The Facey Romford Papers: Days in the Life of the NHS. An Everyday Story of Nhgbpsd Folk (Public Policy)

Thông tin sách: The Facey Romford Papers: Days in the Life of the NHS. An Everyday Story of Nhgbpsd Folk (Public Policy) (Hardcover, 352 trang) – Edward Everett Root Publishers, 2017. Ngôn ngữ: Tiếng Anh.

This unusual, witty, satirical, pseudonymous, controversial and very pointed work gathers together the 50 episodes which were originally published on the famous and widely-read nhsManagers.net eletter run by Roy Lilley, which has some 30,000 subscribers here and abroad. Both the author, and Mr. Lilley – who are not one and the same – have been Chairs of NHS Trusts and advisers to government. Mr. Romford dramatizes the current issues and problems of British healthcare – and points out some radical and innovative solutions.The author holds up a mirror to the NHS and public service, its foibles and peculiarities. He shines a light into the dark recesses and makes us think, entertains us, pokes fun and encourages us to do better. His characters are a delight and his stories grasp the issues of the day and sets them out in a new light. Editorial Reviews Excerpt. © Reprinted by permission. All rights reserved. The Facey Romford PapersDays in The Life of the NHS. An Everyday Story of Nfsd Folk.By Facey Romford Jr.Edward Everett Root, Publishers, Co. Ltd.Copyright © 2016 Facey Romford, Jr.
All rights reserved.
ISBN: 978-1-911204-02-2
CHAPTER 1

EPISODE 1

Days in the life of the NHS: An Everyday Story of Healthcare Folk.

The story begins.

By Facey Romford, Jr.

Dramatis Personae:

Sir Cyril Squoffington-Squogg, OBE, JP, Chief Executive of The Tower of London NHS Hospital Trust, London, E. He is aged 67. His wife, Lady Bernice Squoffington-Squogg, is also Chair of The Wiltshire Artists Benevolent Fund. They live during the week in Sloane Street, Chelsea and at weekends at Wobblybottom Towers, Minceyglade, Wiltshire. He is a retired senior civil servant, department of pensions. She is a former ice-skater. She is aged 39. Their son, Paul Bristol Squoffington-Squogg, is a nature writer on the Financial Times, contributing the popular weekly column 'Splashing About Happily.'

Major-General J.J. Slopkins, MM, MC, CBE, etc., is his Chairman. He is a retired cavalryman. He is aged 82. He lives at Coggeshall in Essex.

Mr Barney Wells, BEM, is Chief Executive of The Arthur Scargill Memorial Hospital, Chessingfield-on-Soke. He began his career as an accounts clerk in the S. E. Regional HQ of the NHS. He has also played hockey for Bexhillon-Sea Deficits, the leading local club. He is aged 56. He is the father of nine sons. All are employed as trade union officials.

The Chair of The Arthur Scargill Memorial Hospital, Chessingfield-on-Soke is Mrs. Barney Wells, MBE, a local Unite Trade Union official. She left Downhills-on-Soke comprehensive school aged 15, with one GCSE. She has contested four parliamentary seats, without success. Very Old Labour. [Later, elected as a Labour MP.]

'Brenda' When. A North Country lass, is a secretary to Mr Wells. She is a graduate of the University of Kent at Canterbury, and a working Mum. See below.

Our sources:

We can reveal the following telephone conversation as Mr. Wells, an admirer of the Rt.Hon. Anthony Wedgewood-Benn MP [The Viscount Stansgate], is in the practice of recording his conversations. He acquired this habit when hearing that Mr Wedgewood-Benn did likewise. However, there is within his office someone who does not approve of him. We will call her 'Brenda.' She will appear from time to time in this everyday tale of NHS folk. We will also, in later reports, draw on correspondence and e-mails, where available.

* * *

Telephone conversation recorded by Mr. Wells on 2 July 2013.

[Telephone rings].

Brenda: Sir, it's Sir Squoffington-Squogg. Shall I put him through?

Barney: Yes. Right away please.

Sir S-S: That you Barney? Just rang to congratulate you. Though it WAS a bit risky, that caper!

Barney: Hello. What's this then Squoffy?

Sir S-S: Those new A&E signs, that's what. I know about it all. I have my sources. I have my reports. I know, and you know I know, and you knew I'd know I know. So come clean. Right now! Stop your finageling!

Barney: What me? Those big blue and white signs on every road 5 miles out, do you mean? Those signs with RAC-type lettering? The ones saying "Your nearest A&E is in Derby Road, Stoke-on-Trent"? Those signs?

Sir S-S: Yes, Barney, indeed those! Bloody Derby Road is 30 miles from your A&E, and going in entirely the wrong direction!

Barney: Well dunno anything myself about them. Mea no culpa. Mea innocenti. Mea incognito. Me know nuffink. Me in-the-clear!

Sir S-S: Oh, come off it Barney. You've had all those signs put up directing people miles away, to some other poor bloke's A&E. So your A&E isn't full. I know it was collapsing. I know you are being investigated. I know there are no consultants there from 5.30 p.m. on a Thursday until 10 a.m. on a Monday.

Your MRI isn't working then is it? No scans? No proper examination of x-rays? Only junior docs? And a steep rise in your death rates. As to morbidity, you have no idea, do you? You don't record it, do you? No-one does, do they? Now you are having it easy! But be careful. You'll get done for it.

Barney: Well, I confess that on my way into work when I saw those signs they were all in French and English, like those signs 'Drive on the Left' at Dover. a gauche and all that. And I – I mean, someone unknown – has had 'Made in Belgium' stamped on the back. They looked like official signs to me.

Sir S-S. Well, Barney, once again I have to tell you the real solution. We know that A&E represents about 55% of all NHS hospital work. We know that even under the Blessed Margaret's regime we all just got paid directly from the Treasury for A&E work and none of that mobile GP Fundholding business. We know we can predict A&E work – how many injuries, what kind, how many drunks and druggies etc, how many pub fights, which days and peak times. We've got good data over many years. So we can do something real about it. We could easily require every voter, by law, to insure for A&E use. This would pump billions into the system, enable us to expand facilities, pay the consultants more ...

Barney: More!GOOD LORD!

Sir S-S: Yes, more. Economic incentives. Works. .... and would solve the problem. Otherwise, deficits as deep as the Grand Canyon. Mortality rates higher and higher. More political bullying from up there. More and more Trust failures, collapsed Hospital Trusts, Special Measures, you name it.

Barney: Hmm. You know at Brighton once, in the early 90's I think, the big hospital there put GP's into A&E. They saved a lot of money. Fewer referrals into beds. Fewer drugs prescribed. Happier patients. Less Saturday night violence. That might work?

Sir S-S: Would certainty help. But that experiment got squeezed out as the Region didn't continue the budget, I think. Short-sighted.....

Barney: Well, got to go. But just one more thing. Seen this report of Trusts letting lawyers advertise for actions on injuries caused by clinical errors, on hospital notice-boards?

Sir S-S: Yes. Totally amazing. Like a supermarket having a notice on the way in which says, "Insure here in case our sausages give you salmonella!" Or a petrol station advertising "If our petrol blows up and kills your Mum, insure with us first."

Barney: Well you should take it up with that health minister, who was he, Lord L.B.W. 'Owzat, who opened your sponsored Costa coffee-shop last week?

Sir S-S: Don't bring that one up, please. I'm in trouble because the coffee price has risen and I've also had to squeeze out the volunteers who did it all for free. Big fuss in the local Chronicle.

Barney: Oh! Well, got to go! But just one more thing. My chum Sid Daley, you know, works in the NHS archives? Just sent me the following old Sir Humphrey stuff. Nothing changes, does it???

Bye for now!

* * *

A Message from Sir Humphrey Applebird, from the NHS Archives.

My Dear Bernard,

Yes, of course I did see that Editorial on the R. Lilley site about somehow allowing voters to have their hands on our tax budgets. I am surprised that you should have been reading it however, and not doing your work. I see everything. Do not think I can't be everywhere. I am. Yesterday, today, and tomorrow. I am all-seeing. I am all-listening. I am all-knowing.

And, yes, I have also seen the convoluted advice note from the Minister's teenage Special Adviser about trying to reduce 'noise' about the NHS and its alleged "systemic difficulties." AND I have noted the Minister's annotations, insofar as they were legible.

As to the note from the Minister's Special Adviser, by all means refer it to the DoH longer-term study group. But I would think an appropriate target date for its consideration would be in 2019. A new coalition may have coalesced by then. I do not expect another majority government.

As to the specifics for action today ...

1. By all means let us retain the Friends and Family interview project – just launched. So to see what people say, lying in their hospital beds (but with the doctor or nurse listening carefully close by, of course). BUT DO NOT GIVE PATIENTS CONTROL OVER THE MONEY.

2. Let's have some more community consultations about reform plans, closures etc, led by local Chief Executives (with an eye on their pensions) ...

... BUT DO NOT GIVE PATIENTS CONTROL OVER THE MONEY.

3. Let's give local councils a bit more of a say. Perhaps. Sometimes. To be considered. BUT DO NOT GIVE PATIENTS CONTROL OVER THE MONEY.

4. Let's form some more committees of patients and GPs in local commissioning, perhaps testing this on car-parking provision. No budget, alas, but let's think about it. Talk to Mr. Wiezel. BUT DO NOT GIVE PATIENTS CONTROL OVER THE MONEY.

5. Let's talk more to some "expert-patient groups." We could begin in the Scilly Isles. Usuaul suspects. We appoint. BUT DO NOT GIVE PATIENTS CONTROL OVER THE MONEY.

6. Let's issue more leaflets, guides to services [open and closed], information on bus routes, long-distance weather reports, paint-cost futures, etc. BUT DO NOT GIVE PATIENTS ANY CONTROL OVER THE MONEY.

7. Let's encourage more NHS read-to-old-ladies volunteers, tea-ladies, carpark assistants, notice-board aides, A&E light-bulb changers, board-room dusting staff, and emergency porters – many more much needed, I know – BUT ... BUT ... BUT DO NOT [NOT!NOT! NOT!NOTALOTNOTTYNOT!] GIVE PATIENTS ANY [ANY!!!] ANY CONTROL OVER THE MONEY.

Tax-based individual healthcare funds indeed!

People exercising individual financially empowered choice, indeed!

Taking their mobile tax-based fund to a co-operative, 'democratic', mutual purchasing organisation to bully providers to do what individuals think they think they want, when and how they want it, indeed!

Such a notion would play merry hell with what is after all a very proper state monopoly. Not even Andrew Lansley thought such ideas appropriate.

As to any choices, we made those in 1947 with Mr Bevan, and so we should let well alone. Well. ALONE. If we encourage such ideas there will be a general election about it, and who knows then what might follow? Bernard, do not venture your toes onto thin ice. Not ever. I hope I make myself clear, Bernard? Very clear?

Yours, with my usual helpful and careful guidance, I trust.

[signed]

Sir Humphrey Applebird, KCMG.

* * *

And ... two days later ...

Bernard,

Come and see me at 1.12 p.m. precisely today. You will not require lunch.

I have your note in reply to mine of the last inst.

Bernard, why are you sending me such thoughts when you should by now be well ahead with the detailed proposals for the new State Directed Food Warehouses, which will replace Tesco's, Sainsbury's, Morrison's, Waitrose, M&S Food Stores, The IceLot, etc when Mr Milkkiband is elected shortly. We must make progress promptly with the plans for these vital improvements in the locations of food stores, their stock, quality and price. I have already approved the opening hours of Monday to Wednesday, 11.30 a.m. to 2 30 p.m., and we have drafted the Order in Council. I ask myself why we spent all that money sending you to North Korea in Mr E. Balls' party if you are not now making the necessary progress in your work. Bernard, you must do better!

As to your suggestion that it is "their money to start with" concerning the electorate and the funding of the NHS, I do not see how you can have reached such a weird conclusion. Surely you have read your Beatrice Webb diaries? Please be reminded that WE are the "experts." WE know what is best for people. WE [and only we] can be trusted to make the right choices. They cannot. They shall not. They will not. Indeed, some are even supporters of the club which I believe is known as Moaners United! Surely this in itself is sufficient guidance for you?

You will now shred your copy of your note and of this note, remove it from your computer, and do not cc anyone else with it.

Bernard, I still have high hopes for you and your career. You do not, after all, really wish to apply for a transfer to Coleraine and to the Liaison Committee with the Provisional IRA at Gerry Adams House, do you?

Be prompt at 1.12 p.m.

Yours, very sincerely,

[signed]

Sir H. Applebird, KCMG.

PS. DO NOT....

* * *

Facey adds: "Let the Guilty be known!"

CHAPTER 2

EPISODE 2

Cleanliness next to Godliness ... The West Boggleypool-on-Sea scandal!

Dramatis Personae:

Sir Cyril Squoffington-Squogg, OBE, JP, is Chief Executive of The Tower of London NHS Hospital Trust, Traitor's Gate House, Embankment, London.

Mr. Barney Wells, BEM, is Chief Executive of The Arthur Scargill Memorial NHS Trust Hospital.

Mrs Barney Wells, MBE, Chair of The Arthur Scargill Memorial NHS Trust Hospital, is a local Unite Trade Union official.

Brenda When, a North country woman, is Secretary/PA to Mr Wells.

Today's Guest appearances: Mr. Percy Tistleton-ffolkes, a patient, and his wife, Edwina. And Mr S. Higbon-Ballcock, who is [temporarily] Chief Executive of the West Boggleypool-on-Sea NHS Hospitals Trust, Snape Street, Suffolk.

* * *

[telephone call transcript].

Sir S-S: Morning, Barney. I see that today is declared "Save A&E Monday!" Lovely day, anyway!

I'm sitting here reviewing the 'papers. Got to go on to my local commercial radio later today, to take calls. Seen the announcement by the PM of £500 millions extra for A&E. Bailing out the duff ones yet again. Why don't we just let them close? Daft to go on giving bonuses to those at the bottom of the class. But all these crises may actually be just what we need to force some real, deep thinking and some proper reforms!

Barney: Yep. Maybe. Gordon spent all them billions. Stuffed those doc contracts with gold. More money for less work, big drop in productivity. Very progressive! No needed changes. So, is this at long last the last-chance saloon?

My Secretary Brenda calls the £500m bail-out Cameron's A&E-lection fund!

And I see that already the Emergency Docs are whingeing about it. Usual: "Won't be enough-too-little-too late, no one asked us, etc." They don't seem to mention Brown's new doctor contracts much, though. Or weekend work. Personally, I'd spend it all on social care and home help. Oblige GPs to open, too. Got to stop the flow into A&E. Or even employ some of those extra French Border Guards! The BMA to blame for there being too few A&E consultants, of course. They control the training and so the supply.

Sir S-S: YES! 'Course, the PM – the Duke of Optimism in a Trollope novel – goes on declaring how wonderful everything is. But that isn't politics – it's spiritualism, religion, faith without facts. The bourne from which no PM returns!

But, heavens above, Barney, have you seen the story about West Boggleypool-on-Sea? That bloke Higbon-Ballcock is for the high jump there, and no mistake As they say, "What a mistaker ta maker!"

Barney: Nope. Haven't seen it. But don't read the Health Service Jungle any more. Too glum. No job ads suitable for me. Don't know anyone who does read it. Well, apart from the Unite lot. For the job ads.

Sir S-S: Well, Barney, it seems that what happened was that a very well-founded local Solicitor, one Percy Tistleton-ffolkes, was taken ill at a taxirank in Bogglepool.

There he was, off to the 7.03 a.m. train to Liverpool Street – bowler hat, pin-stripes, furled brolly, black leather briefcase, FT. But suddenly taken a bit queer.

Faints. Ambulance arrives. Into A&E. Admitted for observation. An old mixed ward, but with a plastic curtain divider. Wakes up mid-afternoon. Disgustingly appallingly, really awful, almost burstingly dreadful smell under the bed. Stank, rank. Gets out of bed, slowly, and takes a look. There he finds a huge, grey, putrescent, rotting, maggot-writhing, long-tailed, much swollen RAT. Clearly very dead. Very smelly. Very nasty. Very long-time long gone. Presses emergency buzzer. Red and puffy in the face. Holding nose, trying not to breath.

Almost bursting with rage. Fifteen minutes passes. Then a very surly nurse comes in, "Yes? What?" The said Tisleton-ffolkes draws her attention to the rat. She vanishes. Not a word said. Five minutes pass. Then said patient is hurriedly wheeled away by a grim-faced uncommunicative porter, no name badge, into another ward two floors up.

Anyway, Tistleton-ffolkes turns out to be OK. So is sent home that evening. Next day he takes the entire day off, and writes the most furious letter. But then nothing happens. No acknowledgement. No reply. No action taken. Three whole weeks pass. Getting angrier now by the day. About to write to the Sec. of State, local MP, local 'paper and radio station, cc to everyone he knows. Actually has traditional 'Swan' ink-pen in hand when the postman comes.

(Continues...)Excerpted from The Facey Romford Papers by Facey Romford Jr.. Copyright © 2016 Facey Romford, Jr.. Excerpted by permission of Edward Everett Root, Publishers, Co. Ltd..
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