More food for thought…

Jonathan Glass is a consultant surgeon at Guy’s Hospital in London. He has just written the following blog for the British Medical Journal. It is called “If surgeons lived Lewis Hamilton’s life”. It is an interesting reflection on the insularity of F1 thinking.

Many of the medical conferences I have attended recently have included sessions suggesting that the NHS is failing in its processes and that there is lots we can learn from industry. Most recently, I have been educated by the aviation industry, the energy industry, and the oil industry — as well as being shown what Formula 1 sport has to teach us. The lecturers were good and the information was interesting, but is it of any benefit to me, as an NHS clinician?

We were shown how the Formula 1 team spend their life practising in order to execute the perfect pit stop: running and re-running the events and scenarios that may crop up in any race, briefing and debriefing with the whole team to learn how the training day went, and running human interactive simulation—all in preparation for a 90 minute race.

What struck me from the presentation was that the costs were huge, human resources were plentiful, time was allocated for all this activity, and the person at the pinnacle and other members of the team were paid handsomely. Furthermore, the chief focus of the team is on providing the perfect working environment for the driver—this from a team which was unlikely to change for the season.

So, considering all this, how much can we really take from each other? To illustrate the difference in our working lives, I’ve conjured up this role reversal: Lewis Hamilton as me and me as Lewis Hamilton.

So, Lewis working in the world I inhabit. Imagine the end of a race. After tearing around the track for about 90 minutes, Lewis would immediately have to write a report of the race and ensure it is scanned into the team computer. He would also have to submit details of the race to a national register, so his race performance can be compared to the performance of others. He would have to input the data himself. He would then talk to his junior colleague, who had just watched the last race, and explain that the junior colleague could start the next race, but if after a certain number of laps it wasn’t going so well, he would take over. They certainly wouldn’t risk a poor outcome, although they recognised that the junior needed to develop his skills. He would be told, before completing all the paperwork associated with the last race (including an assessment of his junior colleague), that the car was on the start line ready to start the next race and he needed to get back to the car immediately.

Incidentally, Lewis might be told that when he has a pit stop in the next race, unfortunately, the team will be agency pit staff who have never seen a tyre change on this car before, but they’ll have a go. Oh, and they may have to change the pit staff if the race goes on too long as some of them are only allocated until 5pm. Lewis would squeeze in a debrief as a further imposition on his day, although no time had been allocated for this when it was introduced as an additional mandatory part of the day. While in the second race, Lewis may get a call over his headphones asking him his opinion about another car in another race.

Meanwhile, I am living the life of Lewis. I have a programme with one operation every two weeks. Immediately after completing the op, I would pour the team some champagne, celebrating our successful execution of the procedure, while spraying the champagne over the anaesthetist and other members of the treatment team. I would then attend the timetabled debrief to look at how the op went. In the next two weeks, prior to the next op, we would run a virtual reality mock-up of the next procedure. The team, who would be the same all year, would practise getting the kit ready for the op again and again until they could do it in 45 seconds consistently. Every effort would be focused on the best possible outcome for the next op, after which the team would fly off to Monaco for a few days rest. We would run simulations of various scenarios that might occur during the op so there are no surprises. Of course, financing the supporting team would be no problem, with everyone getting paid extremely generously.

So you can see why I am not convinced that there is sufficient crossover between the life and financing of a Formula one team, and the life and financing of an NHS department, from which we can extrapolate from one “business” to the other. While both endeavour to deliver a high quality, focused performance I fear that our worlds are far apart. Theirs is a world of glamour, of endless practice, of minimal pressure on time (except at the moment of the race), and with limited intrinsic value. Ours is a world of severe financial pressure, of responsibility to the public (to care for the individual and to ensure best usage of resources for the community), of endless demand, constant criticism, and clear and simple value.

Lectures at medical conferences by industry are entertaining—they allow discussion to flourish and they provoke some thought, but is there a huge amount they can bring to our sphere? Perhaps instead we should start educating industry about how to offer excellence in a context of intense public scrutiny and very limited resource?

51 thoughts on “More food for thought…

    1. We all make choices in life Wilson – it could have worked out badly for Lewis. The biggest risk a doctor makes as a student is failing his or her exams – if they succeed they’re unlikely to be killed routinely doing their job by a freak accident, for example. You know who I’m thinking of.

      1. You are missing the point. The post by the doctor is how those trying to improve the NHS have no idea of the process and restrictions in place.

        The NHS cannot learn from industry as there is no comparison. The doctor is not complaining about their career choice.

        Joe is posting this as it is the off season and somewhat topical (geddit?) to F1

        1. Not really. We’re talking about two different subjects. I wasn’t inferring the surgeon was complaining about his career choice.

  1. The surgeon comes across as very dismissive and a little arrogant (perhaps qualities which make for a good surgeon). For example, the suggestion that after the race the drivers spray a bit of champagne and they are done for the day. Ignoring the press conferences, interviews with the media and hours of debriefing. He makes some good points about how the team has vast resources all focused around a single goal which obviously the NHS can’t do. However, generally there are lessons that could be learned from F1. F1 teams are full of engineers and engineers are natural problem solvers and I’m sure there are things the NHS could learn. Its easy to be dismissive of how other professions work but there are (usually) lessons to learn. For example the adoption of checklist for surgeries and briefings, which I believe they copied from the aviation industry.

  2. Brilliant! While the F1 scenario might be extreme I wonder what relevance the other industries have to the NHS?

  3. I guess that in an ideal world, every doctor would get the support team and would be able to practice / prepare his OP as well as an F1 team prepares to the race.

    Funny enough, instead of saying that it shows how far the worlds are apart, to me it proves how much that should be an example to strive towards in many a field of real life!

    Off course if we did, we couldn’t pay for medical services from our health insurances though (hm, live feed of operations is not going to bring much revenue though). But it shows a really clear way of how to improve quality in the health systems. Much the same could probably be said of education, the justice system or indeed of journalism (with many large media companies cutting down on research staff currently) and certainly the games-business!

    Maybe less so in racing, where the reduction of variables and increase of predictability is far less of a positive :-o.
    So maybe we should just tell the teams that they have a budget limit, a staff limit and just have to cope, like the NHS etc? Then they would not be able to analyse every angle, simulate as many situations up front and we would be back for more interesting racing?

  4. Oh dear. The Public Sector mantra of ‘I am what I spend’. Did not cross the mind of this self proclaimed high value person that the admin system is completely off the pace, that some of the stressful additional activities are not appropriate when delivering high quality services?

    I appreciate much of F1 ‘chat’ is ultimately irrelevant to the automotive industry apart from PR related to entertainment, let alone the greater global commerce activities. But really? We are all irrelevant unless we are surgeons?

    It’s time the NHS faced up to its own issues – and that is not possible via any facet of the Civil Service.

  5. While I can pick all sorts of holes in his analogy – for a start, his analogical equivalent is not Lewis Hamilton but rather the Chief Engineer – I think Mr Glass has a fundamentally valid point here: you can’t just cut and paste the bits you like (the cheap bits!) from someone else’s situation into your own work. Government would do well to remember that!

    While I agree that it is pointless to beat up the NHS and point at organisations in a fundamentally different position and say “why can’t you be more like them?”, I was also reminded of Martin Bromily’s work with surgeons in importing practice from the aircraft industry. One could have correctly objected that surgery is different in from operating aircraft in all sorts of ways, but the transfer of experience seems to be working.

    1. As you say – this surgeon hints at a link to education by or with the aviation industry. The Reith lectures 2014 by Dr Atul Gawande (and interviews since), included reference to the “go/no-go” checklists that pilots use to ensure that nothing is missed before commencing a flight and how the system has been studied and implemented by medical teams who are willing to learn from other industries to try and prevent errors in the operating theatre and other areas of complexity. I am sure this system is used in F1 where people are relying on members of a team to perform correctly without constant direct reference to the other members’ actions. However his “sour grapes” points about briefings and reports rather than champagne showerings misses that F1 drivers often refer to the requirement by their teams for them to de-brief and report on their sessions behind the wheel. Interesting.

  6. He forgot to say there’s only 20-odd doctors talented enough, trained enough and lucky enough in this imaginary world. Ditto his team. The rest don’t get any work or work in burger joints on a minimum wage.

  7. I guess the NHS is more like McDonalds – maybe that would be a better target to share idea’s/best practice with than F1 😉

  8. A very interesting comparison and a great point.
    F1 is extremely technical but exists in its present form because it’s primarily show business and panders to the celebrity culture we now live in.

    Jonathan Glass, like high-end engineers and drivers, has enormous skills and commitment, yet very few people will ever see what he does.

    Maybe a ‘Promoter’ could introduce a TV based Surgeon’s World Championship. There was a series of one-hour programs on Discovery Channel (or similar) in the 90’s called ‘The Operation’ which were very popular with viewers with strong stomachs.

    Eight years ago The Wellcome Collection televised a live 3-hour open-heart operation by leading surgeon Francis Wells on Channel 4.

    Drama indeed.

  9. “….while spraying champagne over the anaesthetist.” I giggled at this line.

    God bless the NHS and all who sail in her.

  10. Sounds like the metaphor needed targeting a little higher in the NHS chain of command. Ideal to that Muppet pulling the puppet-strings from Whitehall.

    Good blog though. And a good perspective check for a few in the sport.

  11. Excellent article, in a nutshell, my take on this, how much emphasis we put on unimportant things (elite/professional sport in general) whereas we give for grated the most important activities.

  12. I think the point is an interesting one, but I also think unnecessarily defensive. I don’t imagine for a second that the introduction to the F1 world is done in the belief that a hospital can run like an F1 team. If that is the belief then the believer should have their head examined.

    I would understand the intention to be one of a shift in perspective. The approach taken by F1 teams (or successful ones) is best liken to the British Cycling’s “marginal gains” or the Japanese “kaizen”. It is a world of relentless improvement and refinement. One of identifying the points that introduce the most friction into their universe and tirelessly working to reduce the friction.

    It would also be naive to think these things don’t happen in the NHS or other civil service institutions, but sometimes a look into the world of others allows for a shift in perspective that helps to break the deadlocks. I don’t think the F1 world, in this regard, is any more insular than the NHS itself.

    I suppose, though, that the value is delivered not in the demonstrating of super quick pit stops, but more in how they came to identify the quickest way of doing it. The methodology used to identify the most important weak points to focus on.

  13. A very interesting and valid point of view……

    There are always lessons to be learned and although I’m sure that some technologies, experiences, processes and working practices may be transferrable between industries, its a long long way from a simple ‘cut and paste’ of what works for me will work for you too.

    Apples and Oranges are simply not the same fruit, not now, not then, not ever. It’s the same with many ‘pairs’ of industries.

    However; Perhaps this surgeon could give Bernie and CVC the benefit of his experience in being able to extract every last valuable organ and drop of blood from a once thriving body that’s now reduced to little more than a hollowed out and desecrated cadaver. On second thoughts, perhaps they already know every trick in the book on this one……It’s bringing the corpse back to life that’s the tricky point, assuming they can even be arsed enough to bother….

  14. A point well made by the consultant surgeon. I have been passionate about F1 since a child, but I agree, Joe, that many in F1 can display a very insular attitude from within those fortress paddock fences with regard to their thinking.

    I also appreciate paddock access must be limited to avoid overcrowding in a working environment, but it saddens me to have often seen so many fans peering through said fences at a very quiet paddock thoroughfare wishing they were allowed even brief access. Part of F1’s business model, I guess, based on exclusivity. The same exclusivity which seems to apply when attempting to obtain a media pass for an F1 meeting.

    Remember the old joke about how an F1 team principal changes a light bulb? He just holds it in place and waits for the world to revolve around him…….

  15. I don’t get it. Lewis drives an F1 car. He’s not a surgeon or in any job where other peoples lives are in his hands. It’s a sport (edit: Entertainment–BE) I wish people would stop whinging about Lewis and his lifestyle. He’s winning on the track so it’s not really effecting his performance. Once he stops winning, then ask the questions, but not now.

    As an example, football is littered with fantastic talents that had too much money too soon and wasted that talent by partying and not working hard on their careers. They disappeared into obscurity because they didn’t focus on where that money was coming from.

    Lewis has just won his third world championship. Does he have a wife? Kids? Responsibility? Is he trashing hotel room? Are you reading about his orgies on the front pages of the sun? No. Then leave him to do what he wants.

    Oh, and I’m the furthest from being a Lewis fan EVER and I don’t think I’ll ever be won over, but he’s got the mentality of work hard, play hard, and he seems to have the balance pretty much spot on.

  16. It’s interesting but this article to me says what’s wrong with the NHS. Everyone else tries to show them how to work better and they just moan about how things currently are. If you’re busy moaning about paperwork that other industries don’t have slowing them down surely there is the opportunity to do something better? But as seems to be the case across the NHS everybody is doing their best and there’s no room for improvement, nothing to be learned and its all the governments fault for not signing blank cheques.

    Maybe there’s no agency staff in F1 because the team bosses know they need to look after their staff, so they don’t get stressed and go off on long term sick. Maybe their processes are designed so that they separate front line personnel from analysis and data gathering. Maybe when someone is identified as not performing in a role in an F1 team they get moved on, rather than having a cosy management job for life and maybe when it comes to cutting costs in their budget Management in F1 teams look beyond their payroll.

    The NHS has plenty to learn from other industries, its just too petulant and stubborn to realise. Unfortunately when the public are always “Behind the NHS”, there’s no motivation to change.

    1. Um, no.

      In a previous career, I worked in hospitals… in the US… in famous wealthy private hospitals… and in most respects, it was pretty much as described above….

      This is not about public sector vs private sector… it’s not about people in any particular outfit being “too petulant and stubborn”…it’s about the values our societies attach to various kinds of human endeavor…

      God bless the people who do that work… after a decade, I couldn’t put up with the BS anymore, so I changed careers… the people who do that work, and who keep doing it despite all the BS, are better people than I am… (honest, no kidding).

      1. I’ve dealt with the NHS enough to know how backwards their thinking is. Buying things at year end and storing them simply to protect a department budget. Having systems demoed that are shown to help massively with data gathering and service delivery and reduce the workloads for frontline staff but baulk at a rather small initial investment despite the obvious huge roi in both monetary and staff well being terms. Catering to a vicious agency nurse industry where agencies can sign up nurses exclusively and name their price because there’s no set guidance or rates for agency staff within the nhs.

        The NHS has fantastic front line staff a lot of who are unfortunately leaving the profession due to the way they are being worked. Unfortunately the people making the poor decisions above them stay put.

        1. Martin, UK, you say “The NHS has fantastic front line staff a lot of who are unfortunately leaving the profession due to the way they are being worked. Unfortunately the people making the poor decisions above them stay put” and that is indeed part of the point made in the article.

          That the people actually doing the work have to perform under high stress, with short deadlines and very limited resources and certainly are expected to deliver quality work at the same time.

          1. But if these doctors at the top who wield some power are reluctant to change, how is anything going to get solved?

            Like the comments about visits from airlines. As I understand it this is training in effective crew management in emergency situations, the aviation industry is lauded for its high standards and effectiveness in this area. Doctors don’t like it because it encourages those around them to question their decisions if they are not confident the right decision is being made and a lot of Doctors don’t like being questioned.

            A captain of an airliner is used to being questioned, handing off tasks to his co-pilot being questioned about whether something is right by someone who may be junior to him but still has plenty of experience and may have even experienced a situation the captain hasn’t. Doctors in most cases seem to hate the idea of that.

    2. Completely agree with you Martin UK. From everything I know about F1 (and Mr Glass’s analogy with Lewis wasn’t appropriate at all) every single member of the industry, from the truck drivers to the team bosses, basically discard any semblance of adhering to ‘normal’ schedules and take however long it takes to get the job done. No clock watching, endless time pressures, looming deadlines (I have no idea where this blogger gets the notion that F1 has ‘minimal time pressures’ – that’s patently absurd) and a culture of excellence, hyper-efficiency and passion above all else, regardless if you’re earning the big bucks or not. And many in F1 are not.

      So I kind of think this blog post is a crock of sh*t really, and backs up all that I’ve known about the public sector’s prevailing mindset ever since I interviewed public sector workers (from councils) for my own company a few years ago, and was genuinely shocked at what they were telling me, how much they complained at how their hours had been extended from 5pm to 5,30pm home time, how they claimed to struggle to get by on months of paid holiday each year, and how they harboured a snippy ‘well it ok for them’ attitudes towards the private sector workers whose taxes paid their salaries.

  17. This was an interesting read, but not what I expected.

    I had thought that the surgeon would turn up late because he’d been partying, then eschew sanitized scrubs for a lamé jacket, making sure everyone knew that although it’s a team operation, HE is the star.

    I hope the surgeon gets his fair share of red carpet events, and has ample time to play around in a recording studio.

  18. I think it is a very interesting article, but I think he lets himself down with the last sentence. The NHS has huge resources, but in 95% of the time it doesn’t have a clue how to deploy them. I work along the NHS and have lots of family members who work in it and the NHS is getting more frustrating to work in. I go to meetings where people are urged to “think outside the box” when the real problem is that no-one is thinking “inside the box”

    For most part the NHS is tribal and insular and won’t accept any criticism from anyone from the outside, so it does have some things in common with some F1 teams!

    There is no doubt that F1 teams could improve the way the NHS operates in terms of how it functions in critical areas. Have a look at the stats of how many limbs and organs are removed by mistake in an operating theatre

  19. No mention of technology transfer? the application of motor racing / top level engineering style PLM software would hugely improve efficiency.

  20. It is interesting that he only caught an idea of somewhat less than half of what an F1 driver has to fit into his time. But no doubt he is too arrogant to consider that his view might be wrong or that the probably is paid (oops I nearly said earns!) considerably more than most drivers on the grid.
    Does he arrive at theatre not knowing if his instruments will work? Does he know that his lowly paid assistants worked all night rebuilding the machines that will be used during the op? Or that one of the machines broke in three different ways at different times and had to be dismantled and reassembled and was only ready seconds before he was to use it? Does he have a limited supply of blood to use during the op or a limited supply of oxygen or of anaesthetic which mean that if he uses them wrongly the op will not be completed and the patient will die.
    His version sounds like Bernie or Flav briefed him.
    Admittedly the NHS seems to think that doctors work best with little or no sleep and gross violation of the EU working hours regulations. I do hope he has the opportunity to experience placing his life in the hands of a junior doctor who has not slept for 3 days; assisted by one staff nurse (who often knows more than the doctor but dare not say) on her double shift and two agency helpers who do not speak English but can tell when to clock off on the dot. One or two other bods may float about but who they are or their function is a mystery, the just seem to chat in different parts of the A&E rooms. There is no uniform standardisation between hospitals and agency staff wear different uniforms any way so there is no telling who or what. The doctor may or may not speak intelligible English, if his three standard tests show no cause the would be patient will be turned out with no means of getting home.
    The almost complete elimination of common sense in medical organisation, coupled with a Luddite attitude to computerisation and a medieval subservience to surgeons will hamper the NHS until Bernie buys it and imposes some systems.
    Think of the opportunities for secret under the table agreements between various parties. Of course none of us would be able to afford to attend.

  21. I’d like to have heard the surgeon’s views on the acceptability of doing second rate operations late in the year because the earlier ones had gone so well…

  22. This “role reversal” stuff has already been thought of. And it’d probably look more like what’s depicted in this here Vodafone commercial:

  23. Be great to get a comment from Gary Hartstein on this one
    I think the comment at the start ,it is a interesting reflection on the insularity of F1 thinking,is so true.Obviously some people here are so enamoured with F1 that any criticism is unacceptable,but come on guys one business is about saving lives the other is entertainment/sport.Any criticism of his blog should be aimed at NHS management not front line staff

  24. Having spent 30 years working in this area, mainly Oil & Gas, but also as a consultant across many engineering and other industries.
    In terms of transferring knowledge the important thing is the management system and the culture driving it. In my career it went under many titles, Safety Management Systems, Loss Control, Health & Safety, Quality Systems. The point being its how you control and do the job, not necessarily the SoP, CoP which implement it.
    Its why the ISO suite of management standards are not industry specific.
    Like any cultural approach the difficulty is that as a change process it has to have a senior ‘champion’ to change peoples way of working and attitude.
    I was involved in the early migration of “Modern Safety Management” from coal mining, to chemical industry to an integrated global O&G. It wasn’t too difficult to sell a moto “Loss Control is Good Business.
    However, in the same way, there are intransigent industries, top to bottom. The culture of we have 150 years experience, we know what we’re doing, despite dreadful avoidable fatal accidents, despite a so called (and several) commitments to culturally change has left one National interest with new names but the same appalling safety and general engineering performance.

  25. A few years ago a British millionaire spent six months investigating how the NHS works for a riveting TV series. There was so much obviously fixable without trouble but, e.g. operating theatres were not being used on Friday afternoons because consultants liked to go off early to play golf (in the case of one hospital he visited, not automatically transferable elsewhere); of two theatres side by side, only one was used at any time because there were not enough qualified theatre staff to man both, etc. He held meetings with staff and management about ideas to improve things and came up against a series of brick walls. With that mentality, no lessons from F1 or elsewhere will help (the usually quoted exception is Great Ormond Street Children’s Hospital applying F1 pitstop organisation from McLaren to moving patients from theatre to recovery room).

    All that said, I personally know consultants who work from 6 am to 9pm, and are on call for 24 hours some days, handling patients in both private and NHS hospitals.

  26. The underlying point here is that despite being brilliant in many ways, F1 is extremely inefficient in terms of how resources are being used. It’s fascinating but completely bonkers that hundreds of million Euros and 500-800 people are required to field two racing-cars in twenty (or so) races. Reality is that it’s getting incredibly difficult to finance this excess.

  27. As someone who has worked for it, and had to deal with it as family of patients, the NHS does a lot with its allocated money, but is far too chaotic, and systems are not fully thought through or logical. The system of overworked junior doctors doing ridiculous hours needs a complete overhaul. Some staff are fantastic, just brilliant, and some staff are very poor. Note to the writer. If you are complaining that your job is not as good as an F1 driver, well yes, join the queue. However, I think many people in motorsports work ridiculous hours too.

  28. Thanks for sharing Joe. I thought it to be an interesting and thought provoking article. I didn’t read sour grapes or arrogance from Jonathon Glass, his comments were well put.

    I am saddened by some of the responses the article generated. I know public service bashing is a welcome theme for some people, disappointing to see it raise it’s ugly head here. Most industries will have areas that could be improved upon, sometimes these aren’t always clearly apparent to those within the particular industries, sometimes we can’t see the forest for the trees. In my experience many public services are provided with limited resources, unrealistic demands, and over the top criticism. I’m not in the UK though so I can’t comment on the NHS. Largely the problems with public service issues are the govts, ministers and senior bureacrats that oversee them, most people are doing their best with what they’ve got the same as the rest of us. I’ve seen numerous public services handed over to private enterprise and watched disaster unfold. For the record I have been an employee of both the public and private sectors, currently self employed.

    I don’t think the doc was attacking or denigrating Lewis in any way, and I’m really surprised to see some people react like that. All looks a bit knee jerk. I often think that if someone gets instantly defensive it can be a pretty good sign they know deep down they are on thin ice. I’ve got nothing against Lewis or any of the other drivers (ok, I don’t like Maldonado in F1) but to compare them to a doctor and claim that the driver has a harder lot in life is just bs. There is no politer way to put it. I would be surprised if Lewis, Seb, or any of them saw it any different.

    Thanks for posting again, and Merry Christmas to you and your family in case I don’t get the chance to say it later. Thanks for a brilliant year of posts, and for continuing to tread where others fear to go.

    Cheers,
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  29. A great article. Except one mistake by the author. “and with limited intrinsic value. ” Intrinsic value is the value derived from the person doing the task because they are interested in the task and enjoy doing it for the sake of doing it. Regardless of the task, it could be marking exam papers, colouring colouring books, painting a room, painting a work of art, cleaning bins, piloting a fighter jet or playing the violin, the actual task is irrelevant, what counts is your engagement with the task. If you are deeply engaged in it you are most likely getting intrinsic value from it.

    If the people doing the F1 tasks are doing those tasks because they believe in them and are deeply engaged in them, then they are intrinsic to the person doing that task (not to anyone else, be they someone else doing that task or person observing – if you aren’t doing the task you don’t get to say what the intrinsic value is). The only way they could be “limited” is if the person isn’t fully engaged in the task and then it would identified motivation or introjected motivation or one of the other forms of motivation.

    Sorry for the nit picking, but if you’ve spent the last year or two reading up on Self Determination Theory mistakes like this shine out at you.

    If the author hadn’t used the word “intrinsic” I could have no beef with this. But he did. And for that part of the article, he is (based on reading Joe’s writing the past few years) deeply mistaken. F1 peeps seem to be deeply engaged with what they do (whether that is a good/bad/other thing is a completely different discussion and would vary from person to person and task to task).

  30. Surely we are missing the point. Isn’t it the role of the NHS to employ as much statistics, administrators and external efficiency consultants as possible to give employment to those that can’t do a meaningful job. We need all of these committees and reports so that we can show how wonderfully we are doing. Heaven forbid that we might actually spend money on treatment. That would be like giving F1 income to the teams and not to CVC. Perish the thought..
    Tongue now partially removed from cheek and best wishes to all for the festive season.

  31. All i can think of is that’s it’s good that Lewis is not a surgeon. With his partyhard lifestyle we would have a greater chance of a fatality every two weeks than in F1.

  32. Good piece, and one I sympathise with. I have spent my working life in Aerospace/highly regulated engineering industries and as an avid follower of F1 and having an appreciation of the effort and dedication which goes into problem solving, I have often tried to approach situations from the same angle…but I cant. Why? Resource and Management philosophy. Mercedes, Ferrari, RBR etc, spend around a million pounds a day working on one product. It is a shared goal with total focus from top to bottom with one very important difference to a commercial operation…spend what you need to to get the job done…win at any cost…literally! Try doing that in almost any other industry! It makes a massive difference. Adam Parr of Williams fame once said that F1 is the only industry in the world which fights cost reduction and insists on spending more. He’s right you know and the bottom line is that money talks. If the NHS had the same approach to resource and spending as F1, first of all there’d be no more illness, but secondly, we’d all be paying about £10K more a year in tax. I agree with the good Doctor, you can’t transfer ideas without the backup of investment.

    One thing I do disagree with however…his comment “Immediately after completing the op, I would pour the team some champagne” . This should have read “during the 90 min op, I push myself to my physical limits, genuinely risk serious injury or my life and understand that I will lose my job very quickly if I don’t get results or if the political winds change direction.

    God bless the NHS and all who sail in her.

  33. F1 racing has loads of money and the crew are well trained and qualified. The problem with most of the NHS is to many managers with little or no qualifications and limited experience. We have NHS consultants getting around a quarter of a million a year yet still taking on private patients on NHS time and services. We need a little respect and find a level of fairness were people are all paid a fair wage.

  34. Here’s why this comparison is invalid:

    1) an operation is not a competitive event, with 19 other doctors all trying to perform the same operation, the winner being the first who successfully completes it without killing the patient
    2) an OR room does not sell tickets and TV rights for millions of fans to view (along with the associated sponsorship that comes with such coverage)

  35. Oh, Joe, do,you ever wish you hadn’t posted what was presumably meant to be a fairly lighthearted post season piece after all these rather animated ongoing responses?

    1. Couldn’t care less. They are designed to incite discussion, which is never a bad thing, except for those who are frightened by it…

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