Centralised bureaucracies work so well, don’t they?

“Little progress” has been made improving patient safety in the NHS over the past 20 years, the top health service watchdog has said.

Serious accidents such as surgery on the wrong part of the body remain commonplace due to an “insidious” culture of defensiveness and blame, the Chief Inspector of Hospitals at the Care Quality Commission (CQC) said.

Professor Ted Baker yesterday revealed he receives between 500 and 600 reports of “never events” a year, incidents that are wholly preventable whatever the circumstances.

This includes an occasion where surgeons operated on the wrong eye of a patient.

He told a safety conference at The King’s Fund that hospital managers routinely hide evidence from the CQC, because they regard the organisation as out to blame them.

8 thoughts on “Centralised bureaucracies work so well, don’t they?”

  1. This kind of behaviour is discussed in The Checklist Manifesto.
    Easy to solve and increases safety and staff morale too.

  2. Looks like the standard line “our thoughts and prayers are with the family” isn’t working any more. Time for a new cynical ‘whatever’ sentence, complete with onion held under the eyes!

  3. Bloke in North Dorset

    He told a safety conference at The King’s Fund that hospital managers routinely hide evidence from the CQC, because they regard the organisation as out to blame them.

    Why isn’t that illegal, or at least gross misconduct and insistent dismissal?

  4. Nobody who fucks up in the NHS starves, loses their pension and, extremely rarely after years of gardening leave, their job. At least in a private system word gets out among gps who they should avoid referring patients to because of incompetence and patients get to choose their gps on a basis of word of mouth and trust.

  5. @Ljh

    If mistakes were regularly punished in that way wouldn’t that make the blame, secrecy and noncooperative culture worse? As far as I understand it the aim is to move to something closer to air crash investigations, where the causal analysis doesn’t stop at “employee did a stoopid” but goes on to consider whether they were adequately trained, overworked, overstressed, given too much responsibility, given too much information input to process, why a safe system of working didn’t prevent the failure (eg following a checklist ought to prevent surgery to the wrong eye).

    I don’t know how successful this approach has been outside air safety, I believe rail accident investigators also use it, not sure to what effect.

  6. “Why isn’t that illegal, or at least gross misconduct and insistent dismissal?”

    We’re talking about an organisation where one of its employees routinely murdered hundreds of patients and nothing whatsoever was done about it (the Gosport Hospital scandal). So the likelihood they’d consider disciplinary action is merited for hiding a few statistics from the CQC inspectors is somewhat akin to finding Elvis hanging out down your local Chippy.

  7. @MBE

    I believe the requested target of book-throwing is the people who hide stuff rather than the original up-cockers.

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