UK government and doctors agree to end “blame culture”
BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7303.9 (Published 07 July 2001) Cite this as: BMJ 2001;323:9All rapid responses
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Sir,
The attempt by the government and the care providers to stop blaming
each other is laudable but it may not achieve much as other stakeholders
in healthcare delivery system have been ignored while striking the deal.
Health care providers, care seeking public, the industry (diagnostic,
therapeutic and insurance), media, consumer/health activists and
governmental machinery are six key players in the health care delivery
system.
Each key player is a vital link in the healthcare delivery chain. If
all of them stand together to achieve the goal of ethical and effective
health care for all, then the system will be strong and functional. If
each player sets his/her own agenda, forgetting the common goal, then the
system will be dysfunctional and weak - as weak as the weakest link.
Some examples of such deviations are:
• Ignorant, corrupt or unethical health care provider
• Non-adherent or deviant care seeker
• Exploitative health care industry
• Biased media that glorifies or vilifies a health care issue
• An activist with a one track mind resulting in a stand off among key
players
• A government that puts profits and convenience before citizens' welfare
The outcome measure is not profit or high technology processes but
quality care based on provider-seeker trust. If the basic trust is
undermined, the health care system will be in jeopardy and every player
will ultimately be a loser. Trust is the glue that keeps the system
together.
One of Bernard Shaw's concluding remarks in his preface to The
doctor's dilemma (1906) is worth noting here: "Of all the antisocial
vested interests, the worst is vested interests in ill-health."
Yours truly,
Dr K.R. Sethuraman. MD, PGDHE.
Founder President - Society of EQUIP
<http://www.geocities.com/equip_india/>
Competing interests: No competing interests
Quality on the Cheap
Not one penny of additional funding has been made available to
bolster the support structures for clinical staff working in the areas of
clinical audit, clinical effectiveness, risk management, and promoting
greater patient involvement. At Sheffield Children's Hospital, the absence
of adequate funding has meant that we have had to put on hold a major
development to improve the quality and comprehensiveness of cross-
disciplinary guidelines.
Also, how can clinical staff spend more time on clinical governance
initiatives when their clinical, training and managerial/administrative
duties are increasing daily?
The private sector invests large sums in quality control and quality
assurance systems. If the government is serious about improving the
quality of clinical care it must deliver the funds to us to enable us to
deliver the quality. You can’t get quality on the cheap.
Competing interests: No competing interests