EBME Forums Forums Management Medical Equipment Management Managed v's In House Service

Yeh! Change. How many times have you heard the phrase "this is the way it's always been done" These are the people who need moving on.

Yes ... but on the other hand, why keep reinventing the wheel? As some may be aware, if I get involved with any kit at all these days, it tends to be what we might call "retro era" stuff ... and I'm constantly amazed how "right" that old stuff was (and is).

In my humble opinion, much of today's kit is brought (booted out?) to market in a tearing rush, and then "developed" during service, at the expense of all concerned (does that ring any bells?).

Many so-called systems are not designed (or so it would seem) as a homogeneous whole at all, but are more likely to be cobbled together from clever circuity devised by wizards in San Diego, bunged into a plastic box in Shenzhen, and then stuck on top a rolling stand in Hemel Hempstead (or wherever). Not to mention technical documentation* (if, indeed, this exists at all) in some sort of weird patois "English". All supported by an office in Chennai, needless to say. Is this really progress?

And I would suggest that it's the same with the management of technical support. Most (if not all) of the problems were solved quite satisfactorily many years ago. The only things that have changed are matters like shorter working hours, "new technology" and stuff like that. That is, the tools may be different, but there remain only so many hours available in the working week.

In our line of work, the other big changes have been:-

1) An explosion in the amount of kit found in hospitals (and, don't forget, out in the "Community") ... but no corresponding increase in resources with which to maintain it all (in other words, having to do more with less).

2) A tendency for the kit itself to be more reliable (but, alas, also less easily repaired when repairs are needed). There is some very clever kit about (some of it needlessly so), but there still remains a fair amount of ... er, crap (even though it is supposed to be "medical").

3) Ever increasing regulation and interference from so-called "management" (who seem to have Gone Forth and Multiplied, as well ... pity, though, that they saw fit to er, Come Back)!

* Technical documentation from circa 25 years ago is definitely of superior quality to that generally found (if at all) today. I have many examples here ... and get great pleasure from reading bits and pieces from them. You can actually learn from those old manuals. On the other hand, some of the modern stuff I have seen has been little more than sales literature.

Geoff, when, as we have throughout this life, visited quite a few sites, you take the 'good' from each site and hopefully implement it at the next site therefore improving as we go. The bad you would hope gets thrown to the bin. Got a technical label from Korea, I will scan it tomorrow and let you see, good for a laugh.

... meanwhile, back at the Thread ...

Perhaps the real question here (as far as government hospitals are concerned) is simply this:-

Is it right that financial profit be made from essential services?

or perhaps the question should be......

Should the tax payer continue to fund the public service if private industry could provide better value?

*note, value includes not only costs but also service standards.

Private Industry? private industry is and always will be about shareholders and making a profit. Services are the main area for cuts when a company goes private.

True but that very fact tends to make them more efficient. This can (sometimes) mean that every bit as good a service can be provided at lower cost than that provided by the public service. Private industry tends to carry lower overheads, fewer managers (or layers of managers) and higher performance expectations of staff.

I think the in-house team should be either given a chance to bid for the contract or given 2 years to meet the terms of the contract before it is offered to a private company

No. But somehow I doubt that would ever be the case. What could be the case is that a contractor may be able to provide service in circumstances (of the type I have already mentioned) where no incumbent is immediately available.

But ... I notice that my question has not yet been answered!

If "In-House Services" do their sums properly, they should always win! In theory at least, they (should) hold all the cards. That is, staff already in place, local knowledge, the support and encouragement of the users (we hope), and access to detailed (and supposedly accurate) costings.

I can recall cases back in the early days of NHS Hospital Trusts where IHS bid ... but I have no information about any who were actually awarded a contract. Hopefully someone will come on here later with more joyous recollections!

For what it's worth (and that's probably not a great deal), my own preferred model would be a "worker's co-operative" made up of in-house biomed staff, non-profit and operating on a so-called zero-budget. How about it, Mark.N of Taunton? Or Bob in Yeovil? Or both?

Hardly the "Sandham Model", then, I should imagine (sorry John).