An official communication about the second reading of the health bill arrives with the cheery headline: “Putting patients and health professionals in the driving seat.”
Putting more than one person in charge of a vehicle is never a great idea.
Crash scene officer: “So who was driving?”
Patients and health professionals: “We all were!”
It may only be a figure of speech, but it exposes one of the real difficulties of the reforms. The driving seat is not a position anyone really wants to occupy, certainly not patients or health workers. In the passenger seat telling the driver where to go or in the back seat instructing him not to go any faster, yes. Driver’s seat, no.
In the generally rather poor Panorama programme, which turned out to be an extended opinion piece rather than the promised investigation, the secretary of state for health swerved the wrong way down a one way street when he compared hospital closures with the decision to close a supermarket.
You wouldn’t take a decision to close a hospital at head office, he said. The programme’s presenter, Gerry Robinson, disagreed. Where else would you take it? Cue crunch of ministerial gears and high-speed reversing manoeuvre.
The problem isn’t so much equating hospitals with branches of Tesco and Asda, though that isn’t wise in itself, but to go on to qualify the remark, as Andrew Lansley did, by insisting that hospitals will only ever close if patients agree to it.
This is only a realistic scenario if you can also imagine the following headlines appearing: “Local anger as hospital kept open”, “MP blasts health chiefs for failure to close much loved institution”.
And here’s another rhetorical fishbone to choke on. There will now be a “duty of candour”, according to the same people who brought us the multi-driver NHS. This is apparently “a contractual requirement on providers to be open and transparent in admitting mistakes”.
“The hospital removed both my legs instead of my appendix, but I was impressed by their candour,“ said a patient.
“It was us all right. Second major cock-up in a week, but at least this one didn’t die,” admitted a hospital spokesperson.
Health service providers already have a duty to own up to their mistakes and a much more important duty to avoid mistakes in the first place. Is anyone seriously proposing that an incompetent provider might mitigate other failures by acts of outstanding candour?
And what about organisations incapable of causing unnecessary harm to patients? No mistakes would make it impossible to demonstrate candour. Contract termination must surely follow.
LGF thanks Moley for the copy =D