitals, longer waiting times for appointments and procedures, and a decrease in the quality of care.
Another challenge is the shortage of healthcare professionals, particularly doctors and nurses. The high levels of stress, long hours, and low pay have led to burnout and a decrease in morale among healthcare workers. This, in turn, is leading to high levels of staff turnover, which further exacerbates the problem.
Furthermore, the NHS is also facing a significant backlog of patients waiting for treatments, surgeries, and appointments. This is due in part to the COVID-19 pandemic, which has put an immense strain on the healthcare system. The pandemic has also highlighted the need for a more integrated and coordinated approach to healthcare, both within the NHS and with other health and social care providers.
In addition, the NHS is facing major issues with regards to technology and data management. The lack of a comprehensive, integrated IT system is leading to duplication of efforts, increased costs, and a decreased ability to deliver effective, efficient care.
In conclusion, the NHS is facing a multitude of challenges, including funding and resource constraints, shortage of healthcare professionals, backlogs in patient care, and inadequate technology and data management. Addressing these challenges will require a concerted effort from all stakeholders, including government, healthcare providers, and the public.
In the conversations that David and I have we discuss many things and as such decided to capture them.
They won't all have conclusions, however, we hope they add value.
To find out more about Guy Bloom and his award winning work in Team Coaching, Leadership Development and Executive Coaching click below.
The link to everything CLICK HERE
UK: 07827 953814
Email: guybloom@livingbrave.com
Web: www.livingbrave.com
The rather amazing David Pendleton and myself have a conversation about the NHS, this is something that is dear to David's heart and he really has a deep understanding of the topic. This is David's article on Linked In, on the topic: Click here.
It is no secret that the National Health Service, or NHS, is facing numerous challenges in recent times.
One major issue is the shortage of funding and resources. The NHS has been struggling to keep up with increasing demand for services, rising costs of medical supplies and treatments, and an aging population. This has led to overcrowded hospitals, longer waiting times for appointments and procedures, and a decrease in the quality of care.
Another challenge is the shortage of healthcare professionals, particularly doctors and nurses. The high levels of stress, long hours, and low pay have led to burnout and a decrease in morale among healthcare workers. This, in turn, is leading to high levels of staff turnover, which further exacerbates the problem.
Furthermore, the NHS is also facing a significant backlog of patients waiting for treatments, surgeries, and appointments. This is due in part to the COVID-19 pandemic, which has put an immense strain on the healthcare system. The pandemic has also highlighted the need for a more integrated and coordinated approach to healthcare, both within the NHS and with other health and social care providers.
In addition, the NHS is facing major issues with regards to technology and data management. The lack of a comprehensive, integrated IT system is leading to duplication of efforts, increased costs, and a decreased ability to deliver effective, efficient care.
In conclusion, the NHS is facing a multitude of challenges, including funding and resource constraints, shortage of healthcare professionals, backlogs in patient care, and inadequate technology and data management. Addressing these challenges will require a concerted effort from all stakeholders, including government, healthcare providers, and the public.
In the conversations that David and I have we discuss many things and as such decided to capture them.
They won't all have conclusions, however, we hope they add value.
To find out more about Guy Bloom and his award winning work in Team Coaching, Leadership Development and Executive Coaching click below.
The link to everything CLICK HERE
UK: 07827 953814
Email: guybloom@livingbrave.com
Web: www.livingbrave.com
Guy Bloom 00:00
Welcome to leadership bites with myself, your host, guy bloom. This is a leadership podcast where I have conversations with colleagues, I chat with guests, and sometimes they'll be just me talking. You can connect with me at livingbrave.com and when you enjoy the episode, subscribe and please tell everyone. Hello Sir, how are you?
David Pendleton 00:20
I'm doing fine. How are you doing?
Guy Bloom 00:21
I'm doing well and I know that we have a topic which will launch straight into. So I'm gonna get you to do the OR. This is why it took my interest and then we'll see where the conversation takes us.
David Pendleton 00:33
Sure, absolutely i'm i thought that we should talk about the NHS. I'm very, very bothered about it. You know, the the NHS has been around longer than we've been around and it came in at a time after the Second World War when people if they got ill. They must have been terrified of getting ill because they couldn't afford diagnosis, let alone treatment or medication or whatever it might be. People were dying in pain. It was a real horror show when the NHS came in and the NHS. Came in in a blaze of idealism. The whole idea was if we can, if we can spend money on looking after the nation, then the nation will get healthier. And however much we have to spend at the start doesn't matter because eventually, you know, the amount of money will come down because the nation will be less sick and so on. And exactly the reverse has happened. What's happened is when the NHS came in, in the late forties, we spent about 4 % of GDP on it. And now we're spending around ten ten plus % of GDP on it. So I'm not talking about the amount of money. I'm talking about the proportion of of of of GDP that we spend on looking after the nation's health. And the problem with that rising inexorably is that it we either can't afford it now or they'll become a point where we where we can't. And yet the track record of the NHS lately has been very poor. You know, we've got 7 million people waiting for treatment. We've got doctors and nurses collapsing because of the amount of stress and strain on them. We've got nurses on the streets saying you're not paying us enough. You you were happy to applaud us during the pandemic, but now the government won't even person inflation based. Pay rise. So we've got signs of stress and strain all over the place. And I'm bothered because someone once said that the NHS is the closest that the Brits have to a national religion. In other words, we love it, but at the moment it's a love hate relationship. And if you talk to people about the NHS, if it ever comes up over a dinner or a drink in the pub, you find people weighing in to the issue about how ain't it awful? Excuse me? To me, just the other day someone said yeah, I can't get through to my GP practice. They clearly don't care. You know you you get there and and you find there's an empty waiting room. So what the Dickens are they doing with their time? And there's absolutely no understanding of the stress that the the doctors are under themselves and that the fact that they've got empty waiting rooms is because they're trying to practice infection control at a time when the the bugs are still around the the, the the pandemic is still with us and and so all sorts of misunderstandings are going on at the same time. So the thing that's triggered my concern is that the NHS, on the one hand we love it, certainly we need it, but at the moment we're not paying enough as a nation. To look after it and to look after the people who work in it. And yet it's consuming greater proportions of GDP.
Guy Bloom 03:40
So I recognise that I have a layman's understanding of the NHS and I also know that you know a lot about it. So I'm. I'm super alert to that, I guess when I look from the outside in, I've used the NHS a few times, and the big one was when my little boy had an asthma attack and this ambulance turned up about 10 minutes later. Put everything right. We took him to the Birmingham Children's Hospital, which is technically down the road from us, and they took him straight to the front of the queue because of just age and symptoms. And it was all fantastic. And he's all he's all well and good. You only have to need it to go. What the hell would you do if it wasn't there? You've made a phone call. The lady answered the phone. I was on an hour ring. She said. I can hear his breathing. I'm sending an ambulance and you go, right. So it's like all things, you know, people say, well, I don't believe in God and go, well, unless somebody shooting at you and then you go, dear God, if you Get Me Out of this right, I'll be a believer. And what I'm trying to get at is you don't think about these things maybe until the moment. And when I look at it from the outside in, I see anything from in the news drugs that people create that cost an exorbitant amount of money. And you get a sense of profiteering, you get a sense of wasted money. On things that have been invested in and and haven't happened, diversities, ours, things that make you go hmm you know there are all sorts of reasons why costs why medical inflation in outstrips the growth of GDP. One of them is we we have an ageing population the the the demography of our country is particularly problematical. You know we've got the baby boomers I'm one of them coming through and they are now inflating the. Higher age echelons, the the older population is getting bigger and the the productive younger population, which is meant to support that old aging population is getting smaller, relatively speaking. And so demography is one reason, research is another one. Exactly as you're saying, we can now treat more and more things, but often with more and more esoteric and that equals expensive medication and even if you strip away all the profiteering. Because you're dealing with more rare and unusual conditions, drug companies can't amortize their research over so many prescriptions per year or per month, so So what they have to do is charge rather more to get back the investment that they made in the research in the 1st place. You've also got the third factor, which is incredible, which is that most people have an expectation now that all ills can or should be cured. And that that if if not then someone screwing up, you know what why can't they deal with it and and that tends to bring with it a kind of over medicalisation of everyday issues. So the other day I read an article about someone who's trying to think about prescribing for loneliness. Well that seems to me to be bonkers. You know that that you've got to if someone's lonely what they need is contact not medication. And and so there's all sorts of fundamental reasons why medical inflation. Increases at a faster rate than the growth of GDP. But even though I can explain that, we have to realise that there is an intrinsic danger in that, and that is that at some point we've got to say enough, we can't afford to do that anymore. And it seems to me that there's this, well, I've called a kind of triplet at the heart of it all. What we want is 3 things, and any two of them you can have, but that you add the 3rd. And it's a problem. One is we want access, we want to be able to get to our healthcare provider. Quickly and easily when we need him or her. Secondly, quality. We want to make sure that the care we get is of the highest professional standards, not just in absolute terms, but also relative to other prosperous countries. We we we don't want to settle for second best. And and the third is, we've got access, you've got, you've got quality, but you've also got affordability. We, we, we want as a nation not to bankrupt ourselves paying for all this. And you can have any two very easily, but the moment you add the third one, you've got a problem. In the old days what used to happen was we'd get high quality care and it was reasonably affordable, but we let waiting lists increase, so access dropped in order to be the balancing mechanism in that little trio of of of of issues now. Long waiting lists are unacceptable. Even though we've got 7 million people waiting for treatment. But, but you know, waiting in a, in A and, E waiting for treatment, all of these things, we've got rules and targets that are that are imposed in the context of and and and and so we can't have that balancing mechanism anymore. Now I'm not arguing for waiting. It's that's not a good thing at all. But other countries don't seem to have this as a problem. I was talking to a practitioner from Belgium. The other day, who said, you know, if tomorrow you wanted to get your hip done, you could get it, you just go and you know you you pitch up and someone will do it for you. For some reason their blend of public and private funding seems to have solved a problem which we in the UK haven't solved. And I think it may be that the other way of putting it is this. People want everything dealt with for everyone and free. Well again, you can have only two but not the third. And maybe we've got to think quite hard fundamentally and maybe firstly about what's called the funding model. Is it sensible to try and do all this through taxation?
Guy Bloom 09:34
At its most simplistic is this. We're either in or out. If we're all in, to what level? To what end? The bottomless pit? Or are we? No, we're in. We're committed to an NHS I suppose. Is it the problem that cannot be solved? Sorted because you have politics, you have people on three-year terms? You have. People that are embedded in for life in roles that probably are quite difficult to get dismissed from unless you do something fundamentally criminal. And just like any big beast and it is a big beast, that there'll be excellence in there, they'll be dedicated high level people who just give their lives to it and then guess what? They'll be those that probably shouldn't be enrolled. But that's the same in any organization. It's just that with a with a big piece like that.
David Pendleton 10:17
People work for the NHS so exactly so.
Guy Bloom 10:20
Her chance that there'll be some of each yeah so there's a distribution curve right and I just wonder, when you're talking to people that really know about these things, does anybody have what they would say is the answer?
David Pendleton 10:35
No at the moment there are a number of initiatives that are trying to address it. The, The Times, I don't know if you've noticed, there's the the times have created the Times health and Social Care Commission. It is a grouping of about, I'm guessing about 20 people sit on the the Times Health Commission. They've got the great and the good, they've got Lord this and Lord that and they've got, you know, people who run major institutions, major organisations and so on. And they're receiving evidence every, I think it's two weeks from experts in the field and they're going to report on the the future of the NHS and social care in early 2024 They're meeting throughout this year. 2023 to try and come to some sensible conclusions about that the answers the reason they're throwing so much effort at at it and presumably quite a lot of money at it as well is because the answers are not obvious and they're not easy. If they were we'd have done it by now the the second is people like the Institute for Public Policy Research who are if anything is slightly sort of leftward leaning think tank and they've got a they've got a an investigation a Commission going on at the moment in which they're looking at the relationship between. Fairness in our society, health in our society, and prosperity that their argument is a fairer society as a healthier society is a more prosperous society. And so they're examining a variety of issues to do with that. So a number of people are directing their attention at that at the moment at at these issues and even I and my colleagues at Henley Business School along with David Haslam who wrote the the book side effects, we are going to have be having a symposium in June about all of this. The the point is guy that it's a very, very complex issue and you touched on something which really matters here and that is that governments of both right and left. Are not in the best position to initiate change in this area because it's takes it will take much longer than usually a political horizon extends to the you know what what does a government think about they think about five years. Why because that's roughly the term of a parliament and so, but but my guess is that to change the the NHS and the way we use it fundamentally it would take a generation I suspect and we've got to think much longer term and much more ambitiously. But one of the things I do believe. Very firmly is that we aren't going to get there. By doing the kind of modelling through and tinkering that seemed to be characteristic of most governments at the moment. I I also got a slight suspicion that the Tories can't fix it because they won't be trusted. People might have a chance to do it if they come in next time around. And that's only because not only did they create the NHS in the Labour Party, but but maybe they'll be trusted that if they're taking tough decisions it might be because they believe in the greater good for the greater number of people. Whereas I think that although it might be a stereotype, I think an awful lot of the reactions to a Conservative government is that they are more likely to want to serve the interests of a small number of wealthier people.
Guy Bloom 13:50
So does that. What is in a place where there'll be lots of educated people or people with an interest having fantastic conversations? Reality is we have a political system. That means unless there's a bipartisan agreement, that regardless of political views, we are going to work on this. Because whatever the rotations, one of us is going to keep on ending up with the NHS. So actually, you know what, let's agree to fix it regardless of anything else. If that doesn't happen, it's a potato that keeps getting passed.
David Pendleton 14:20
I think. That's right. I think that the the governments of right and left have tended tended to kick the can down the road. You know they've they've come up with short term temporary. Pressure relieving sums of money. Every few years in order to sort of. Bypass or if you like, relieve the the the pressure for fundamental change. I think the problem is that if a right wing government raises the issue about we need to change the NHS fundamentally, I suspect they'll lose the next election. If a left wing government says it the the charge is always are here we go tax and spend again. And of course right now Keir Starmer and the Labour Party are trying to. Portray a much more responsible fiscal image that they're not gonna be a government that simply spends money right, left and centre and simply increases national borrowing, you know, so, so I think that each, each part, each to some extent hamstrung by the impressions that we all have. And my own view therefore is that I think that we've got somehow to get the nation involved in debating this. You know, when we do our our conversations through these podcast guy, we sometimes wonder kind of what's the punchline? Well, I think that for, for me the punchline about the NHS is we've all got to talk about it a lot right now and not just in OD awful terms, you know, we've got to think about. So So what would be a better solution for all of us. And partly it's going to be implications for us all. Maybe we don't use the NHS very well. Maybe we have unrealistic expectations of it. You know, my daughter who's a GP and my son. The law her husband who is an A and E, consultant they will they will tell you that for all the people waiting in accident and emergency there are an awful lot of people who haven't had an accident and it isn't an emergency. So why are they there and they're there because they believe that you know they they can't get through to their GP. So someone's got to deal with this you know so they've they're going down well get the care that they that they think they want or need or deserve. One way or another, and maybe we've got to sort of try and exercise a little more discipline. Maybe we've got to go upstream. We've got to practice prevention more. We've got to sort of put a little more weight on each other to lose weight, you know, eat more healthily, you know, do all of these things. That actually means that we don't just emphasise our rights to to care, but also our responsibilities to look after the system and so on. We, but the nation needs to debate this. Government can't sort this for us.
Guy Bloom 17:03
So you alluded to countries that have and there's probably no version of perfection, but seem to have it more right than wrong. Is it historical? Is it? No, it's because recently what they did was. What is it that gives them that more right than wrong?
David Pendleton 17:20
Well, if this is an interesting one, the moment you get into international comparisons. You realise quite quickly that you're not comparing light with light. As I said, we've got a particular problem in the UK of an aging. Population now everyone's got an aging population and particularly because of the baby boomers, they're kind of it's a it's an OECD wide problem, but. But we have a particularly strong version of that, so we wouldn't be comparing quite light with light. But here are two statistics which I think are are worth conjuring with. One is we spend roughly the OECD average as a proportion of GDP on healthcare. It's about we spend about 10 2 % and the OECD average is about 10 2 %. So we spend roughly the average.
Guy Bloom 18:10
Of you just say what those things stand for for people.
David Pendleton 18:13
's gross domestic product, so, so. You know the the UK the the gross domestic product let's say is roughly 2 trillion a year or something in the in the in the UK we spend about 10 point 10 2 % of that on health and social care and and and that is the OECD average the the organization for Economic Cooperation and Development that's the that's the organisation of in a sense the the richest countries in the world. And, and we're one of them. And so we spend roughly the same proportion of our national wealth on health and social care as the OECD average, but. That still doesn't mean that we get the same amount available per person, because another estimate that Fergus Walsh gave, and I've checked it out, he gave it on on on the BBC. Just recently we spent if you compare, the amount of money that we spend per person. On healthcare in the UK, it's roughly 18 % less. Than the OECD average or for like the the average of amongst what are called the old European economies, you know, that's which are reasonable comparisons for us like Germany and Italy and France and Spain and so on Belgium.
Guy Bloom 19:37
And that's going into administration or?
Guy Bloom 19:40
So where's.
David Pendleton 19:42
That going? It's it's going, it's going into lots of places. But it's it's partly to do simply with the the numbers of. The amount of provision per head of population so so although we can spend overall a similar proportion of GDP, and it may be that because of the size and shape of our distribution, it doesn't, it doesn't translate into the amount to be spent per person. Yeah, so. An 18 imagine 18 % we we spent, I think it's 168 billion on the NHS. Last year, hundred and sixty eight billion and. Were 18 % less per person. Imagine you. So a government comes in and says we're going to fix this. We need 18 % more. So you know, 18 % of 168 billion. There's an awful lot of billions of pounds. And if all that go goes on taxation, you know people are gonna throw their hands up in horror, particularly when there's such a big cost of living crisis. But, but. We've got to do something radical. We've got to, we've got to get away from some of the old sacred cows that have stopped us introducing radical change so far. Like, for example, you know, it costs roughly forty pounds per GP consultation that the NHS has to pay forty. Pounds well, I could afford to pay that, so could you? 40£ So why don't they ask you to pay for it?
Guy Bloom 21:23
Well, we, but I would, I would pay that.
David Pendleton 21:25
Yeah, I would too. I would too, but OK. But even. But then, then what happens is you mentioned that and and an awful lot of very well informed, very well-intentioned people. And I can tell you a whole bunch of them. For example, I've sat on the trustee board of the Royal College of General Practitioners and the GP's themselves are massively against it because they say it, it punishes all the people who've got the greatest health problems. Ok, so I I get that. But what about charging people, at least for the consultations that they don't turn up for, that they miss? Ohh, that pushes all the wrong, people say.
Guy Bloom 21:56
It's means tested and you don't get to the front of the list by paying. It's just that when you do get the appointment you can pay.
David Pendleton 22:02
Yeah, I think, I think we've got, we've got to start considering we've got to shoot, shoot a few sacred cows I think and and a mixed funding model is got to be one of them. This notion that it all has to be free at the point of use. Maybe the thing that needs to go first, there will be other things as well but but that needs maybe to go first. And I I've I've come reluctantly to that conclusion personally that we've got to probably pay disproportionate amounts per unit of care because and and probably on a on a as you said means tested basis and the simple way of doing that presumably is through is through taxation you know that that if you've got higher rate taxpayers why wouldn't they pay per consultation or pay more per consultation than people who pay basic rate. Or no tax at all, you know, so it it it does feel to me as if there are some mechanisms that we could start to introduce if we'd once allow ourselves the freedom to consider these more radical solutions.
Guy Bloom 23:07
So this is one of those moments where one of the things we started to say is we're going to talk about topics that kind of make us go without necessarily having the answer. And there's definitely no answer to the NHS.
David Pendleton 23:18
There isn't a single answer. I think my sense guy is that we've got to get this debate going nationally. If there's anything I would like to initiate right now, it's a national debate about these things. We've got to get ordinary people, you and me, talking about it, not politicians. Not just senior doctors, of course, they need to be a part of the conversation and so on, but. The National Health Service belongs to all of us. It serves all of us. It's the most precious thing in the world.
Guy Bloom 23:51
You know, could it get privatised? Could could that actually could that be a thing where it just.
David Pendleton 23:58
I'm not sure what you gain.
Guy Bloom 24:00
No, I don't mean game, but is there a threat to it being just culturally privatised? Yeah i think, I think there is. I think the more people experience frustration with it, the more there's a tendency to throw our hands up and do something that might be precipitate. And always the fear is that governments of the right wing want to privatise it. I'm not sure they do, but, but, but it's always the great fear. I suppose it's possible that that a government could decide to do that. But I think that they would have to put the they'd have to consider the very real possibility that the moment they mention it, they lose their extinction.
Guy Bloom 24:33
Yes, just because of people's reaction to their love for it or belief or needed it. And this is I guess, and I'll just throw this little hand grenade into the into the conversation. I speak to people as well and some people will go. So why are we in the Ukraine then and not spending that on the NHS? People look at things that we do that might go ideologically. I can see why we might want to be in there. You could agree or disagree with that. When I hear how much a tank costs, when I hear how much every one of those missiles costs, what is the actual sum that has gone into funding that intervention which meant we were willing to spend it, which means the money could be found, which means why wasn't it already found put into something of that high value? Of course, I have no answer to that. Those are the kind of rhetoric that I think people can get quite frustrated about it, which is about, and maybe you're getting people to talk about it, is it's got to be if we can make it so high on the agenda. That the politicians know that it has to be addressed to win the battle, so to speak for them. Because at the moment it seems to be, well, we've got the Ukraine, we've got education, there's such a a smorgasbord of things to deal with. It's just another one of those big problems. So we just divvy up all the money, but do you know if we can push it to the front of the of the of the conversation, it's got to be dealt with.
David Pendleton 25:49
Do you know that we spend more on the NHS than we spend on education and defence combined?
Guy Bloom 25:56
I can believe.
David Pendleton 25:58
So you know, and and and the other thing is that liberating short term funds isn't the solution. That's the kicking the can down the road. We've got to do a root and branch rethink. It's got to become sustainable what we what we don't want is you know this silly form of Brexit argument about 350 million a day or you know per nanosecond or whatever it was you know we we could spend it on the NHS well we've got Brexit we didn't spend it on just fair enough but but the but the but the point is that. It's a it's a fundamental rethink of how this whole system works that we need to get the people debating. You know, what would you be, in other words, if if I if I could create a conversation for every single man and woman in the in the in the country to to have it would start with. If I could promise you an absolutely first class healthcare system that you could get access to quickly and easily, what would you prepare to pay for that? What would you be prepared to sacrifice or contribute to pay for that?
Guy Bloom 27:06
This is a podcast called Leadership, while we're talking about the NHS. Well, I think it leads us into little topics like when you're running organisations, you can't kick things down the road because eventually it's going to bite you in the arse.
David Pendleton 27:17
Well, you know, we were chatting before we started to record about. Big Beasts who come in and make radical changes to their organization. We talked about Elon Musk laying off a whole stack of people at Twitter and so on. Because when you come in from the outside you think what the Dickens are we doing spending all this money on the XYZ? And it seems to me that that the. You can do that in an organisation because you understand that most organisations have lost sight some time ago of the fundamental core purpose of their organization and they've got an awful lot of people who are not contributing to that core purpose now. It's an old example, but I used to do consultancy years ago for what used to be called London Weekend Television, and I remember talking to some of the programme makers and they said that for every program maker that they hire here, they hire 10 people to stop them, you know? That's what they thought of the admin, the legal department, etcetera, etcetera. But, but, but that that was the kind of belief and and this idea of coming back to the absolutely fundamental purpose. But I'll tell you what's interesting about Sir David Haslam's book side effects is it raises this horrifying question. What is the purpose of the NHS? It can't be to treat everyone for everything free, can it? But that can't be the fundamental purpose, because that's not sustainable right from the start. So what is that fundamental purpose? And when, when at Henley business, when we when we debate this in June, that's the question we're going to debate. What do we want the NHS to do for us?
Guy Bloom 28:52
It's quite interesting, isn't it? Because you could say well we'd like accident and emergency maybe we'll discipline around filtering out. I'm having a heart attack. I'd like an ambulance place that kind of level. Yeah maybe there is a core you've got heart problems if you've got kidney failure and and I don't know where the lists stops but maybe the tier one and we're going to give you those for free. And then there's a cost for Tier 2 and there's a cost for tier.
David Pendleton 29:14
Three exactly so.
Guy Bloom 29:16
And that's maybe the big debate, right? We can't be everything free forever for.
David Pendleton 29:19
Everybody that's exactly, you know, you. So let's just think about those three things. We deal with everything. Well, maybe we don't. Maybe the NHS, as you said, is for a certain number of core problems, conditions, issues, whatever and anything else there's an increasing level of charge for. Yeah, yeah. Or what about the other? We deal with everything, but not for everyone. So maybe there are certain people who get covered by the NHS. Maybe the NHS becomes a system for people who are relatively impecunious. They haven't got an awful lot of funds. And maybe what it is, it's a kind of a safety net and that everyone else pays for there for their care.
Guy Bloom 30:05
But what we are saying is that just like any commercial enterprise, there needs to be a recognition. At number one we can't kick the can down the road number two we might be on a 3-4-5 year career cycle but the reality is if we actually care about this organisation then we need to take a longer term view as well as a short term view. There might be also something here about the willingness to make radical decisions. You know sometimes when you see a car that's had its shape redesigned you go ohh that's awful and three months later you're used to it and you go actually that's quite good. Apple got rid of the disk drive and we all thought well that is the computer work that takes that radical kind of the might be a bit of pain but. We have thought this through to actually go. The sign of madness is repeating the same pattern and expecting something different to change. So we've got to do something, and it is a social experiment to a point, but it probably can't go that wrong. So we're going to go for.
David Pendleton 30:53
It there is an upside, I mean firstly that the folks who work in the NHS. They are, they're bloody wonderful, I tell you. I I know I'm slightly biased cause i've got a couple.
Guy Bloom 31:04
Of no, my family might.
David Pendleton 31:06
Do but they. But you know.
Guy Bloom 31:08
The vast majority.
David Pendleton 31:09
Ohh, they're fantastic yeah no wonder we applauded them. You know, they put their own lives on the line for the rest of us, you know, that's about what is it, a greater love hath no man than this, that a man lay down his life for his friends. I mean, I sit in a sexist way because it was written as a sexist way, but you know, but that's that's that's true. And they did that they did that willingly you know no one made them do that. I absolutely fundamentally believe in the in the motivation of of of NHS people so I I think that that's something that is a cause for optimism but but we can't keep trading on that. My my daughter bless her heart GP was was having not not an argument but a a discussion certainly with a practice manager the other day you know and and she said look the systems broken why are they breaking us to fix it? Because you know, you gotta do more, you gotta do more, you gotta be more. Interestingly, incidentally, the evidence is that in general practice, fewer people are treating more patients. In secondary hospital care, more people are treating fewer patients. That's the way it is at the moment and when I go into organisations it's broken. So why they're breaking us to make it work? It's not an unfamiliar.
David Pendleton 32:27
Story right. No, that's right and that does exist. So just my recognition there is this needs to become a conversation that maybe is picked up by people and we make it something that actually rings loud enough that the bell is heard.
David Pendleton 32:39
I think that's right. I mean, my my sense is that always the fear is that you're crying wolf. I now think actually that the. Risk of the demise of the NHS is simply a statement of the blindingly obvious. It's no longer crying wolf. It is a very, very real risk. And it's too precious. We've as a nation, we've gotta, we've gotta look after it and we've got to do it in, in the most deliberate and participative way. We've got to get more and more people. There's an organization that I came across recently called engaged Britain. It's part they were presenting at this Institute for Public Policy Research Symposium just in December, just just last month. And what they do is they they run focus groups around the country, discussion groups around the country, to ask people what they want of their government in order to try and facilitate what they call bottom up policy making. I really applaud that idea. That seems to me to be really sensible. After all, we are a democracy in which the the government is meant to serve the population, serve the electorate. But there isn't always a simple way of making sure that that happens. Whereas organisations I think, like engaged Britain, have a way of of starting to do that, starting to convene the groups that have these discussions. I applaud them. I'd love to take part in. Haven't I? I will try to make contact with them fairly soon, but I'm very, very, very keen that more and more of us should make our voices heard around this, this stuff. And as I say, I I don't want to bang on about it endlessly. I could ball for Britain on the subject and probably have one already, but but I think we've all got to get involved in this one, mate.
Guy Bloom 34:23
Well, I think just bring it to an end. You'll care about if it's not there, right? And you'll care about it if it's not working.
David Pendleton 34:28
To the point where it's absolutely broken.
Guy Bloom 34:30
So I think hard to have an opinion if you've taken no care to engage. I have an opinion. What have you done about it? Absolutely nothing. Well, hey ho, that's definitely a factor on that note, I'll bring us to a close and we will pick up again as we see new topics that peak our interest. But once again, I'll sign off and see and speak to you soon.
David Pendleton 34:50
Take care, guy.
Guy Bloom 34:51
That's it. So I hope you enjoyed the episode. Please share so others get to hear about us and subscribe so you keep up to date on new episodes. Also visit livingbridge becom if you want to connect with me and find out more about executive coaching, team effectiveness and changing culture ohh and of course you can buy my book living Brave leadership on Amazon. So on that note, see you soon.