{"id":953,"date":"2019-07-31T21:02:30","date_gmt":"2019-07-31T21:02:30","guid":{"rendered":"https:\/\/randomthoughtsltd.com\/?p=953"},"modified":"2024-04-06T16:43:32","modified_gmt":"2024-04-06T16:43:32","slug":"whacking-moles","status":"publish","type":"post","link":"https:\/\/randomthoughtsltd.com\/?p=953","title":{"rendered":"Whacking Moles"},"content":{"rendered":"\n
First published in the NASGP Newsletter in February 2018<\/h5>\n\n\n\n
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Whacking moles may make you feel you are doing something, but it doesn’t solve the problem.<\/h5>\n\n\n\n

Last year the malware WannaCry attacked IT systems worldwide. Microsoft wasn\u2019t making any more money from their hugely successful Windows XP so to encourage sales of a new operating system they had stopped maintaining XP. Some NHS trusts were among the thousands of institutions and companies that suffered. <\/p>\n\n\n\n

A new hospital opens with a fanfare\nand a celebrity. It is smart and up-to-date. Well, up to the date that the\nplans were approved. What does it look like a year later? Ten years later? How\nstained is the concrete on the outside and how scuffed the paintwork on the\ninside? How many of the lifts are out of order today? Are the shrubberies now\nsprouting discarded coffee cups? Is the IT system just limping along? <\/p>\n\n\n\n

And 100 years later? My local hospital does procedures in the cellar of its decaying Victorian buildings. Keeping the ceilings up, the leaks stopped and stairways safe is an expensive and ultimately unwinnable battle. <\/p>\n\n\n\n

Proper maintenance is a long-term\ninvestment. It costs. It\u2019s boring. Perhaps the only sexy maintenance project\never was repainting the Forth Bridge. <\/p>\n\n\n\n

Ignore even modest wear and tear and any system spirals down to dilapidation. By the time people realise it\u2019s seriously affecting their ability to do their job, breaking the vicious circle isn\u2019t easy.<\/p><\/blockquote><\/figure>\n\n\n\n

In health it\u2019s an axiom that\nprevention is better than cure, but we are often poor at applying those\nprinciples to our environment. If molehills appear in your lawn, you whack the\nmole. A satisfying cosmetic fix, but sooner or later the mole pops up again. It\ndoesn\u2019t solve the underlying problem. <\/p>\n\n\n\n

The demands on the NHS have\nincreased relentlessly, but since 2010 funding has flatlined. The government\nhas not maintained the system so this winter the seasonal pressures are even\nworse than usual. Ministers conjure some magical thinking on the Today\nprogramme, dump the responsibility on hapless NHS managers and produce a sop if\nthe problem doesn\u2019t go away. Whacking moles with a feather duster.<\/p>\n\n\n\n

Ignore even modest wear and\ntear and any system spirals down to dilapidation. By the time people realise\nit\u2019s seriously affecting their ability to do their job, breaking the vicious\ncircle isn\u2019t easy. But it can be done. Zero tolerance  calculates that clamping down on\nwindow-breakers and litterbugs will discourage serious crimes. It may not\nfulfill that promise, but people love it and feel safer. <\/p>\n\n\n\n

Facilities managers need the\nauthority to foresee and uncover potential problems. They need adequate funding\nwhich can\u2019t be raided to fund another need. No hospital should be relying on\nsticking plaster to cover deficiencies before the CQC comes round. Maintenance\ncrews aren\u2019t odd-job men; they need manifold skills. And they deserve\nrecognition and our thanks. <\/p>\n\n\n\n

It\u2019s not just hospitals, motorways\nand the Houses of Parliament that suffer from lack of maintenance.<\/strong>\n\u201cNever go to a doctor whose office plants have died\u201d observed American\nhumourist Erma Bombeck. She\u2019s right; first appearances set the\nstage. Locums have little control over neglected poinsettias but they can check\nthat their shoes aren\u2019t scuffed and they can whack a few moles to improve the look\nof the room before they start consulting. <\/p>\n\n\n\n

There are times when\nshort-term thinking is inevitable. Given a terminal diagnosis, who buys new\nshoes? If a building is scheduled to be demolished, the budget for maintenance\nwill have been cut. But then the demolition is postponed, so the sagging\nstructure staggers on, difficult to work in and depressing for everyone who\nuses it. <\/p>\n\n\n\n

We are living in an increasingly throw-away society. Grandmother said A stitch in time saves nine\u201d. But who darns their socks now? Clothing is so cheap that it\u2019s rarely mended, and Christmas-themed jumpers are worn once and thrown out to end up in landfill. And why hang on to last year\u2019s phone? Last decade\u2019s washing machine? Cars? Modern technology has done away with young men in oily overalls who enjoyed spending their time trying to keep aged Austin 7s on the road.<\/p>\n\n\n\n

Few new buildings now meet future needs, because the predictions that underlie their design are almost invariably wrong. And buildings designed to be maintenance-free are hard to repurpose \u2013 think of the Pyramids. If buildings are going to stand the test of time, they need to be flexible. There must be better ways than tacking on Portacabins. Simple buildings are usually more adaptable. They\u2019ll need maintenance, but they can \u2018learn\u2019. <\/p>\n\n\n\n

Homeostasis is a beautifully\nintricate maintenance system, an arrangement of chemical pathways which\npreserves our internal environment. It\u2019s so reliable that we take it for\ngranted. But when something goes wrong the outside maintenance team is called\nin. That\u2019s us. <\/p>\n\n\n\n

So there will still be work for Vishnu, the god of maintenance, and he\u2019ll need to be ever more vigilant. E.M. Forster\u2019s novella The Machine Stops <\/em>was written as science fiction but it could easily become science fact. Undersea cables carry 97% of global communications and so underpin almost every aspect of our lives. How well maintained are they? They are vulnerable to sharks, those in the sea and those occupying seats of government, and if the network goes down, so will we. <\/p>\n\n\n\n

\n
Next post: Sin City: the Redemption<\/a><\/div>\n<\/div>\n\n\n\n
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First published in the NASGP Newsletter in February 2018 Whacking moles may make you feel you are doing something, but it doesn’t solve the problem. Last year the malware WannaCry attacked IT systems worldwide. Microsoft wasn\u2019t making any more money from their hugely successful Windows XP so to encourage sales of a new operating system … <\/p>\n

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