WELL ANYWAY, IT AMUSED ME - No. 19

Well there I was, standing in the queue at the Doctors waiting to collect a prescription for some drugs. Reading all the various notices adorning the Pharmacy my eye alighted on the notice below.

This had been issued by the local NHS Primary Care Trust to all GP Surgeries explaining about the use of non branded medicines.

Something tells me it was not written by someone nearing retirement.

Actually, having read it again, I’m now wondering about the 5th word in the second paragraph. Next time I go, I'll check!

Can I really be this sad?

Tags:

spelling,
nhs

IF THE MRSA DOESN'T GET YOU, THE PHONES WILL

I don’t know if you’ve been in Hospital recently, but, if you haven’t, believe me, it’s a stressful experience. Ignoring the fact that there’s a man with a very sharp knife waiting for you, and that to minimise your litigious potential to them, they insist on telling you that your chances of survival are of the same order as playing Russian Roulette with a 12 chambered revolver, and the fact that, as soon as you manage to get to sleep, they throw the lights on, Guantanamo Bay style, to wake you up, and feed you food that you’d think twice about giving to a pet you didn’t like much, there’s always the telephones.

When you settle into your bed, you are faced with a Startrek style screen, which you are told is your lifeline with the outside world. It has a personal TV screen, a phone, some games and probably a lot more which, because you're ill, you can’t be bothered to find out about. They inform you that you cannot use your mobile phone “because it interferes with the equipment on the ward” so you are condemned to use the phone on this screen, since they have eliminated the Ward's Public Pay Phone, for reasons you can probably work out for yourself.

A Company called Patientline runs these things, and it seems they have a vice-like grip throughout the NHS. They have apparently installed 75,000 of these in over 150 hospitals, and run the system like a military operation. In another of the hugely successful, good old New Labour/NHS computer projects we have come to love and admire, some seven years ago they won a contract to put these screens into Hospitals to integrate doctor’s access to computerised patient’s records, allow electronic meal ordering, electronic real-time drug prescription and ordering of patient X-rays, as well as providing patients with entertainment and telephone services.

You can probably guess the next bit – the medical IT side of the process is still not working, so there is little or no payment going from the NHS to Patientline to recoup their £160million investment, so the only way the company can recover its outlay and make money, is to soak the patient. And they are about to be pushed even further under water.

The costs for this service are about to be raised by 160% according to the Newspaper. The Government, bless their cotton socks, maintain that a lifeline from a patient’s family and friends outside “is a luxury, and should not be funded by the taxpayer.” So, guess who pays the costs?

If you ring in on a landline to find out if a patient is still with us, you will be charged 49p per minute in peak time to talk to them. A 3 minute call from a Mobile phone to one of these Patientline machines will cost the caller £2.37p, and if you are stupid enough to ring out from your Hospital bed to a UK landline using one of these machines, you will be charged 78p for a 3 minute call.

The real solution here seems simple. The Medicines and Healthcare products Regulatory Agency (MHRA) conducted tests on mobile phones a couple of years ago, and concluded that “Only 4% of (hospital) devices suffered interference from mobile phones at a distance of one metre, with less than 0.1% showing serious effects.” Why not get the manufacturers of the 0.1% of equipment with a problem, to modify it and screen it in such a way as to reduce the 0.1% to zero. Then, we could all use our mobile phones to our heart’s content, making a huge improvement to the patient’s well-being – or am I being silly in still thinking that that the patient is No.1 on a Hospital’s agenda? Or alternatively, tell us which particular makes of phone the Doctors and Consultants use as they go on their rounds, and we will all pick one of those when we next go to Carphone Warehouse for an upgrade.

A combination of these two fixes will sort the problem out just like that. The Government can then do a deal with Patientline to pay them the revenues they expected to get, and, had the Government managed to deliver the IT Project on time, would now be receiving (Pigs/Wings/Fly). The elegant result here would be that the people causing the problem would then face the pain of paying for their failure.

Except of course, it’s our money they’d be using.

Bugger.

Tags:

patientline,hospitals,nhs,phones

NHS PENSIONS - A PRESENT FOR OUR CHILDREN

I wrote a short piece the other day about the way that numbers are presented affects the way we perceive them. This was prompted by an almost throwaway article in the paper noting how the NHS Pension Scheme liabilities had increased by some £37 Billion over the last year to a new total of £165 Billion, presented in a way which made the difference look like “rounding”.

The more you ponder on this, the more you get worried by it. The presentation is one thing, but the staggering size of the amount of money involved is a much more serious issue. I know enough about the maths of how Pension Schemes work to know that I don’t know enough about it. When their clients so demand, the actuaries who do these calculations can call on almost David Blaine-like powers involving lots of smoke and quite a few mirrors to make numbers “sit up and beg” for them.

They use a discount rate which reduces future pension costs back to present day figures to calculate today’s liabilities. One of the changes the actuaries apparently used in increasing the NHS Pension scheme liabilities for 2005-6, was to reduce the Discount rate from 3.5% the previous year, to 2.8% for this year. Just changing that percentage by that seemingly little amount can have staggering effects on the amount of money they say is needed today. The only problem with bringing it down to 2.8%, is that for most sponsored schemes in the private sector, that percentage would typically be 2.0%. If you factor that number into the maths, the liabilities would grow, according to Watson Wyatt, a very respected firm of pensions experts, by a further £28 Billion to £193 Billion.

There are a myriad of other factors which must be fed into the maths, all of which can change the final number dramatically. Try Life Expectancy for instance, which is changing at a rate none of us, including actuaries, can predict. It seems to have increased over the last couple of decades at a faster rate than we ever imagined, partly due, you may note rather elegantly, to the efforts of some of the people in the NHS Pension Scheme.

Simple maths says to us that, if a scheme supports 1.26 million members, and it has a total liability of £165 Billion, then each member’s “pot” is around £140,000, which is supposed to last around 25 years – the predicted lifespan of someone who is 60 when they start to take their pension. That’s around £6,000 per year on average. If they get the average age of mortality wrong by just one year, and that’s actually very easily possible, then the calculation is wrong by nearly £1 Billion. It's actgually impossible to calculate what the true liabilities of such a scheme are, but you can guarantee that, whatever number you choose to think of, the final one will be higher!

All these figures seem horribly large, and almost beyond comprehension. The really worrying thing is that the NHS scheme is UNFUNDED – meaning that the Government has put nothing, absolutely nothing away anywhere to pay for it. Unlike all Private Pension scheme, there are no Assets anywhere which have been "ring-fenced" to pay these enormous sums. They have made this colossal commitment to 1,260,000 people, and the only way it gets paid is if you and I pay taxes to support it, for as long as we live.

And that is only one scheme, albeit the biggest, which is handled by the Government in this way. If you take all the state schemes where the taxpayer has been forced, through payment of taxes in the future, to underwrite these schemes, the total amount we will have to pay is around One Trillion Pounds. That’s only three little words, but numerically it looks like £1,000,000,000,000, or a tad more than the whole of this country’s Gross National Product for a year – just get your head around that if you can.

It does rather make the efforts by Gordon Brown to diminish the pension of anyone in the Private sector look very, very sordid and very, very unfair.

Tags:

pensions,
nhs,
gordon brown