WRITTEN ON September 25th, 2004 BY Tom Fuller AND STORED IN Across the Board, Save Time and Money, What do we want?
As might be expected, most of the posts so far have been citizen-oriented, in terms of what eGovernment can and should provide. I hope it is not controversial to talk about what eGov can provide for government, as it’s an entirely different kettle of fish.
Across Europe, the public sector shares two characteristics; size and age. Almost every government has more people working for it than they need, and almost half of these public sector workers are approaching retirement. Installing appropriate technology, integrating it to work with other systems, and getting it up and running would permit large numbers of public servants to retire without being replaced.
There’s really no need to sack tens of thousands of workers–natural attrition will serve just as nicely over the next 8 years. Back office systems working with revenue, benefits, administration, etc. can and already have replaced human drudgery (nobody really likes that work–they just like government pensions).
Governments will probably (okay, certainly) be reluctant to return the saved money to citizens in the form of lower taxes, but even the most curmudgeonly citizen will acknowledge that the money saved from three redundant posts in the Department of Work and Pensions will fund a nurse, teacher or police officer.
It does seem that the UK is going about this from the wrong end first–committing to reducing headcount without having the systems in place. But that could be a failure of communications. Does anybody know?
4 Responses to “Once in a lifetime?”
Pan
I agree with what you say about getting things in the right order. Bitterness understandable given what you feel about how the change is being done.
But can we focus here on what comes *before* the work analysis? In what manner and to what extent do people want e-enabled public services to help them stay healthy?
How do they – we, of course – want NHS Direct to evolve, want our records handled, appointments and referrals dealt with, how much do we want to find out about conditions and drug interactions, how much discretion and control do we want over the information and resources that can flow around a future NHS like quicksilver? Leaving aside whether the national IT programme is right for doctors, what is it that patients want, or indeed those who are not ill?
Tell us your ideas of what comes before the work analysis. If we get a lot of good ideas on health I’ll offer to present it to Richard Granger also (no promises – he gives short shrift to anything he doesnt see as pertinent to what he’s trying to achieve).
This brainstorming process we’re trying here can’t solve the – evidently genuine – morale problems caused by how public servants are managed and treated. But it is meant to focus on the right starting point to make it, as you say, easier to swallow. Just saying “save x%” aint good enough, I can quite see that.
Health ideas: (bit of a brainstorm…)
I think a lot of the ideas currently being developed / put into action regarding electronic patient records / lifelong health records, are a huge step in the right direction. I want my doctor to know what my past medical history is, want him to easily see what other practitioners I have been referred to have said about my conditions. I don’t want to have to go “tell” my doctor if I was taken into A&E over the weekend, I want him to be alerted to the fact.
I’d like e-mail consultations for those times I just want some advice, or where I feel more comfortable in a non face-to-face environment. I want to receive e-mail prescriptions, to save me having to take time off work just to pick one up.
I’d like to be able to book appointments by SMS, or online, I want to be able to access my records, check their accuracy or content, and add notes or further information that I feel would help in proper diagnosis of problems. I want to be able to get an instant second opinion by submitting my records to a panel of independent GPs / specialists.
As for security / control. I want the people who need to see my records to give good quality, integrated health care, to be able to see them, or the relevant parts of them. This means, doctors, dentists, opticians, nurses, pharmacists, and any other person involved in my care. I don’t want insurance brokers, my employers, etc. to have access – I want them to submit a request for specific information (not the whole record) where needed, and the electronic record will make the report easier to write. I use Internet Banking, and am happy with the security measures there – so I’d be happy with a similar process for my health records. So long as this was updated as new security measures become easily available to the home user. However, I appreciate many people don’t use e-banking because they’re not content with the security measures – so they won’t get involved until something is suggested that satisfies them.
Some of the above is in progress, whether it will end up being as I hope is yet to be seen. It clearly needs huge IT investment and training. We need homogeneity across the systems being used in the NHS, (and also to be honest with private medicine, because we’d want our doctors to be able to see any results of private tests etc.). We need massive training, and to instill a feeling of ownership for both medical staff and patients. What we also need is cross party support, because what’s the point of putting the time and money in, if the goverment changes and rips up all the good work you’ve done.
That’s great; I’m going to re-post that as an article. Please email me if you want details of your author account, anything other than Pan as the pseudonym, and anything other than a fake email address. William
Well, from my experience in the Department of Health, which started a “change programme” before the current round of civil service cuts, we were told that we were to cut by a third, and then told to figure out what work to drop / new ways of working to enable us to cope with the cuts. Totally topsy turvy way of working. Now the cuts are pretty much in effect, you have a department full of overworked, stressed and completely demoralised staff. It’s a disgrace that civil servants seem to be the only group of people whose livelihoods can be used as political ammunition without people going “you’re making how many people redundant?” and questioning whether it is a necessary or just cause of action.
People get into the civil service because they want to put something into society, help things run smoothly, ensure ministers have the best evidence and advice to base their policy decisions on – and this is the thanks you get.
If we’d have been asked to do a work analysis first, looking into duplication, technological solutions etc. *before* they announced how many jobs were to go, I think people would find the whole process easier to swallow. And it would be less likely to just be a political ploy. Oh, look, it’s election year, lets watch the parties play “how many civil servants can we get rid of (and give nervous breakdowns and make them not be able to pay their mortgages in the process)”.
From what I’ve heard these culls just result in the taking on of highly paid consultants (because these aren’t classed as civil servants) when they realise the staff left aren’t able to handle the work load.
(Sorry to sound bitter, but it’s hard to stay positive in the current environment)