Dalrymple’s July 27th BMJ column recounts his attempt to read Making Sense of the NHS Complaints and Disciplinary Procedures:
It was not a title that normally would have attracted me much, even if, having been published in 1997 (an eternity ago in terms of NHS reorganisation), it were not likely to be already completely obsolete. Moreover, it was written in bullet point prose, and I am afraid even a small number of bullet points causes my mind to glaze over immediately; the effect of 240 such points in the compass of the 111 pages of this book can easily be imagined. As to numbered paragraphs, further subdivided, I have not counted them. A few flow charts completed the anaesthetising effect.The enumerated desiderata of a complaints system were enough to induce a state of suspended animation in my brain: responsiveness, quality enhancement, cost effectiveness, accessibility, impartiality, simplicity, speed, confidentiality, and accountability. One could just hear the droning voice in a stuffy lecture theatre in one’s mind’s ear: blah, blah, blah. The proliferation of this well meaning and high minded cliché provoked a need for subversion, and to escape from the instantaneous boredom I began to imagine the advantages of a system that was unresponsive, expensive, ineffective, slow, complex, incomprehensible, and completely unaccountable.