Monday, 18 April 2011

Heads I win, tails you lose

I just learned today that the head of the Care Quality Commission (the health and social care services regulator) is the former chief executive of West Midlands strategic health authority (SHA) on whose watch the Mid Staffordshire affair occurred.

I suppose you can look at that in two ways, either it is a tacit admission that regulatory authorities cannot be expected to know what is really going on in the organisation they supervise and so bear no culpability for their failings, or, it shows how catastrophic failure is absolutely no bar to career progression for NHS bureaucrats because they take no responsibility for the direct clinical failings of their administrative decisions - heaping all the responsibility onto the front line staff because they can always hide behind the claim that ultimately everything is a 'clinical decision'*.

* I'll reproduce a comment I made on Neuroskeptic's blog:

"I love this quote:

"The Department of Health insists that although Primary Care Trusts can issue guidelines on the amount of drugs GPs prescribe, it is up to the individual GP whether he or she wants to follow them.

"Hazel's Primary Care Trust, NHS Enfield, admits it changed its guidance to GPs in January but insists doctors were not obliged to follow it."

Classic administrator response - they will relentlessly hound the GPs who don't follow their guidance to reduce script length yet when they're called out on the negative consequences of their decision they basically say it is all down to the GP and not their fault.

I'm seeing this behaviour more and more in the NHS - bean counters and other non-clinical staff make decisions that directly affect patient care, usually without any clinical input, and then when the shit hits the fan they blame the clinicians because, after all, they're the ones with clinical responsibility (but no power).

Heads I win, tails you lose." 


blackdog said...

Have you been living in a cellar?

pj said...

I may well have heard it at the time she was appointed but it seemed to make more of an impression on me when I heard it again yesterday.