Yossarian Lives

Music is Substance 1987 - New Order

(not quite Joy Division but read this)

All names in the following piece have been changed.

I should stop reading the comments regarding the Israeli/Palestinian 'problem'. It seems that no one wants to stand up and say that both parties need to have there heads knocked together and told to stop it. There are plenty of complexities in the situation and I know if I add my comments on the situation, someone will have a return comment on why I am wrong so I will not bother. This sounds like fence sitting I know but anything that saves the life of one person is worth doing. I am afraid this gets us into net lives lost/saved, which seems a terrible way to determine the success or failure of any plan for peace. It seems to common these days for success to be defined in easily measurable terms like lives saved or hours waiting in casualty but this ignores the complexity of the situations being measured. The terms of measurement should be a general perception that things are getting better though these criteria seem to be more and more defined by the media. I know I rage against the huge amount of money wasted in the health service on management and empty initiatives designed to have a positive affect on the numbers, but the breakthrough will never come while people's idea of casualty is 3 hour waiting time.

I wasn't much of a fan of my sociology lectures at college but there is one phrase that I have always remembered - that problems occur when people begin to see their own role in a system as an end in itself rather than the means to an end. Does the Health Service Manager who decides that all wards should write a mission statement believe that this makes the nurses and doctors who write the statement any better at giving the care they were trained to give? I bet in a lot of cases he or she just sees the goal as being to get every ward to write one and when the last tick is in the box, the job is done. Something as complex as our health service cannot run on boxes ticked. I am sure you are aware that in most cases an illness does not end at a specific moment - break an arm and it heals gradually maybe leaving residual pain for years. Even a simple cold doesn't go away in the night; there is no point when it can be said to be over. There is no bottom line. The running of a system designed to cope with such fuzzy edged concepts needs to be fuzzy itself. Lists, targets, mission statements etc are just an insult to the complexity and judgement of the people responsible for delivery of the basic service. I did read that there is one manager (however that is defined is .. er .. undefined) for every bed in the Health service. There is that old office-wall staple about the loss of a seemingly important person in an organisation, is like removing your arm from a tub of water; the gap is instantly filled. I am sure you have seen cases where a 'manager' is absent from your organisation and things run just as smoothly (sometimes better but that may just be specific cases). I am not saying we don't need managers, but after all, who are responsible for appointing the managers in the first place? Yes! Managers!

I could go into specifics of the ridiculous systems in place in order to facilitate management but they wind me up too much. There is a lot of self-justification going on.