Cocoa How have the mighty fallen OT. 716

On Wed, 19 Jul 2006 09:31:32 +0100, Mary Fisher wrote

It would be hard to find one worse than the NHS, Mary.

In one sense you are right though. I do spend a lot of time solving difficult problems and have done for many years. Flying around is hardly an exciting prospect any longer when one is visiting four cities in different countries in a week, out of the airport, visit the customer and back to the airport - i.e. there is no excitement in the travel aspect.

However, in working with customers for several decades, (and others say successfully), I have learnt and use several fundamental principles:

- Always try to do what you say you are going to do, and be prepared to move heaven and earth if necessary to achieve that.

- If that is prevented by circumstances that were impossible to foresee, make sure that the customer knows as far ahead of time as possible so that alternative arrangements can be made. Then make sure that the customer is overcompensated for the effects.

- Always tell customers the truth, even if it may not be convenient at the time. It pays back with dividends.

- Involve and encourage customers to participate in solving issues. It makes things run more smoothly and quickly and in the future they can help themselves.

- Over achieve on promises and reasonable expectations. When this is done, the unreasonable ones seldom happen.

- Deliver on the customer's expectation of or the agreed timescales.

- Always remember that the customer is paying for what he is getting and is enbreastled to expect to receive that.

The result of doing these things is success for both the supplying organisation and the customer.

It isn't difficult, and my experience is of having customers that I have worked with through multiple career-company changes (theirs and mine) and achieving a level of trust that they can safely and effectively work with me.

Of course this relates to the commercial world, but almost all the principles can be applied to any situation.

It does mean that when I am a customer, I expect the same standards from organisations from which I buy goods and services. This does not mean that I am looking for something for nothing or for something for which I am not willing to pay.

I select a supplier based on my own research and on what he says he will do. However, I do expect that he will deliver on his promises both in terms of content and in the agreed timescale. That has been part of selection criteria.

If he over-delivers that's nice but I don't expect it.

More often than not it all works out and what was agreed happens when it is supposed to happen.

Occasionally there is a problem and the supplier takes the trouble to tell me and a fix is agreed. I'm usually perfectly happy with that because if a supplier can demonstrate to me that he can fix a problem if it occurs it gives me confidence that he will be able to do that in the future and that my business is well placed.

However, if something goes wrong and the supplier is either apathetic or worse still lies to me or tries to evade responsibility, I think that it's entirely reasonable to expect and insist that they resolve the issue or refund my money with compensation. Obviously one has to include a factor of reasonableness in terms of what can be expected for the price paid - however, I always factor those issues into the original decision.

All of this relates to normal commercial and consumer transactions, which although important in themselves, are not very significant in the global scheme of things and certainly not in comparison with healthcare, which is the most important purchase that people make - however they do it.

Now.... when I map these principles and philosophies to the way that the NHS operates and my experiences of it, to say that I am a disappointed customer would be a gross understatement.

I think that it would be reasonable to expect that it should deliver on most if not all of the principles of customer service that I outlined above. I have difficulty in finding a single one where it does to any acceptable degree if at all.

I have the ability to fund my own healthcare either through insurance or if necessary out of pocket, so one might ask why I care about it. I could even justifiably complain that I shouldn't need to do this out of already taxed income. Moreover, I could even argue, and on occasions have done, that I should be able to opt myself out of the state system.

However, I would not go so far as to say that people should fend totally for themselves if they are unable to do so. That is not correct and reasonable in a civilised first world country. I would prefer to pay less in taxes but consider it reasonable to contribute towards the healthcare of those genuinely unable to do so for themselves whether it be partially or completely.

I therefore consider myself a customer of the government in terms of its responsibility to fund healthcare for those unable to do so for themselves - I am paying them to do a job, even though it may largely be for the benefit of others.

Successive governments, for half a century have manifestly failed to live up to their responsibilities in this area through the medium of the NHS. If it were possible to fix it, one would think that that would have been done by now. We have seen the effect in the British car industry of what happens when one attempts to maintain the untenable.

If the NHS was actually ever going to work, it would have done so by now. Instead it lives by growing ever larger, increased wastage, worsening standards and spending money on marketing to try to convince its customers that it's doing a good job.

I am angered and at the same time saddened by the whole thing because healthcare does not have to operate in this way, and it is not necessary either to move to a non-state-funded environment.

I would like to see my money being spent properly and see no prospect of that happening all the time that the state remains involved in the delivery of healthcare.

All of this leads me to the inevitable and much considered conclusion, that the only way forward is to close the charade that the NHS has become.