Is there no beginning to Ritchie\’s competence?

Really rather glorious argument here.

That means that NHS reform should concentrate as much in ensuring that there really is progress in ensuring front line services get to people at least reasonable cost. So the next reform I have to proposes has this goal in mind.

IT reform in the NHS has concentrated on big data issues, the NHS spine, and such issues. Well, that was the land of Tony Blair fantasy (he who had never touched an email).

OK, centrally planned, imposed, IT reform is really not what we need.

But there’s no central direction in the NHS to demand this.

That’s the price of the absurd policy of local decision-making – it leads to massive local inefficiency as best practice is not shared and has to be re-learned locally, time after time again.

Start a basic IT revolution in the NHS, I say, and do it nationally, now.

Therefore we need centrally planned, imposed, IT reform.

We also have another description of that best practice being shared. The creation of best practice is also known as invention and the spread of it as innovation (see William Baumol for more). And invention can happen in any system, but we know very well that market based systems foster innovation much better than planned systems (Professor Baumol again).

So Ritchie is actually arguing for, central direction and planning of IT, exactly the opposite of what will gain his desired goal, the spread of best practice in IT in the health care system.

Quite remarkable really. Is there no beginning to this man\’s wit, erudition and competence?

9 thoughts on “Is there no beginning to Ritchie\’s competence?”

  1. A minor aside – there’s no such thing as best practice in IT. As with almost everything, it’s horses for courses (which, if you say it quickly, sounds like a statement of obvious biological necessity). A healthy IT ecosystem has lots of people trying lots of different things using their own initiative, thereby creating a fertile soil for evolution, not one in which some consultant imposes a narrow vision from on high.

  2. Dickie seems to think that ‘best practise’ is not shared through the NHS grapevine. It is. They have conferences, newsletters, meetings and whatnot like other enormous organisations do.

    It’s just that what the NHS bureaucrats think is best isn’t necessarily in the interests of saving money and treating people.

  3. Interesting that he is suddenly posting so much about the NHS reforms – doesn’t his wife work for it?

  4. Sorry, under-grad preparing for dissertation time; Which paper of Baumols shows “that market based systems foster innovation much better than planned systems”? That could be really useful.

  5. I’m fascinated that he thinks best practice cannot spread through an industry with strong professional organisations and in the age of the fucking internet, which has helped the spread of information a bit.

    It’s a variation on the old socialist fallacy that market systems are wasteful and inefficient, and thsg it is more efficient of the state behemoth to do everything instead.

  6. well i am amazed that they don’#t use something like expedia to book hospital appointments…but have to write a susystem themselves from scratch

  7. Rob,

    20 years ago, software was very insular to a company. The mainframe supplier gave you the hardware and tools, you went on courses, and the only other source of “best practice” was your boss.

    IT is much more cross-company today. Developers ask questions on Twitter, post blogs and debate ideas.

    In fact, that’s why there aren’t all these macros that Murphy wants. Because we went through all that, and Office macros are about as far from “best practice” in IT as you can get (they have their uses, but are best avoided).

  8. Tim A: So you’re saying that statists are clinging to a mindset that stopped being relevant decades in the past? Say it ain’t so…

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