No more coverup covering up...

The NHS candour question

It’s one of the quirks of the legal and political mind, I think. Unless something is actually outlawed, then it’s okay. So, unless you actually legislate so that hospitals (they’re trusts or something now, rebranded by someone, but still hospitals really) can’t cover up their mistakes, apparently it’s fair game for them to do so. That’s an awful way of looking at things, with lives and medical outcomes at stake.

Old rhyming slang, Jeremy Hunt, has suggested introducing a candour requirement, so that mistakes will not be denied, rather hands will be held up and lessons taken forwards to avoid making the same mistakes again.

I did understand the argument put forward that we need to address a national culture of negativity, blame, and litigation, not just take on the NHS in isolation. That’s absolutely right. Instead of celebrating and learning from successes, there’s a tendency to hold long and adversarial stewards’ inquiries looking to apportion blame. There’s too much focus on “how’d we get here?” and not enough on “where do we go now, and how do we avoid pitching up here again?”

That’s a bigger picture, though, and there’s no reason to resist on those grounds: it comes across like the small child seeing other kids given greater freedom or more relaxed boundaries, “I know it’s wrong, but how come they’re getting away with it and I ‘aint?” Just because other departments, enterprises, companies are covering up like mad (the railways having twenty-seven definitions of ‘late’, twenty-six of which are absolute rubbish designed to avoid criticism, duck making compensation payments, and skew any statistical performance analysis comes to mind) does not mean you should be free to continue doing so.

It’s just occurred to me that should there be the proposal of an absolute candour requirement for Hunt to open up about his dealings with BSkyB when he was Culture Minister, he might not greet that with quite the same enthusiasm he seems to have for the Health Service.

Will the candour model be applied elsewhere? Hillsborough? The police luring striking miners into violent ambushes and misreporting, politicising the industrial action? The expenses claims made by MPs? Their latest practice of cross-paying each other inflated rents using taxpayers’ money?

The thing about a litigious, blame-driven culture, is that it leads to hugely expensive back-covering exercises, which saps time, haemorrhages money, and absolutely kills momentum. I think it’s the basic physics the legal and political mind struggles with. They don’t understand momentum, that every time they grind things to a halt, there’s another massive overhead to pay in terms of overcoming the inertia and getting things moving again. Isn’t the man who knows the letter of the law just another version of the man who knows the price of everything and the value of nothing?

Maybe it’s time to hand control to the scientists, the doctors, the soldiers, the teachers and the engineers. The legals and politicals have been running (ruining?) the gaff for thousands of years now, and we still have starvation, poverty, war and misery on a similar scale to when they started.