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  1. #1

    Default Fundamental change in health services?

    This is about the NHS in the UK, and mainly england given that in Scotland and NI health and social services are jointly publically managed in trusts, its a little different but not completely.

    I find this interesting because for the first time ever it is not proposing that further commercialisation, marketisation and business ethos will correct the problems in the NHS which resulted in widespread neglect and even deaths.

    In fact there appears to be many implications that it was precisely these things which caused the problem, that prioritising cost savings, expenses and business strategy rather than patient centred practice caused the problem and that since health service management and regulatory authorities were in agreement on this there was no one highlighting and fighting any corner when problems occured, other than patients themselves, perhaps through litigation.

    I really like the Stafford report from what I've heard of it this morning, there will be news stories on this which I'm going to add to the thread as soon as they become available, the two big things which I think are really interesting are the idea of a legal requirement for a "duty of candor" that there can not be any "sins of omission", that reports, responses, investigations can not simply avoid or become avoidant and remain silent when they know there are problems, the second thing I thought was significant was the idea of a "ineligibility for leadership" bar upon individuals who are found for different reasons to be, well, not good for leadership, I can see how that would be abused for sure but I also believe that there has been a culture for a time of promoting into higher ranks people who perform badly and struggle in the lower, closer to the direct public, ranks.

    He said that personal responsibility than no longer mean "leaving it to someone else" which I really like the sound of because I know of so, so, so many people who are very clever at applying those kind of principles, performing amazing feats of avoidance while the whole time championing that others need to exercise the responsibility, and that it is a good lesson to them, when they are unavailable or unwilling.

    This isnt going to break the back of managerialism, which I think is a curse not on just public services but also private ones, but I'm beginning to think its a start and that this is at least bringing this into the discussion at last as opposed to the old "none thinking" of "market will take care of it".

  2. #2


    This whistle blower thing is pretty important too, in the private sector and in privatised systems anyone acting that way is simply laid off, fired for insubordination. Dont see how privatisation is going to fix that.

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