A Healthcare System Suffocated by Bureaucrats

Being American, I had heard nothing of the scandal at Mid-Staffordshire NHS Trust, but a quick search reveals the shocking and disgusting details of as many as 1,200 patients dying unnecessarily in a single hospital due to being left unattended, unfed and ignored. We missed this Dalrymple piece on the scandal in Standpoint, written before the publication of the official report into the matter, and reading it now, two weeks after the report’s publication, it seems he was not pessimistic enough about its conclusions:

What the Francis Enquiry will almost certainly reveal is a combination of the ravening ambition of bureaucratic mediocrities, institutionally perverted incentives that reward those who do worst, the creation of a nomenklatura class at the head of an apparat staffed by bullied, intimidated, fearful but also unscrupulous apparatchiks, intellectual dishonesty with compulsory lying on a vast scale, the proliferation of procedural objectives and bureaucratic tasks completely unrelated either to reality or to the welfare of patients, all combined with a revolting tendency to Pecksniffian self-congratulation and righteousness and an inability or unwillingness to speak or write in plain English.

In fact, the inquiry may or may not have revealed these things – no one can know – but regardless, they were not included in the report, which apparently names no names. In fact, the head of that particular region of the NHS at the time, David Nicholson, CBE (!), is now chief executive of the entire NHS. Perhaps the management style of this former Communist Party member, criticized as “centralised” and “top-down” by even the Guardian (!), though probably inevitable in a government-run health system, explains this Dalrymple anecdote from the piece:

Not long ago I was asked [to] conduct an inquiry into a spate of fatal events among the patients of an NHS Trust, and to determine whether there was a single factor that explained them. There was not; but when I reported to the Medical Director of the trust that while there was no such factor, it was clear to me that his staff were incompetent, unmotivated and completely unaware of what the purpose of their work was other than the filling in of forms (thousands of them, often with contradictory answers to the same questions in them), he replied with an almost Buddhist calm, ‘But that is the standard expected these days.’ He reminded me of a collaborator in an occupied country explaining that there was nothing he could do in the face of overwhelming military force.

5 thoughts on “A Healthcare System Suffocated by Bureaucrats

  1. Andrew S

    I’m particularly interested in this scandal because I live in the area generally known as Mid Staffordshire although, thankfully, another hospital is slightly closer to where I live than Stafford hospital. I look forward to reading this article.

    Reply

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