Diagnosis Salons are usually convivial gatherings, meetings of people who are all singing from the same Clinical Leadership hymn sheet. Tonight didn’t feel quite like that. Brought together in the Kings Fund basement were 60 or so Diagnosers, the Prime Minister’s health advisor, a deputy director of the think tank Reform, and me. We were there to talk health policy. I attempted to raise some interest in discussing global health policy, but it was difficult. A mile down the road from us, the Lords were debating the Health & Social Care Bill. Global health wouldn’t get much of a look-in. A fierce debate about NHS reform was clearly the order of the day.
As we chewed over one issue after another, the tension started to clear and we found ourselves airing a rich debate. A debate far more nuanced than was being heard across most of the NHS. We started off a bit polarised: ‘private sector = evil’ versus ‘private sector = efficient, innovative, answer to our prayers’. NHS reorganization is such a controversial and emotional issue that it is easy to default to over-simplistic debate. We managed to get away from this quite quickly. What do we actually think about issues like competition? As individuals, don’t we want to be able to choose to see to a GP who we know is good, even if it’s a bit of a drive? But does this argument really work with hospitals when – outside of London at least – convenience has a lot more to do with it? And what do we think about politics and the NHS anyway? The traditional complaint is that politicians should just stop interfering. But at least the arrangement means that somebody is accountable to the population for the NHS, in a way that systems elsewhere in the world are not. And what about the independent sector? Not to be trusted? Why? And aren’t GPs independent contractors anyway? And have you heard about Circle, the company that now runs an NHS hospital, owned half by City investors and half by doctors, nurses and other healthcare staff? What on earth do we make of that?
As the evening progressed, more shades of grey emerged, concessions were made. And we acknowledged that we – and most people in the NHS – had not had enough of this kind of grown-up debate. Somehow the Health & Social Care bill had almost been passed, and what we had mainly been surrounded by was anger, vitriol, and less-than-complete understanding on all sides of the debate. And of course, it is not as if there was just a single debate: it is difficult to be for or against everything in the Health & Social Care Bill.
I couldn’t say that we all left the room speaking with one voice, arm-in-arm, the problems of the world put to rest. But that there was perceptibly more mutual understanding than when we started, more acknowledgment of the complexities, more appreciation of the alternative perspective. Most still left the room feeling overall that Andrew Lansley was doing a terrible thing to our NHS. The majority were particularly upset that he felt the need for structural reorganisation, when most of the Bill’s aims could have been achieved without it. And why didn’t he communicate properly before he pulled this out of his back pocket? But there was a stronger collective conclusion: that surely more of this engaged debate between clinicians and policy makers would be a good thing.
So that’s the challenge to all of us doctors and other Diagnosers: the next time a Health Secretary pulls a shiny new Bill from their pocket, let’s do better. Whether it’s a good shiny new plan or a bad shiny new plan, let’s get ourselves faster to a position of informed and intelligent debate than we did this time round.
Monday, May 28, 2012
Sunday, May 13, 2012
Internship with HSJ (Health Services Journal) by Irfan (Barts and The London Medical School)
The HSJ is the leading journal on healthcare policy news and resources in the UK. The internship is a fantastic way for medical students to really understand the changes that are taking place in the NHS, now and in the next few years, which will affect their working lives as doctors. Unfortunately, the medical school curriculum places little emphasis on the leadership, managerial and resource allocation skills that doctors will need to have in the future, to deliver both a clinically effective and cost effective standard of care.
From getting published 3 times in the Journal, to going to the House of Lords for a Health Select Committee Review and interviewing individual who are making high-level decisions about the future of the NHS, my time at HSJ was extremely enjoyable to put it mildly. It was an opportunity to learn different skill sets and knowledge and enjoy life away from medicine for a while.
For most part, what you get out of this internship is what you put in. There are opportunities to spend time on research, writing and the business sides of publishing.
I started my internship just as the Healthcare Reforms were going through the House of Lords, and this made the experience even more relevant, as the insight and commentary of team members made for interesting discussion about the future of the NHS.
One aspect I really enjoy was the responsibility given from day one, by the Editor, Alastair McLellan. I will never forget the moment he came to my desk and asked me to write a story about clinical negligence on my 2nd day at the office. After some investigatory work, I had my news angle and with the guidance of the other journalist, I management to get an interview with the CEO of the NHSLA and wrote my first journalistic piece, which I will look back on with pride.
The team were extremely friendly and had vast expertise on health care service and policy. They are always willing to answer any questions and explain the background in any discussions the team were having. The debates around policy issues were great to partake in and even picking up knowledge nuggets through listening in was fantastic. In a very short space of time I was fully aware of numerous topics in healthcare, which are never taught in medical school, such as commissioning, organisational structure, salaries and pension and the role of private initiatives.
I would thoroughly recommend this internship for any medical student who really wants to understand healthcare policy and the connection between policy markers and clinicians. For those individuals who have a flair for writing, this is the perfect place to hone your skills and understand what medical journalism is all about.
From getting published 3 times in the Journal, to going to the House of Lords for a Health Select Committee Review and interviewing individual who are making high-level decisions about the future of the NHS, my time at HSJ was extremely enjoyable to put it mildly. It was an opportunity to learn different skill sets and knowledge and enjoy life away from medicine for a while.
For most part, what you get out of this internship is what you put in. There are opportunities to spend time on research, writing and the business sides of publishing.
I started my internship just as the Healthcare Reforms were going through the House of Lords, and this made the experience even more relevant, as the insight and commentary of team members made for interesting discussion about the future of the NHS.
One aspect I really enjoy was the responsibility given from day one, by the Editor, Alastair McLellan. I will never forget the moment he came to my desk and asked me to write a story about clinical negligence on my 2nd day at the office. After some investigatory work, I had my news angle and with the guidance of the other journalist, I management to get an interview with the CEO of the NHSLA and wrote my first journalistic piece, which I will look back on with pride.
The team were extremely friendly and had vast expertise on health care service and policy. They are always willing to answer any questions and explain the background in any discussions the team were having. The debates around policy issues were great to partake in and even picking up knowledge nuggets through listening in was fantastic. In a very short space of time I was fully aware of numerous topics in healthcare, which are never taught in medical school, such as commissioning, organisational structure, salaries and pension and the role of private initiatives.
I would thoroughly recommend this internship for any medical student who really wants to understand healthcare policy and the connection between policy markers and clinicians. For those individuals who have a flair for writing, this is the perfect place to hone your skills and understand what medical journalism is all about.
Sunday, May 6, 2012
Internship with KPMG by Assad Farooq, Medical Student at Imperial College
I started my elective in Healthcare Management with KPMG with a scholarly apprehension. Scholarly apprehension because I graduated from the Imperial College Business School with an Intercalated BSc in Healthcare Management, but anxious all the while about the unknown. That unknown lies at the heart of management consulting. The unknown represents unprecedented contingencies, strict performance targets and sometimes unchartered territories. These factors force the consulting mind to think about creative solutions, exercise disciplined project management and to collaborate with colleagues to leverage each others expertise. This was a challenge and yet an attraction all the while. And, this was the essence of consulting for me.
I traded my stethoscope for a suit and I was immediately made to feel a valued and important part of my team. I attended meetings with supervisors and immediate colleagues who all embraced my learning needs and provided a clear direction about my role and responsibilities in each project. I was given the privilege to work on the ground as well as being invited to attend senior meetings concerning overall strategy. This gave me a 360 degree perspective about project management and helped me to understand the extent of collaboration required to provide the optimum solution to clients. I was involved in three projects ranging from operations management to GP commissioning and risk management.
KPMG is an institution that prides itself on their renowned training schemes. As a medical student intern you are monitored closely and provided with constant support. I was kindly paired with two colleagues who were my mentors and provided me with constant advice. This helped me in both an academic sense and in understanding the wider corporate culture. I developed a close relationship with the mentors I had the privilege of meeting and will contact them well into the future for advice in my future career! This was complemented by a number of internal courses that I completed through the KPMG Business School. These provided me with a sound foundation about the important skills and theory before I embarked on my projects.
Doctors are being encouraged to develop refreshing and bold service-level strategies by taking the helms of health care management and embracing clinical leadership.
Medical students rarely get the opportunity to embark on such ambitious internships. This opportunity has given me a fresh outlook on the challenges we face as future clinicians and got my mind overflowing with innovative solutions to many of the problems currently faced by the NHS. It was an honour to work on exciting, demanding and high-level healthcare management projects, and being a student of the most-respected and experienced leaders in these fields.
I would especially like to extend my ceaseless gratitude to Professor Hillary Thomas, Mr. John Howard, Mr. Russ Jewell, Mr. Hugh Neylan and Dr. Helena Posnett for accepting me into there dynamic team and Dr. Harpreet Sood at the Diagnosis Internship Network for making this possible and for his kind supervision throughout.
I traded my stethoscope for a suit and I was immediately made to feel a valued and important part of my team. I attended meetings with supervisors and immediate colleagues who all embraced my learning needs and provided a clear direction about my role and responsibilities in each project. I was given the privilege to work on the ground as well as being invited to attend senior meetings concerning overall strategy. This gave me a 360 degree perspective about project management and helped me to understand the extent of collaboration required to provide the optimum solution to clients. I was involved in three projects ranging from operations management to GP commissioning and risk management.
KPMG is an institution that prides itself on their renowned training schemes. As a medical student intern you are monitored closely and provided with constant support. I was kindly paired with two colleagues who were my mentors and provided me with constant advice. This helped me in both an academic sense and in understanding the wider corporate culture. I developed a close relationship with the mentors I had the privilege of meeting and will contact them well into the future for advice in my future career! This was complemented by a number of internal courses that I completed through the KPMG Business School. These provided me with a sound foundation about the important skills and theory before I embarked on my projects.
Doctors are being encouraged to develop refreshing and bold service-level strategies by taking the helms of health care management and embracing clinical leadership.
Medical students rarely get the opportunity to embark on such ambitious internships. This opportunity has given me a fresh outlook on the challenges we face as future clinicians and got my mind overflowing with innovative solutions to many of the problems currently faced by the NHS. It was an honour to work on exciting, demanding and high-level healthcare management projects, and being a student of the most-respected and experienced leaders in these fields.
I would especially like to extend my ceaseless gratitude to Professor Hillary Thomas, Mr. John Howard, Mr. Russ Jewell, Mr. Hugh Neylan and Dr. Helena Posnett for accepting me into there dynamic team and Dr. Harpreet Sood at the Diagnosis Internship Network for making this possible and for his kind supervision throughout.
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