Outsourcing public services

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Quenton Fyfe
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Yeah we need to stop that John - people will talk.
Molecular--Bob
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Have Serco made any public organisation that they have been brought in to manage better? I have an interest in this as my wife is a clinical scientist in a Manchester NHS genetics lab and there is a good chance that their management will be handed over to Serco at some point.
Roger Ford
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Quote:G4S agreed in December to provide 10,000 guards for the venues, rather than the 2,000 originally asked for, increasing the value of the contract by almost £200m to £284m. This included £83m to cover labour, and a 12-fold increase in management costs, from £10m to £125m. G4S also secured a 22-fold increase to cover uniforms – from £3m to £65m Well at least we'll have well-dressed security guards at the olympics - at £6,500 per uniform I assume they'll be custom-tailored at Saville Row, with gold buttons and matching platinum cufflinks.
Jonathan Kay
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Quoting Molecular--Bob: Have Serco made any public organisation that they have been brought in to manage better? None of us know. The contracts and the performance data aren't available because they are "commercially confidential" despite being paid from general taxation via the NHS. IMHO That sort of contract should be within the scope of Freedom of Information legislation. If some companies didn't want to contract under those conditions I think we could survive. Jonathan Edited by - Jonathan Kay on 19 Jul 2012 10:24:36
Jonathan Kay
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Quoting jingars: I do fear for GP-led commissioning; I suspect that it may well add to bureaucracy rather than reduce it. Plus, the whole issue of "clinical governance" (which I don't think deserves to be in a bull**** bingo generator) needs to be ensured - and that will require a level of the much-hated "management" to be in place - at either central DH or SHA level. Of course the SHAs go as well. But don't worry: there'll be the new 28 (or 29) local outposts of the National Commissioning Board. "Clinical governance": a term impossible to translate into any other language, including English. Jonathan
Jonathan Kay
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Quoting jingars: As someone who works for a PRIVATE company providing patient facing services to the NHS on both DH central contracts and local PCTs (they are still there for the time being; as are the the SHAs) I clearly have a bias, but I am firmly of the view that the services we provide are at least on a par with the level of care and competency provided by the "pure" NHS. Please could you tell us what you do? Jonathan
jingars
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I work for a company that provides primarily diagnostic imaging (either completely managed and reported or not, depending upon the requirement) to both the NHS and the private sectors, but we also run some audiology and endoscopy services where patient treatment is provided.
Jonathan Kay
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Thanks. In Oxford we use private imaging providers to top up either specific modalities or for extra capacity. Do you do it that way, or provide the whole service? Any experience of doing the interpretation in e.g. India? I teach an MSc module on telemedicine and use the model from the East Coast of the USA where they do that overnight. Jonathan
jingars
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Our NHS contracts specifically prohibit the offshoring of reporting. We have a number of mobile scanning units that can run short or long term "scan and burn" services to cut down waiting times, cover for building work that takes existing kit off line, etc. I am just an IT guy - no clinical training.
Gavin H
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Quoting Jonathan Kay: IMHO That sort of contract should be within the scope of Freedom of Information legislation. If some companies didn't want to contract under those conditions I think we could survive. Jonathan Edited by - Jonathan Kay on 19 Jul 2012 10:24:36 I wouldn't be surprised if the confidentiality was to protect the government from flack. Whilst there is understandable disdain when things go wrong, the accountability is still with the outsourcing department - they are responsible for drawing up an agreement that covers the necessary performance goals, key performance indicators (to ensure a drop of quality below acceptable standard is recognised early enough to be addressed), and suitable punitive clauses to ensure that the provider feels the ramifications if it fails to meet the targets set out. The outsourcing department then needs to take responsibility to monitor performance, and to do something about it when it goes wrong (which it will, from time to time, privately outsourced or still within the public sector). I fear there may be an attitude that, once outsourced, the outsourcing department is not longer accountable - this leads them to take their eye off the ball, and pass blame when issues arise (which is not to say that the service provider does not also deserve some blame, just not all of it). Adequate outsourcing management would go a long way to preventing this - the contracts have to be properly thought through, and then managed, with decisive action when there are failings, implemented by the outsourcer.