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Can we trust anybody anymore at the top of this organisation?People retire with big pensions and nobody is taking to task for wrongdoing.Or move on to top jobs.Names have come forward regarding the maternity wards it beggers belief.
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Dead fish rots from the head down.
When those further down the trough feeders pecking order see those who should lead by shining example further their aims and careers by for example dodgy WMD dossiers and Cast Iron Guarantees, then its hardly surprising that the simple truth gets shifted into the ''only if absolutely necessary'' tray.
Tell them what they want to hear is the order of the day.
Principle honour patriotism and integrity seen to be despised traits at the very top, indeed those lacking in such lauded and endorsed by that most precious thing, the vote, we get the leaders and the standards we deserve.
Monkey see monkey do, minions follow suit.
Last edited by: gordonbennet on Fri 21 Jun 13 at 18:23
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Would you protect the job/source of income of a boss who admitted he'd totally screwed up ?
So why be surprised if they hide it when they do?
Reward honesty and that's what you'll get. Punish it and this is what you get.
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>> Reward honesty and that's what you'll get. Punish it and this is what you get.
That's about the size of it.
Put a surprisingly large proportion of normally law abiding folk in a tight enough corner and they will do the most surprising things, especially if they are ambitious types and used to being in control. I learnt that when I worked in a bank in Bradford 40 years ago, and it has come in very handy.
When nearly all the textile firms were struggling, a fraud was uncovered involving 3 firms cross-firing cheques. All were long established, respected family firms with boards full of JPs and aldermen, some of whom went to prison.
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Survival is probably the strongest instinct of all.
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And just how do you decide that the boss has screwed up royally Mark?
Looks like a ball was dropped by their organisation then self-preservation kicks in.
The problem here is not about honesty/dishonesty: it's a management culture that enabled impunity for failure by simple non-disclosure. It's bad management whether a private or public organisation.
The decision to suppress this kind of report, if available at all, should have been made at a level far above the food chain of the CQC - the fact that they felt they could do just that suggest they are not fit for their position.
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>> The decision to suppress this kind of report, if available at all, should have been
>> made at a level far above the food chain of the CQC - the fact
>> that they felt they could do just that suggest they are not fit for their
>> position.
Suspect that Cynthia Bower and her deputy are going to be the fall guys for this. Deservedly so some will say.
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>> Suspect that Cynthia Bower and her deputy are going to be the fall guys for
>> this. Deservedly so some will say.
>>
Hope so...then maybe it will deter some of the other faceless senior bureaucrats who are willing to pocket a large salary and tell a conscientious, but more junior, member of staff to bin an important report... then condescendingly and rudely tell her "watch my lips" etc when she rightly queried it....
When you think they've covered their own dept's failings at the direct expense of people's lives..it's unbelievable...and not even surreptitiously put into motion anything to address the failings???..........Just let it carry on.
Jail time please...and sooner rather than later. Selfish, incompetent *&^%$.
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an interesting read, presuming it's somewhere near the truth, about Cynthia:
tinyurl.com/Guardian-Bower
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She's no different to Sharon Shoesmith....absolutely convinced in herself...not at all able or willing to do the job properly.
Bung it all under the carpet and hope it all goes away...meanwhile people die.
We need a properly working whistleblowers charter...trouble is we've currently got the absolute opposite, anyone wants to whistleblow they're done under 'misconduct in public office'..and if you're not in public office but help facilitate the truth, you are 'conspiring to commit misconduct in public office'.
This is consideraby more troubling than some young lefty needing a 'p' at at demo and having the ache about giving her name and address.
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>>And just how do you decide that the boss has screwed up royally Mark?
I wasn't clear. I was not talking of one particular issue, I was generalising that honesty about mistakes is not appreciated or rewarded so people don't do it.
>>The problem here is not about honesty/dishonesty: it's a management culture that enabled impunity for failure by simple non-disclosure
I intended that to be my point. There are very few evil, disgusting dishonest people running our organisations in any sector or industry. Sadly, we do have many incompetents.
But someone who makes a mistake will never admit it, because that is certain death. Trying to hide a mistake is only possible death.
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>> But someone who makes a mistake will never admit it, because that is certain death.
>> Trying to hide a mistake is only possible death.
It's so obviously counterproductive to allow that situation to exist, that it shouldn't, at least not in terms of mistakes made while acting in good faith. But it seems to be a feature of public office. It woul help if it was always absolutely clear, in the event of a cover up, that the peccant party left without a pay off.
The press have a lot to answer for, but of course we, or at least the general public, lap up their villification of those in what we perceive to be high office, whether they are incompetent, malicious, or neither.
I have always flagged up anything I've been responsible for that looks as if it might go bad, usually at the same time as producing the plan for dealing with it. I have always been backed up for doing that. I used to work for a well known FTSE100 CEO, one of whose mottoes was "good news keeps, bad news doesn't. I want to know when it happens" and I took that to heart.
Last edited by: Manatee on Sat 22 Jun 13 at 18:51
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I think the NHS needs a complete culture change.
In the Submarine world it is drummed into you during your training that if you make a mistake you report it immediately, and you will not be in trouble. Try to cover it up and you will be in the deepest crap you can imagine. The system works and it saves lives.
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If you impose a layer of overpaid office manager types who wouldn't recognise a medical ethic if it bit them in the bum with a mandate to ride roughshod over the entire NHS, which started to happen under Mrs Thatcher and has got worse since, that's what you get: lying incompetents trying to protect their undeserved salaries.
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>> If you impose a layer of overpaid office manager types who wouldn't recognise a medical
>> ethic if it bit them in the bum with a mandate to ride roughshod over
>> the entire NHS, which started to happen under Mrs Thatcher and has got worse since,
>> that's what you get: lying incompetents trying to protect their undeserved salaries.
>>
Couldn't agree more.
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Quite a few politicians have learnt, to their cost, that it's not the malfeasance which does the most damage, but the subsequent cover-up.
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Covering up stuff is not the sole province of the NHS. Its pervasive throughout industry, commerce, finance, government and the civil service. The blame culture has ruled in all of those areas for years,
And yes it DOES apply to the military as well, but in a different way, level and concept.
When was the last person, in any of those above, congratulated and praised for owning up to mistakes or incompetence?
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Look on the positive side - at least women are not under-represented in this field.
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>> When was the last person, in any of those above, congratulated and praised for owning
>> up to mistakes or incompetence?
>>
An incompetent would not get through submarine training, there are many people with a vested interest involved, everyone makes mistakes, even you Zero, it is how you deal with them that makes the difference.
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>> An incompetent would not get through submarine training,
So why do so many UK sub commanders keep hitting things? They have a worse record than I do.
If you think the UK military, at various levels, do not cover things up you are sadly mistaken. And yes, it has cost lives. The military does not entirely consist of the submarine service.
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We make mistakes (GPs, managers, nurses, admin staff) from time-to-time.
Own up, learn from the mistake, reduce the risk of everyone else making a similar mistake in the future whether by making a "Significant Event Analysis" or changing practice procedures.
Fail to understand that you made a mistake at all and re-education/disciplinary action is likely.
Try to cover it up and you can collect your P45.
It's not about congratulating/punishing mistakes, it's about learning from them.
Of course some events constitute gross misconduct in themselves and may lead directly to jail.
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>> So why do so many UK sub commanders keep hitting things? They have a worse
>> record than I do.
>>
I assume you are referring to the Belgrano.
I don't recall any hitting a bus with a submarine.
Armchair experts are so boring.
Last edited by: Old Navy on Sun 23 Jun 13 at 08:48
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>> >> So why do so many UK sub commanders keep hitting things? They have a
>> worse
>> >> record than I do.
>> >>
>>
>> I assume you are referring to the Belgrano.
No I was referring to the Isle of Skye, you would think they they could miss that, I mean its been there long enough, it doesn't move much, but sub commanders keep hitting the damn thing. Oh of course then there was the French sub they hit, despite all that fancy tracking equipment designed to find other submarines,
Submarine commanders have the worse record in the Navy by some margin
>> Armchair experts are so boring.
You seemed to have spent so long locked in a cigar tube you don't seem to recognise the existence of any other from of military. I didn't mention the Submarine service by name in my original comment but you chose to push it. Having done so, on closer scrutiny the sub service really doesn't come out with flying colours. They don't really have a great deal to be proud of in the field of competence. Still you are right, at least they haven't kept their cock ups quiet.
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>> Still you are right, at least they haven't kept their cock ups quiet.
>>
That statement alone puts you firmly in your armchair. :-)
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I thought I was a misanthrope, but then I (sort of) met Zero :-)
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The feeling is of course mutual. I don't have the need to feel superior when I have you as a an example.
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>> I don't have the need to feel superior when I have you as a an example.
Then why say it ;)
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I know silly really, I should never make him aware of it. He might change and then where would I be.
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>>Submarine commanders have the worse record in the Navy by some margin
It can't be easy driving those. No windows as far as I know?
Do they have reversing cameras and parking aids?
Maybe Honda could fit their collision mitigation system.
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>> Do they have reversing cameras and parking aids?
Yes
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I bet they knock a few wing mirrors off.
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>> If you impose a layer of overpaid office manager types who wouldn't recognise a medical
>> ethic if it bit them in the bum with a mandate to ride roughshod over
>> the entire NHS, which started to happen under Mrs Thatcher and has got worse since,
>> that's what you get: lying incompetents trying to protect their undeserved salaries.
Like all good press constructs there's more than a grain of truth in the NHS Manager legend. But let's not forget that trained professional managers were brought in to stop NHS leadership being a theatre for clinicians egos and politicking.
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>> trained professional managers were brought in to stop NHS leadership being a theatre for clinicians egos and politicking.
I don't doubt that managers often make medics' lives easier by dealing with the bureaucratic side of things leaving their hands free, and I note Lygonos's discretion on this specific issue which may be significant.
But there's another side to it, these damn ignorant civilians pushily interposing themselves between the patients and the actual mechanics, in the worst cases interfering with communication and making uphill work for everyone, patients included. Same stuff going on in the other public services (education notably) for the last thirty years.
This isn't a 'press construct' or a 'legend'. It has been going on before our eyes for ages. I have a brother-in-law who used to be a senior jack-of-all-trades manager at a heavyweight private Harley Street clinic. When neo-management arrived people were parachuted in over his head and made his life impossible. He resigned, so I have no idea how things went after that, but I imagine the system cost more and am convinced that it would have worked less well. This crap doesn't only affect the NHS or only affect governmental organizations. It's wall to wall.
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No big organisation is perfect and mistakes will be made.I think it is a difficult time at this moment for the N.H.S.We are all living longer (We hope) and we need more care as we get older.I was on the phone to my sister the other day and there is lots of unrest in the Dutch N.H.S.A similar system to the U.K.Older people are sent home who are long term sick.
Government statement was that family should look after their mother or father which isn't always possible.It all boils down to cost and availability of beds and of course the nursing staff.
Baby's dying in hospital of infections or lack of care is unforgivable.
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If this is true they are well out of order
www.bbc.co.uk/news/health-23021098
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Politicians are involved, I would believe it. Maintaining their place at the trough overrides all.
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The management in the NHS is awful. This is largely because the incentives, measurements, goals, pay, prospects and support are such that nobody experienced, appropriate, competent or with ambition would be tempted.
I worked for Wessex in the 80s and I was briefly involved in London about 4 years ago. No significant change in management competence, worse if anything.
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>> The management in the NHS is awful. This is largely because the incentives, measurements, goals,
>> pay, prospects and support are such that nobody experienced, appropriate, competent or with ambition would
>> be tempted.
I'm not convinced at that.
NHS managers, council senior execs and similar earn vast amounts of money compared to say a Tesco equivalent manager.... but are they truly worth that? Is that really the going market rate or what they've been able to fiddle out of the system.
I believe there is a system that encourages complacency, 'I know best because I'm the manager' and likewise 'do as you are told because I am the manager'.
In the old days senior Doctors were in control, with the support of a secretary or something.
The theory might have been sound to have professional managers oversee purely management issues and leave medical decisions to the doctors/nurses...but...the proof is in the pudding, it has failed miserably. The old system, with no doubt flaws, was much better.
The professionals have been frozen out and the bureaucrats are in control. It's the same virtually everywhere. It's an experiment gone horribly wrong.
When was the last time an NHS cost saving had a tier of management culled?..Oh no, shut another ward....Lost sight of why they're there, perhaps?
Last edited by: Westpig on Sun 23 Jun 13 at 17:35
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Austerity has ripped at the Police but guess which tier remains unscathed with all the perks?
Regionalisation had potential for massive top end savings but all that transpired was some joint working and collaborative agreements with the same structures remaining. Cuts were at the lower end.
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>> This is largely because the incentives, measurements,
>>goals, pay, prospects and support are such that nobody experienced, appropriate,
>> competent or with ambition would be tempted.
>I'm not convinced at that.
One of the points I mentioned was goals. If one of the goals was "Keep wards open and we'll give you a bonus" how many wards do you think would ever get closed?
I mentioned "measurements". If one of the measurements was "Mgmt as a %age of total staff" how many new managers would be recruited?
>>The old system, with no doubt flaws, was much better.
Now you're being silly. It was an awful system. Rubbish service, endless waits, obnoxious matrons, and endless unaddressed malpractice.
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>> One of the points I mentioned was goals. If one of the goals was "Keep
>> wards open and we'll give you a bonus" how many wards do you think would
>> ever get closed?
>>
>> I mentioned "measurements". If one of the measurements was "Mgmt as a %age of total
>> staff" how many new managers would be recruited?
You are absolutely right....and your view matches exactly what I've just come out of.
My point is though, a decent high ranking manager should see through the crap, work out what is trying to be achieved..and achieve it. Not just achieve the goal set if it's flawed or someone has got one element wrong and misjudged it...
...or even politely feed back to those at the top, where they got it wrong...not just go with the flow for an easy life and a bonus.
Bigger picture and all that.
>> >>The old system, with no doubt flaws, was much better.
>>
>> Now you're being silly. It was an awful system. Rubbish service, endless waits, obnoxious matrons,
>> and endless unaddressed malpractice.
At least the obnoxious matron could kick backside and make sure the patient got fed or the sick was cleared up off the floor or prioritise who really needed what.
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>>a decent high ranking manager should see through the crap, work out what is trying to be achieved..and achieve it.
And of course you are correct.
My point though is that a decent high ranking manager won;t take the job if he see's the system designed to stop him.
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>> My point though is that a decent high ranking manager won;t take the job if
>> he see's the system designed to stop him.
I agree with that, and I wouldn't go there for a king's ransom from what I've seen.
I don't agree that the answer is to use measures as targets. The processes in the NHS are far too complex for that prescription to work, and it leads to the sort of unintended consequences we have seen at Stafford and elsewhere.
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>> endless unaddressed malpractice.
Any chapter and verse to back that up FMR?
Waiting times come down have they? Matrons winsome yet?
Ogre matrons were who kept a lot of low-level stuff on the rails, down where it mattered.
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>>Waiting times come down have they?
In my experience, yes. A&E, where I spent a distressing amount of my childhood, was a whole day trip every time. These days one gets seen pretty quickly and is out in a couple of hours.
Waiting times for operations are again, in my experience, significantly shorter than they were in the 60s/70s.
I can think of no factor which I think was better in the 60s/70s than it is now. Again, in my experience. Yours may differ.
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>>Any chapter and verse to back that up FMR?
By the way, yes. My left arm.
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>> yes. My left arm.
Guh... sorry FMR, didn't know you'd been malpractised on. Even so, 'endless unaddressed'? Looks like overstatement.
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>>Even so, 'endless unaddressed'? Looks like overstatement.
Perhaps, personal experience is never a reliable or objective measure.
But I am personally aware of a GP and a Surgeon, both supported by nursing and admin staff, who were dangerous and should not have been practicing in the late 60s and early 70s. And it was of no interest to anybody.
I am sure there is incompetence now, but to me it appears to be less and where it occurs it seems more possible to be heard when raising a stink.
The thing is, the problem is not medical care. It is the management of the infrastructure and staff.
A brilliant Doctor who knows everything there is to know is not necessarily a good manager of Doctors. Anymore than a constable can manage the police, a soldier the army or a mechanic a garage.
It is a completely different set of skills, although an appreciation of the other task is essential.
It is a matter of deciding what you want the NHS to achieve, and then encouraging and rewarding appropriate behaviours.
Sadly the one person less qualified to run the NHS than an idiot, is an idiot politican - or as is frequent, a wannabe politician in a trust.
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>> It is a completely different set of skills, although an appreciation of the other task is essential.
I thought that was more or less what I was saying: that unprofessional but pushy managers had been applying seriously defective - almost mentally defective - systems imposed from on high.
Obviously someone has to take care of management at different levels in the NHS. I dunno, perhaps my own experience has skewed my attitude to these people, but like those on high they very often seem to be coarse and out of sympathy with what I think of as brisk medical ethics.
The NHS has stood me in good stead from the time it first appeared until now, once or twice saving my life or doing the necessary in admirably short order. Doubtless managers played a part in that.
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>> A brilliant Doctor who knows everything there is to know is not necessarily a good
>> manager of Doctors. Anymore than a constable can manage the police, a soldier the army
>> or a mechanic a garage.
>>
>> It is a completely different set of skills, although an appreciation of the other task
>> is essential.
See, I used to believe that....until I saw it in action.......and I now know the experienced doctor doing the managing is a better system than the experienced manager with no knowledge of doctoring...because...for some unknown reason the managers manage without due regard for the need to doctor, they seem to lose sight of the real reason for being there.
So even if inefficient, the doctor can make the system work so that the medical side gets priority. The manager makes the system work so that the forms and tick boxes and systems get priority.
I've seen it time and time again in a policing environment. If you bluntly tell them "what are we really here for" you get looked at as if you're mad.
In my old environment, whenever a tricky decision was needed a police manager could and would make it (well not all, but most/many). A civilian manager would tend to have a meeting about it..and another and another...sweeping statement I know and unfair to some, but it IS a big problem.
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>>>In my old environment, whenever a tricky decision was needed a police manager could and would make it (well not all, but most/many). A civilian manager would tend to have a meeting about it..and another and another...sweeping statement I know and unfair to some, but it IS a big problem.<<<
So who was responsible for selecting the senior civilian managers? Was it senior policemen or other civillian managers?
I guess it was was a senior policman in the first instance, since the force did not have civilians at the outset.
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>> So who was responsible for selecting the senior civilian managers? Was it senior policemen or
>> other civillian managers?
>>
>> I guess it was was a senior policman in the first instance, since the force
>> did not have civilians at the outset.
>>
I didn't mix in those circles, but I'd hazard a guess it became Govt policy, the Home Office decreed it...and it was then as you say.
It's now such an accepted practice, it's too late. The lid is off the genii's bottle.
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So the problem is not the concept of civilian managers, but the competence?
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>> So the problem is not the concept of civilian managers, but the competence?
>>
Difficult to say. Why do seemingly intelligent, normal people allow themselves to be distracted from the bigger picture and only concentrate on the issue that directly affects them?
The civilian colleagues I worked with weren't generally stupid or unfit for purpose or necessarily round pegs in a square hole...they just didn't see it through the same set of eyes as an emergency service employee did.
I have no doubt an army officer trying to get stores to go off to war...or a nursing matron trying to organise staff for the weekend.....or fire officer trying to whatever will have the same issues....there isn't the 'can do' attitude, the 'got to be done at all costs' attitude, it just isn't there....and never will be.
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>> >> So the problem is not the concept of civilian managers, but the competence?
>> >>
>> Difficult to say. Why do seemingly intelligent, normal people allow themselves to be distracted from
>> the bigger picture and only concentrate on the issue that directly affects them?
there isn't the 'can do' attitude, the 'got to be
>> done at all costs' attitude, it just isn't there....and never will be.
>>
I think that's a little harsh, it can be there in similar circumstances but perhaps not at the same level or overall the same numbers that have that attitude. But it's not my experience that can never be there, but I agree it's a general trend.
I would suggest that it might because there isn't the same level of experience that in turn doesn't allow them to have a sense of purpose. Not their fault at all, just the system and their role doesn't allow for them to have that motivation that brings about a different mindset. They only look at that one single because that's all their motivated to do and told to do in my experience.
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>> there isn't the 'can do' attitude, the 'got to be
>> done at all costs' attitude, it just isn't there....and never will be.
>>
If they haven't done it, they just don't get the concept, do they.
Last edited by: Old Navy on Mon 24 Jun 13 at 14:16
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But the interesting parallel in the NHS is 'that the NHS is better run than it ever was' (or WTE), coming from our resident health professional.
So why is it that her NHS has made improvements but not the police?
The 'got to be done at all costs' attitude is not relevant in this time of austerity. Maybe it is that attitude for 20? years which has got us to where we now?
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>> The 'got to be done at all costs' attitude is not relevant in this time
>> of austerity. Maybe it is that attitude for 20? years which has got us to
>> where we now?
>>
That's where prioritising comes in, not everything has to be "at all costs". Just hope for an emergency service or military standard of response when you are in dire (life threatening) need and don't get someone driven by profit.
Last edited by: Old Navy on Mon 24 Jun 13 at 14:22
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>> So why is it that her NHS has made improvements but not the police?
The biggest improvements are where changes have been made based on evidence, rather than anecdote or politcal dogma.
Useless operations and drugs have gone by the wayside so problems are dealt with more promptly, or treatments prone to cause more problems (like varicose vein surgery) are largely not done.
Expensive medicines that are no better than cheaper alternatives now take the back seat.
Basically there are more guidelines to good medical practice based upon studies and science rather than the halcyon days of medical practice often being made up on the spot with "it stands to reason" levels of understanding.
Where the pressure has arisen over the past 4 or 5 years is now down to the focus on 'value for money' being (mis)interpretted as 'efficiency savings.'
To make 2-3% efficiency savings every year in a system where the bulk of the cost is in man-hours (now that prescribing costs are more streamlined) means less time per patient per doctor, or using staff who are cheaper than doctors.
As anyone who works in management knows, saving pennies by cutting costs can run the risk of more fire-fighting which can wipe out savings and destroy the service that is offered.
Returning to the initial point: how many big politically driven changes are evidence based? How many are pilotted, then the pilots studied and reported independently, then run out over a wider area? And how many are simply dictated from the top and expected to be sorted out by civil servants, managers and staff at the sharp end?
eg. Poll tax started in Scotland a year before the rest of the UK - it was very unpopular and a logistical nightmare to collect - should have been aborted then after review, but Maggie and her chums knew better and we know how that turned out (I always wondered if it was an exercise in gerrymandering as those who left voters' roles would be unlikely to be Con voters...)
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>> largely because the incentives, measurements, goals, pay, prospects and support are such that nobody experienced, appropriate, competent or with ambition would be tempted.
Pay and incentives look better than anything I've ever seen FMR, although they may pale into insignificance compared to what people in industry and commerce expect. But you seem to be suggesting that by paying office managers more you will get a more ambitious, cut-throat sort of office manager. Is this really what the NHS needs?
Looks to me as if the entire set of structures at the top of the NHS has been scrambled and tinkered into puddingy uselessness by those on high. Same pointless messing around at lower levels, care trusts and the way GP practices are run now. The costs are astronomical, and the interface between patient and medical services often makes me pretty gloomy.
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The NHS is run better than it ever was.
It's still far from great however.
NoFM2R is correct that it is the system that is the bigest problem.
Ultimately the NHS could probably spend twice what it does on very expensive care (probably for very little real benefit on a population level, but for a few individuals it could make a big difference to their eyesight or cancer care).
The demands are rising - aging population but no extra years of good health = more patient/years of ill health to attend.
Government who are the purseholders will NEVER suggest healthcare is to be rationed and expect Trusts to try to balance the books while still being seen to offer whatever is needed, whenever it is needed.
Add this to expensive mortgages through the past 15 years, I mean PFI, to build hospitals too small to cope with demand (find one instance of a sparkly new hospital having more beds thn tthe one it replaced and I'll be impressed).
One good 'flu epidemic and we'll see hospital care be decimated, and GPs be expected to try to look after seriously ill people in their homes - the damp squib that was Swine Flu had the upper echelons sharting themselves.
Waiting lists are massively better than 15 years ago - as long as there is a target for that item (eg. A&E waiting, appointments for cancer care, appointments for new joints) but when you look at non-targeted waits such as psychology or rheumatology clinics you'll find diddly has happened.
You get what you pay for - we are paying for an NHS that is run by the government of the day vicariously through Trusts and now Commissioning Boards, while expecting their political dogma to be followed and adhered to, while deflecting failure onto management whose hands are tied by the idiots at the top.
GPs running the health service? Do me a favour. I expect the exodus of talent in England to Canada/Austalia/New Zealand/Scotland (!) to accelerate until there is a crisis in General Practice that will once again require bribes to retain them - or maybe we'll see hordes of East European doctors moving in.
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Text of a speech by Judge who chaired inquiry into 2006 Nimrod crash in Kandahar.
www.judiciary.gov.uk/Resources/JCO/Documents/Speeches/ch-c-speech-piper25-190613.pdf
Lot of parallels with NHS in terms of cultures (can do, failure to respond to criticism) and practice (outsourcing, proliferation of structures, paper safety over real safety etc)
Last edited by: Bromptonaut on Mon 24 Jun 13 at 10:45
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Excellent link, hopefully it won't take something along these lines for the NHS. That incident was a real sea change across the MoD in terms of flight safety, sad it had to come about from such a loss of life.
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A very succinct report. Having some experience of safety cases, he is correct that the most important aspect of safety cases is the presence (or more likely absence!) of the ability to question.
Outsourced safety cases also indicate a box-ticking attitude, and missing the point. An assumption that safety is a separate issue to managing the business, which can hived off to safety wallahs/"human resources" without involving operational staff.
As to the CQC, even the BMA seem to fail to get the point: if not overhauled, the CQC will not learn. In the Stafford enquiry, the issue of motivation of CQC, the large question, was called the "regulatory gap". CQC would not act on individual incidents. They were action averse. They seemed not to grasp that these incidents could be, and were, evidence of a trend that needed scrutiny. tinyurl.com/lwwea7c
It would not take a great deal to cure this, but the solution lies in making investigation, follow-up and enforcement second nature to CQC. Doubt it will happen. Too close to health industry.
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Cover up at the N.H.S. - -
