Sunday, 7 April 2019

It’s a whole lot of anyone’s money, but it’s also a whole lot more!


The peace and quiet of my mindfulness relaxation was shattered last week by the arrival of two fighter jets. Their engine noise filled the sky and I was sure the bench I was sitting on vibrated. I had no idea what type of plane they were (chickens, not fighter planes, are my thing) but up there against a strikingly blue sky, they looked like those planes children make from folded paper. However, I was kind of hoping they came from the F 35 family. After my initial annoyance at their arrival, I became fascinated by the sheer beauty of their aerobatics as they roared around the sky, high above the sea. Their display was graceful, powerful and totally captivating. The pilots flew their planes in what seemed to be purposeful long moves, each plane mirroring the other and doing so with absolute precision. After five or six minutes they roared away, as fast as they had come and soon the quietness of the morning returned.

Now some readers of this blog may find me waxing lyrical about these planes as being slightly strange. But stick with me please. Officially these aircraft are described as stealth multi-role fighters. They are a fifth-generation combat aircraft specifically designed to perform ground-attack and air superiority missions. In other words, they are weapons of war. Interestingly though, despite being around since 2006 the first time an F 35 was used in a combat mission by any country was May 22nd 2018. It was used by the Israeli Air Force, and later that same year, the US used the F 35 to attack a Taliban target in Afghanistan. 

Ten countries are involved in the production of these planes, with the US and UK being the principle development investors. The UK is committed to buying 48 of them, possibly up to 138 in total over the next 20 years. 500 companies in the UK are involved in producing parts for the plane, and there are a lot of them too – some 300,000 parts, and each plane has some 8.3 million lines of computer code that are required to operate them. For every 1 hour of flight time, 10 hours are required for safety inspection and maintenance. The planes are based at RAF Marham in Norfolk, but even if they flew at the speed of light, (and they can travel at 50% faster than the speed of light), it will only have taken the crew just 8,000 seconds, or about 12 minutes to cover the 269km to get to the Fylde Coast;  which is just as well as it costs some £22,000 per hour to fly these planes. Everything about the planes cost a lot of money – they each cost £100m. That’s a lot of anyone’s money.

Likewise, Kings College Hospital NHS FT is expected to record an in-year deficit of between £180m and £191m this year. It is the biggest overspend in NHS history. For several years, the Trust has found it impossible to balance the books and in 2017 the Trust was placed in ’financial special measures’. There are many reasons as to why the Trust is struggling. Many of these will be familiar to readers of this blog; increasing demand for services; workforce shortages and recruitment difficulties (leading to high agency costs); poor operational performance; and an inability to meet savings targets. That said, like the purchase of a F 35 fighter, this deficit is a lot of anyone’s money. 

However, in that peculiar way I have of thinking, it occurred to me that there were many more similarities than just loads of money between the two! Both the RAF and Kings College have an international reputation in their relative fields. Delivering on these reputations is increasingly complex and costly. For example, the RAF had to spend nearly £500m getting RAF Marham ready for the new F 35 fighters.  The first stage of a new Critical Care Unit at Kings cost £100m. The training to become a fighter pilot or a doctor are similar, although the rate of pay differs immensely as both pilots and doctors progress through their careers. In the case of pilots, it’s said the relatively low pay is responsible for the move of many pilots from the RAF into the commercial sector, where they can be paid considerably more money. 

A huge range of skills and knowledge is required in both services to effectively deliver high quality services. Superb teamwork is essential at every level of operation, along with approaches to effective communication that transcend hierarchies and allow for challenge where necessary. Both the RAF and the NHS rely on a huge range of integrated so called ‘back room’ services, often not seen by the public, but critical in enabling ‘front line’ staff to effectively deliver to meet the needs demanded of them. The F 35 fighter is a great example of how both services are embracing new technology to improve operational efficiency and reach. 

I think it’s also interesting that the NHS could learn so much from the RAF in terms of really getting to grips with putting prevention (think health education/promotion) at the forefront of what they do.  I guess it comes from the well-earned experience and knowledge that, should they be called upon to do the business, they can deliver, and deliver to the highest possible standard. Above all, I thought how similar it was, that many of us don’t really think about either the NHS or the RAF until we perhaps need their services. It’s a fact that each of these services costs a lot of anyone’s money, but I for one am glad that we have them both, and it’s something I thought about yesterday as I sat undisturbed on my mindfulness bench.

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