The Central NHS procurement farce rolls on. It now turns out that the four boxes of gowns bought by NHS central procurement and flown from Turkey by the RAF, tying-up an aircraft and crew for a week, were condemned as sub-standard and impounded on arrival by other officials, the Telegraph reports. And just when you thought it couldn't get worse -
Last week, the NHS banned trusts from sourcing their own PPE because they were seen to be competing for the same vital gear. But procurement chiefs have complained that they have since been sent Chinese-made masks from the national stockpile that do not effectively repel fluid.I'm almost beyond words. If you gave these numpties the job of designing the internet they'd pick a single hub and spoke layout - with the hub in Whitehall and every computer in the land connecting through it.
The NHS has some 4,000 staff engaged in procurement. They used to be called buyers in the old days, just as human resource directors used to be called personnel managers. Both branches have been captured by (H/T Discovered Joys) the clerisy, as HSJ describes -
The new game in town is called the “procurement target operating model”, and is being run by NHS Improvement with the help of Deloitte and a small selection of NHS procurement staff.....
By far the most important take-away from the blueprint is the vision that national teams will lead on creating strategies for each of the categories covered by the model.What it actually means is that even more of the spend by NHS trusts will be managed and directed by central NHS procurement actors - not even employed by the NHS, necessarily, but specialist organisations like, erm, Deloitte. They will extend their grasp into areas such as agency staffing, facilities management, patient transport and clinical waste to add to the 'NHS supply change national supply category' which they already own.
This appears to be a similar tack to the recent changes to NHS Supply Chain, where specialist procurement organisations are tasked with buying products on behalf of the NHS across 11 categories.
The document states “integrated category and market management teams” will be the “driving force for procurement activity across the NHS. They will own and develop a single approach to each spend category to leverage economies of scale and drive market innovation”.
It appears the actual procurement will be done by “consolidated operational procurement delivery teams”, which will “implement the central category strategy at the local level, manage operational buying and undertake low-value sourcing initiatives/reactive buying”.
So what's the problem? Well, it's this. What big national procurement teams want to do is to let big high value national contracts for which only big global firms can bid, crowding out SMEs, local businesses and domestic suppliers. It really, really doesn't 'create value'. It just appears to do so, when the contracts are first signed.
And as events of the past weeks have shown, these jargon-choked central procurement teams may talk a good game, but when it comes to getting on the phones and buying essential kit at short notice, being agile, effective, and pragmatic and able to act with alacrity - critical procurement skills in a crisis - they're utterly crap. Like those Turkish gowns they bought, they're not fit for purpose.
21 comments:
The absolute clusterf*ck the NHS/PHE/Whitehall and Westminster have made of this pandemic would make a hilarious farce - along the lines of 'Allo, 'Allo. Unfortunately, in real life it isn't funny. It's national humiliation inflicted by an arrogant, incompetent and effectively untouchable Establishment.
The only State Institution which seems to be competent is the Armed Service.
And I wouldn't mind betting that EVERY SINGLE ONE of those "central NHS procurement actors - not even employed by the NHS" use the fact that it is is the NHS to NOT get a good deal for the NHS but to get a great deal for the sellers and make a few well placed friends for future fleecings and probably receive a few nice 'gifts' at the same time.
This Tory shower have been in charge of the NHS for ten years.
It is whatever they have made it.
"You can have it fast, good or cheap, choose two". Anyway, flap over, time to move on. Re-purpose as souwesters.
I am sure most on this blog know that there is less to management consultants than meets the eye. A senior civil servant told me, "we know they are no good, but they are someone to blame when it goes wrong".
There is indeed a clerisy, every age has its clerisy, jobs that pay well for parasitic non work. Usually closely aligned with the seat of power. Traditionally the King's court or the Church. Then the Civil Service and more recently the media, big business, the Big Four, the think tanks, political parties and the revolving doors between them.
If you don't like the system and have no talent, then stay out in the cold.
BTW, I am not usually an admirer of D Trump, but his constructive ambiguity over the US lockdown/release is worthy of Machiavelli himself. Boris has a way to go but is catching up.
Down the pike there will be trouble for sure, even those duff gowns may come in handy.
"It is whatever they have made it."
It is a Stalin era managed economy. The GDP of the NHS exceeds many small countries, and its run about as efficiently as any completely centrally controlled economy would ever be, we've had plenty of examples over the last 100 years of how that works out for the people living in them. The NHS is the USSR in miniature, and just as the USSR managed to take a country that was the breadbasket of the world and create a shortage of bread, the NHS manages to screw up just about everything it does, for exactly the same reason the USSR failed, economically at least.
Walter Price, 08:15
"This Tory shower have been in charge of the NHS for ten years."
Rubbish. Not a Tory amongst them. Plus it was the Coalition for 5 years (why DOES Clegg STILL get 112,000 quid a year, more than Cameron still gets in fcat...wierd) so a liberla lefty shower was in charge. Then came May so a inept, liberal lefty. Now Boris...still to decide but edging on the side of liberal lefty. All well left of Blair, and all would make Callaghan's end of 70s government look centre.
It sounds a lot like MOD procurement. There mostly young girls who are, 'to prevent fraud' kept away from what they buy so don't even know what they are buying looks like, place orders on 'enabling contracts' with a few large suppliers who buy from goodness knows where.
I contrast that with the private companies that I worked with had buyers who were 'old biddies'. They knew exactly what they were buying and woe betide any young salesman that tried to pass of junk to them!
Because the MOD girls don't know the market they had lists of alternate suppliers, little realising that ultimately it was the same producer at the start of the chain. This single supply point extends across many fields, and I suspect into the commercial domain too. All those organisations that don't have their own transport or warehouses but have contingency plans to 'buy it in if needed' suddenly find that they have all got an option on the same Ford transit and garden shed.
Having worked in the shipping departments of two very well known High Street retailers I know it is normal in the private sector to ensure that the goods you are buying from another part of the world are of good quality before you shell out payment. There are ways of doing this via documentation and the method of payment and having samples sent before shipment. Any business carrying on like this would not remain a business for long. And anyone allowing this to happen would be sacked instantly and marched off the premises. The NHS buyers are just useless pen-pushers (what did Priti say?) but no doubt they will carry on flushing other peoples' money down the toilet, still useless. The NHS is not the 8th wonder of the world. Though admirable in many ways it is not the layers of useless pen pushers and overpaid fat cats who make it so. When this crisis is over the NHS needs to be reorganised and pared back. Look at other systems (ie the French) and LEARN. You may think yourself the best in the world, you are not.
Having an essential service provided free of charge by the taxpayer and run by bureaucrats is a guaranteed recipe for waste and inefficiency. It eliminates competition and choice. It treats its users as supplicants rather than valued customers.
The 'Save the NHS' slogan really means 'Save the Politicians'. If the NHS was overwhelmed then they would be blamed, who else. Saving lives is secondary as we can see from the deaths per million which is over 400 in the UK so far. Japan, with twice the population and a properly run, well equipped health system, has only 556 deaths which is 4 per million. No saucepan-banging or rounds of applause are considered necessary there.
The NHS needs total reform but no government dares even suggest it.
RE: Walter Price
"This Tory shower have been in charge of the NHS for ten years.
It is whatever they have made it."
I realise you are a lefty nut-job hoping to score a cheap political point, but you have accidentally high-lighted an important point.
The NHS bureaucrats have been utterly useless for many decades. The Griffiths report, published in the 1980's, the one that laid the foundation for what we have today, openly admitted that NHS administrators were not up to the job and that talent would have to be brought in from outside. It wasn't. Instead, the already resident duffers were given pay rises and fancy titles and have been recruiting and promoting their own kind ever since.
For your "ten years" comment to have any merit then it would have to be the case that the NHS in say, the 1990s, was well managed - in stark contrast to what we see today. But that isn't the case. The administrators then were every bit as useless as they are today - a self-perpetuating kakistocracy.
"The NHS is not the 8th wonder of the world"
A few weeks ago I looked up some figures. In 2018 the NHS was only 8th in the world league in terms of numbers of employees. The top spot being the US Dept Of Defence. But a different picture emerges when you compare the number of employees with the relevant population. The NHS is now well in the lead with just over 2% - the US DOD is at 0.1% So it's little wonder the organisation swallows up such vast amounts of money...
8th? Thought it was top 5
So, nothing to do with the Conservative Ministers in charge of setting policy? Perhaps this was all a vehicle to get a boatload of aprons that Boris can use when changing Wilf's nappy.
And these are the folks you trust to guide to the sunny uplands!
Dilyn Dog
It's easy to say "The managers are rubbish, we need better managers". The problem is that really good managers are always rare, and always have been.
However, some good might be done by sharply reducing the pay at he upper levels. That could lead to the departure of some of those who are in it only for the money.
Don Cox
It doesn't matter who is in political control, the NHS is 1.5m people that operate with zero accountability to their 'customers' and get paid regardless of what happens to them. All large organisations, private or public tend to producer capture (ie start trying to make their lives easier at the expense of the customer), the only thing that prevents private ones getting as bad as the NHS is the freedom of the customer to go elsewhere and take his money with him - if the customer stops coming through the door, eventually you are out of a job.
In the NHS's situation the vast majority of customers have no choice, and even if they could afford to go private, the NHS staff still get paid regardless. It actually makes their lives easier if they drive people into private medicine as there is less for them to do. How can any system ever operate efficiently with those sort of incentives at work?
Its high time the NHS was split into two parts - the provision and the paying. The State should still pay, but the provision should be entirely competitive - if your clinic/hospital/surgery fail to get patients because you're utterly crap then you go bust, end of story. That would force improvements.
Its odd that the very same people who have been screaming blue murder over Brexit, and how we should part of the European family seem to change their tune when confronted with European healthcare systems, which operate largely on the model I outlined above - the State paying, but the provision is largely or significantly privately operated. Then they become Little Englanders - the NHS is wonderful! The Pride of Britain! All the other countries have far worse systems than our wonderful NHS! We don't need to learn from any Johnny Foreigner!
I have had to deal with the NHS for both my own healthcare needs in the last year or so, and have seen how it has treated my elderly father in recent years, and I for one am fed up of being treated like a poor peasant seeking alms from a feudal king. When I walk into a shop I am treated like a valued customer, when I enter the NHS I am treated like something on the sole of their shoes. When my father was in hospital the staff treated my mother so badly she was reduced to tears, she a St Thomas' nurse no less. I'm damned if I'm going to clap for people like that.
Well, bugger me!
This reminds me of all the ineptitude of the old S.E.T.R.H.A. in Croydon.
Never ever got a decision, never ever saw anyone with an inch of nous, and never bothered after that...
Just to be clear, who are you saying is responsible for the 100,000 tests/day target? An MP or a civil servant?
@ Span Ows - I used this site:
https://www.worldatlas.com/articles/the-world-s-largest-employers.html
But I note that Wiki puts them at 5th place back in 2015
Sobers, 20:39, good post.
microdave 22:28: thanks for that. Like the per population point anyway, NHS number one!
Anon: 22:08...moving the goalposts for a third time in a single comment thread, impressive.
RE: Anonymous @ 22:08
Just to be clear, who are you saying is responsible for the hundreds of
unnecessary deaths at the Mid Staffordshire NHS Foundation Trust? The Labour
Secretary of State for Health or the incompetent Chief Executive?
ACTUALLY - half correct
Captured, yes - by the crooks & theieves running the tory party
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