Dr Paul Worthington
Cwm Taf CHC
Comment on: Healthwatch needs to punch its weight
Hi there Good and througghtful article. I'm speaking as a CHC (yes we still have them !) Chief Officer from Wales (yes, HSJ, we're still here !). Just wanted to add a couple of thoughts: - when it comes to engagement and consultation. the requiremesnts in wales are very well set out (and no, they don't inclde the Lansley 4) - CHCs have a very clear role in consultation, which is set ou in regulations and statute. This includes the right also to refer a proposal to the Minister if we're not happy.The role of Healthwatch in this area is much less clearly defined - in fact, the role, rights and structure of Healthwatch is arguably much less clearly defined than CHCs in Wales (and less well resourced) - but much stratetgic and service change is of necessity being planned and executed across a more regional basis. It will sometimes be multi-CCG, and that's OK. Over the last 18 months + we've been undertaking major consultation on reshaping a number of acute services across South wales; 5 Health Boards, 5 CHCs, and we've managed it. Not without difficulties and some very hard decision. But one of the factors that has helped it is the clear role of CHCs, plus organisations working collaboratively, helped by some more regional support to co-ordinate. If anyone wants to talk to us across the border about how it worked, we'd be very happy. Perhaps the HSJ may even write about it......
Interesting debate. A couple of things to say: - a few comments above about international comparisons. What are they ? let's have the facts and how many counties have comparable or affordable access regardless of ability to pay - I've worked in the NHS through times when we were struggling to get waiting times below 24 months. Don't anyone tell me targets don't have an impact - the phrase 'as quickly as clinically possible' is being flung around with pretty gay abandon here. What does that mean ? And what impact would it have on management of other non-electic=ve conditions ? - I'm all in favour of debating how and if that's practically achieveable. let's have an open, honest and realistic discussion. But having worked a lot on waiting list issues in the past, it's clear that - although some would like to think so - there isn't a single solution. Individual lists often have their own dynamics, their own issues. What did often work was detailed attention to the processes by the clinicians and staff who are delivering the service. But let';s not try to solve these complex problem with platitudes and generalisations
Can we get someone senior in the NHS to run an eye over M and S please ? Their men's clothing range is rubbish.
Comment on: Vasco-Knight suspended with immediate effect
I want to say just a couple of things: - I haven't seen all the details of this case, but there are clearly serious issues relating to candour and protection of all staff, including who raise concerns. These issues clearly merit serious analysis and discussion - anaonymised character assassination and snide comments don't help that serious discussion - my Doctorate (if anyones interested) is in Medieval History and I worked hard for it; I use the title but I make it clear that I'm not a clinician. It's never caused any problems, as far as I'm aware. I really thibnk there are more important issues at stake here than people's titles
Stephen Useful comment but yiou're missing the point slightly. The business sector isn't always an accurate analogy. If I buy a housr or a a car then I've a firect suppliet-customer relationship. However, in healthcare, commissioning bodies act a lot of the time as a proxy customer, purchasing on behalf of customers. It's not as direct a relationshop. Now, if we want to shift to a more direct cistomer-cipplier relationshop, we can do in some (maybe quite a few) areas. But if we're talking emergency admission, for example, the relationship will always be quite different from the traditional customer-supplierbv relationship. My own view is that the language isn't always as important as we make it. What we need to talk about is decision-making pathways, and be clear about pragmatically where responsibility for decisions lies, and where we can (and should) attempt to shift that responsibility from where it is now.