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Stop Saving the NHS and Start Reinventing it Kindle Edition
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Top customer reviews
With almost religious fervour the politicians and civil servants have performed the age old trick of nursing this organisation to death - doing exactly the wrong things time and time again.
The transformation required takes political honesty and that doest occur in the five year time period of our parliamentary process.
The powerful old blocs of self -interest and the fanatical d-i-y culture need to wake up and read this book.
Well done Colin.
There were good ideas in the book: using the genome to develop personal treatments, using RFID chips to make sure patients are properly identified, the use of expert systems in diagnosis and a "Facebook"-like patient record.
However there are also a few "pie in the sky" ideas, such as robots who look after the elderly, and on social media: "...the greater use of social media opens the possibility of customers managing their own illness. My view is the best person to manage your health is you. Fellow suffers (sic)--or ever the worried well--can lend each other support and can share experiences of what has, and what has not, worked for them." On the one hand, such patient networks are supportive, but from reading "Bad Pharma", patient groups can also be manipulated to promote quack-remedies.
Another dubious idea is to administer Cognitive Behaviour Therapy via computer programmes. Jervis does give evidence that they can work, by asking questions such as "What do you mean by?" "Tell me more about...", so therapists could potentially be replaced by "inexpensive" computer systems. However the efficacy of such systems is more contested than the book suggests (see doi: 10.1186/1471-244X-13-113). Common sense also just tells you that speaking to a human rather than a machine is better for someone with complex pyschological problems in need of CBT.
Jervis sometimes uses ideas that do not really support his conclusions, for example by using "Moore's Law" (that references the continual improvements in microprocessors) to suggest that "standardisation" of "processes" will result in ever increasing benefits. A better comparison would be to Adam Smith's "division of labour" increasing productivity. Moore's Law is not achieved through standardisation, but rather ever rising capital investment costs in R&D into new chips.
What Jervis really means with "standardisation" of "processes" is more private sector involvement, who can pick up these standardised procedures. He says this isn't "cherry picking", but making better use of public money. However the gains through the division of labour could work without private sector involvement, which in part negates efficiency savings by its need to make also make a profit out of NHS patients.
What could have been developed is the need to integrate NHS and social care. The book also demands "vision" without really explaining what that "vision" is. Perhaps there are lessons in the government's gov.uk programme, that parachutes technologically-aware civil servants into departments and instead of "vision" uses the open source model of rapid application development and prototypes to see what works early on.
Colin’s book is a fascinating and easily digestible read and is clearly written by someone who has laboured at the NHS coal face and seen in detail how it operates, particularly with regard to IT. Incidentally Jeremy Hunt, Minister for Health gave an excellent speech at the a/m Health week conference and stated that the only way that the NHS would be affordable in future was through IT. Coin’s recommendations should be gospel for those who wish to try to convert the NHS into an affordable and sustainable entity, able to meet future demands. Even Cuba pays more attention to preventive care than the NHS does, why, because it cannot afford to do anything else. Can we?
The author's ideas on individual pro-active healthcare as well as integrating healthcare systems with software technologies, is refreshing. He mixes his experience with anecdotes and references to science fiction, keeping the tone light and enjoyable throughout.
This book is well written and filled with some truly unique and interesting insights. Anyone interested in what a 21st century health service could and should be like will enjoy reading this book!
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