HCSA

In the old days the Budget came around once a year. The night before everyone would fill their petrol tanks, stock up on alcohol and tobacco or other such luxury that might be targeted by the Chancellor and prepare for a heavy moan the following day. Now the Budget is like the proverbial London bus; you wait a while and suddenly they all turn up at the same time. We have had two Budgets since March - and in October the spending review will no doubt add further pain to an already reeling public.

A few thoughts hit me when I studied the Chancellor’s statement (albeit belatedly having first watched England hammer the Aussies in the first one day cricket international). Golden rule of management - get your priorities right! The first was that by the time the Budget was delivered no-one would have surely been surprised by what was announced. Either this was mastery of political spin or the product of well engineered ‘leaks’ but either way we had been conditioned to anticipate the worst - and sure enough the worst was, in part, not as bad as we had been led to believe.

But the second, and real worry, was that the Chancellor was at pains to say that upping the retirement age to 66 would be “accelerated” but did not say when (2016 is being discussed in the press) and hinted at major changes to public sector pensions confirming that this would be subject to a “review”. Neither helps those in the NHS (or indeed public servants generally) aged around 50. In fact it creates the very same individual economic instability and uncertainty that created such havoc with the national economy.

But for me (as long as I can afford it) the glass remains half full! I imagine the Doctors and Dentists Review Body and all the other quangos examining public sector pay will be consigned to history. They will not be required for a while and surely fall into the category of the now defunct Treasury’s ‘Euro Preparation Unit’. That should save a bob or two!

The other optimistic development is the Chancellor’s wish to engage the public in proposing cost saving ideas. Now there’s a challenge to readers of Hospital Dr - I reckon the editor should award a prize or two for the leading suggestions. Let me kick off, (hopefully better than our illustrious football team) by asking “Why on earth do we, as taxpayers, pay the winter fuel allowance to UK citizens living and sunning themselves in Europe during the winter months?”

Answers, on a postcard please to Number 11, Downing Street, London SW1.

Read more on the Budget.

I have long been an admirer of art in hospitals. Pictures of Mickey Mouse do remind me of some trust management styles, although the bright spark who commissioned a fountain as the central piece in the urology out-patients department was soon advised that this was not such a good idea.

It is a shame though that the recession has hit investment for art in our hospitals. I saw in the news that a mere £70.3 million would secure a Picasso.

What a small price to pay to adorn a shining, brand spanking new Private Finance Initiative hospital! Alas the days of spend, spend, spend seem a distant memory; although we will continue paying for these developments for many years to come. 

If a business case for a Picasso to be hung in the entrance foyer is unlikely to find its way into the capital budget what might be a suitable alternative? Well most trusts have a rogues’ gallery with photographs of the great and the good who manage the organisation. The thought struck me, what would be cheaper - a Picasso at £70.3 million, or the cost to the taxpayer of covering severance payments to executives whose photograph no longer appears in the frame?

Perhaps a Picasso might actually provide better value for money!