FrontPoint Systems Ltd

More about accountability then & I am warming to my theme, what with well argued comments from a number of commentators.

How can you police the competence of a chronically incompetent organisation where the probability of discovery of any single error is very low? Answer: make the consequence of discovery very high. That way you provide the correct incentive to staff and ministers to be competent. They will multiply the probability by the consequence - knowing that it is unlikely that their mistakes will be unearthed, but that if they are unearthed they cannot expect the press and public to be all sweet reason.

I have to agree with this well reasoned opinion from Daniel Finkelstein as also I do with the following from Simon Jenkins.

Who bears responsibility for the deaths of hundreds of Britons from hospital infections, almost certainly the result of the privatisation of cleaning services? Should it be the Tory health ministers who instituted the policy or Labour ministers who failed to reverse it? When should “responsibility” mean resignation?

All we know is that not a week passes without something going wrong somewhere in the public sector and an almighty row ensuing over “whom to blame”. The reason is that the dinosaur’s head is too far from its foot.

The nearer a school, hospital or police force is to its client the easier it is to identify responsibility and thus allocate blame. In the private sector, blame attaches to whoever makes the mistake. The same applies in properly “tiered” democracies. In most cities abroad, a poorly performing school, a corrupt planning decision or a fiscal scandal is accounted to the elected mayor. If the relevant service is provincial, it is to the governor, if national to the minister. Accountability is clean. The franchise bites at each tier.

In Britain nothing bites but an occasional general election. Nobody down the ladder of public administration accepts blame since performance is dictated by Whitehall. The reason why so many police cars crash is that government offers more money the faster that 999 calls are answered. Hospitals are dirty because ministers want cash diverted to lower waiting times. Yet when these policies go awry, the centre pushes blame back down the line.

After all, if even the FT is arguing for failure to have consequences, you know that a tipping point has been reached.

Continuing with the theme, a local GP has his say in the letters section of the Times.

As a GP representative for 20 years I have never before dealt with such an arrogant hospital management which treated its employees, including consultants, with contempt, some threats and a degree of bullying.

Management styles of the type we have experienced in Maidstone over the past four years should have no place in the NHS. We must never allow any trust in the UK to be run by such a publicly unaccountable and — and in the end — ineffective regime again. Other communities should be on their guard and “whistle-blowers” protected.

Something Bedford might want to consider.

And as for this, I am all for it.

GPs who fail to provide out-of-hours services could be penalised if their patients seek treatment elsewhere, a leaked NHS document suggests.

According to the letter, “recharging” would mean surgeries on the General Medical Services (GMS) contract, which has allowed 90 per cent of doctors to opt out of providing out-of-hours care, would be charged if their patients are seen elsewhere.

Just as soon of course, as the GPs also have control of the various other services that would affect their patients health & precipitate an attendance at A&E. After all, they can’t be held responsible for things that are not totally under their control. And then we could disband the PCT & possibly the SHA which would really be an improvement.

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