Idiots

A new criminal offence to stop NHS hospitals “fiddling” official figures is to be introduced by ministers in the wake of the Mid Staffordshire scandal, The Daily Telegraph can disclose.

If you stopped trying to manage the service by figures that can be fiddled then no one would bother to try and fiddle them.

Perhaps Taylorism isn\’t quite the management method required for a complex service?

6 thoughts on “Idiots”

  1. I have a whacky idea – how about prosecuting the NHS staff responsible for leaving old people in their care to die of neglect? If you smacked your child in public these days it wouldn’t take Plod long to turn up at your door.

  2. I can kind of see the point in this – in commerce we have to use financial accounts to allocate resources and it’s a criminal offence to falsify them. In the public sphere those kinds of profit and loss statements don’t exist and (incentives being what they are) there is a temptation to fabricate results so as to gain, or at least not to lose, resource allocations. Arguably by falsifying results that are used to make funding decisions you end up with a misallocation that could cause suffering or even death in patients whose resources you have pinched by lying. This is a recognition that Public Choice Economics exist and that public employees are subject to incentives just as much as businessmen.

  3. Surely we have plenty of law at the disposal of the authorities already.(We’ve got far too much law as it is…)

    Misconduct in public office?
    Corporate manslaughter?
    Health and Safety legislation?

    I laughed at the article suggesting NHS trusts will be banned from paying people to shut up. Of course they will. They’ll just be buying houses for people or employing family members instead.

  4. As long as the NHS is a answerable to civil servants and politicians it will put the desires of those civil servants and politicians ahead of the interests of the patient.
    As long as it is a vast organisation it will be impossible for those civil servants, and especially politicians to know what is happening in it.
    The whole idea is rotten- just get rid.

  5. prosecuting the NHS staff responsible for leaving old people in their care to die of neglect

    There is absolutely no doubt that some staff at Mid.Staffs (and elsewhere) are guilty of wilful neglect – and they should be up on a charge. There were also some ghastly & disturbing errors in emergency care (and some extremely dodgy coding). But patients were also suffering because of organisational meltdown and perennial short-staffing. I’ve worked on those kind of wards – struggling, inadequately resourced & reliant upon agency cover (not least due to high staff turnover, and burn-out). In the NuLav era, DOH was repeatedly warned about pressures on hospital care – and they looked the other way.

    It’s why the ConDems need to be very careful about their rhetoric. Using Mid.Staffs as justification for the current reforms is pretty pointless if one is unable to explain exactly how or why the legislation will be improving things (the recent piece by Nick de Bois on Conservative Home is a good example of such vagueness). It’s a grimly amusing irony that CMD is backing David Nicolson…. much to the bafflement of the party faithful. The ConDems are launching upon an utterly muddleheaded reform of the NHS, at what is probably the worst possible moment – they need Nicolson to enforce the damn thing. Why do they need him? Because he helped push through many of the previous shitty reforms. The same reforms, incidentally, which so skewed the priorities at Trusts like Mid. Staffs (e.g. the Holy Grail of Foundation status, part of which depended upon hitting targets).

    Again, if Joe Public’s experience isn’t commensurate with what has been promised, DOH is staring at a complete clusterfcuk. In the meantime, we will have screwed up what the NHS can do well (e.g. co-operation between/across specialties in acute care). Every major A&E in this country is rammed, with hospitals running at 100% capacity – that is only likely to get worse as services are fragmented (not least as “partnered” providers take their cut & pass the buck on complex stuff). I’m not sure Hunt (or the McKinsey trojan horse that is Monitor) really grasps the magnitude of what is coming (save for those who are actively hoping for creative destruction). I mean, he might well have received notions of what it will look like, but that’s PPE for you.

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