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The claims by the Healthcare Commission that it has raised standards
in the NHS is difficult to contest, partly because it probably has and
partly because we do not have sufficient data to test the claims. But
there are at least two reasons why it has not been a total success.
Firstly, the recent investigations at Stafford and Birmingham
Children's hospitals were into standards at organisations that it had
rated for several years. The 2007/8 ratings for these hospitals do not
suggest that there were serious problems, though quality ratings were not
consistently high over the period 2005-2008. Therefore, it seems that
some aspects of its rating of hospitals do not identify bad performers,
even if others do.
Secondly, the organisation was itself badly managed, with frequent
changes of direction, unexplained to staff; too many departments focused
on inputs not outputs; a willingnes to use sometimes poor quality or
unadjusted data uncritically, on the grounds that it was there; a tendency
for everyone to feel that it was their job to design the next assessement,
leading to endless meetings but no resources for doing the job. In spite
of having a large strategy department, there was a lack of confidence in
direction, leading to frequent use of management consultants. Those used
by DH were popular, probably on the grounds of "Are we thinking what you
are thinking?" Even the transition process has been badly handled, with
confusion over who is staying with CQC and who is going. Success indeed
for the Commission but in some cases at a very high price for individuals
who experienced the frustration of working for it.
Competing interests:
Peter West was head of value for money at the Healthcare Commission, 2005-2008.
The Healthcare Commission for England really does candidly
seem to have done a relatively good job so far.
When I controversially left the NHS over half a decade ago
there was virtually no accountability anywhere in most
English Hospitals and Private Medical Centres.
Although there undoubtedly remains quite a lot of
additional work to be done in terms of Regulation ,
Standardization and Implementation ; I would still
(publicly) like to warmly congratulate the Healthcare
Commission for at least attempting (to try) to do something
at all . . . No Matter How Small !
Competing interests:
Professor Joseph
Chikelue Obi MBBS MPH
FRCAM(Dublin) has
previously harshly
criticized the
Healthcare Commission
during numerous Speaking
Engagements and Posh
Luncheons.
Competing interests:
No competing interests
26 March 2009
Joseph Chikelue Obi
* Leader of Opposition against the General Medical Council (GMC)
Not an unalloyed success
The claims by the Healthcare Commission that it has raised standards
in the NHS is difficult to contest, partly because it probably has and
partly because we do not have sufficient data to test the claims. But
there are at least two reasons why it has not been a total success.
Firstly, the recent investigations at Stafford and Birmingham
Children's hospitals were into standards at organisations that it had
rated for several years. The 2007/8 ratings for these hospitals do not
suggest that there were serious problems, though quality ratings were not
consistently high over the period 2005-2008. Therefore, it seems that
some aspects of its rating of hospitals do not identify bad performers,
even if others do.
Secondly, the organisation was itself badly managed, with frequent
changes of direction, unexplained to staff; too many departments focused
on inputs not outputs; a willingnes to use sometimes poor quality or
unadjusted data uncritically, on the grounds that it was there; a tendency
for everyone to feel that it was their job to design the next assessement,
leading to endless meetings but no resources for doing the job. In spite
of having a large strategy department, there was a lack of confidence in
direction, leading to frequent use of management consultants. Those used
by DH were popular, probably on the grounds of "Are we thinking what you
are thinking?" Even the transition process has been badly handled, with
confusion over who is staying with CQC and who is going. Success indeed
for the Commission but in some cases at a very high price for individuals
who experienced the frustration of working for it.
Competing interests:
Peter West was head of value for money at the Healthcare Commission, 2005-2008.
Competing interests: No competing interests