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>I would advance the
case that that is the nature of NHS reform, it always runs away in the
sands
of over-regulation. <
I agree but accountability is actually a bit different. Accountability
should be a process (in the NHS) for ensuring honest and efficient use of
public money. Hobby horse mode ON---efficient use of public money also
requires that the NHS treat its people a bit better so they can work
efficiently---HH mode OFF.
The HUGE scams, cock-ups and such have mostly been due to bad managers and
poor management like the Wessex computer fiasco. It always seems idiotic
to me that those who talk most about accountability (politicians and
managers) are the last people to apply it to themselves. Evidence-based
working dictates that, like Willy Sutton, we (the great British public)
need to look for gross waste and theft "where the money is" ie where
recent history shows the biggest problems are. There may well be a fair bit
of GP fraud--can't say I have noticed much but then over here most of us
are shit-poor compared to the urban area and the mainland----but so far
there has been relatively little evidence produced of it. Whereas there has
been a lot of evidence of political and sen management naughtiness.
So you, I and about 35000 others are submerged in over-regulation and very
obviously trusted less than a junior check-out girl in Tesco's -----does
the Tesco girl have several hundred pages of regulations governing her
work, payment etc? And all done in the name of "accountability." This
behaviour gives accountability a bad name.
<<As for accountability, well, should we not be accountable? >> Yes why
not indeed? GPs are accountable in face to face dealings with patients,
via the informal complaints procedure, via the formal complaints procedure,
via the civil courts, via the criminal courts (fraud, manslaughter, assault
etc) and finally via the GMC.. Have I missed one? There is also the
aforesaid several hundred pages of bumf ---TOS and SFA-- and lurking behind
that the myriad dead trees of the NHS acts. We are drowning in
accountability!
Declan
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