With these words, we were introduced to the idea of clinical
governance:
“A commitment to deliver high quality care should be at the heart of
everyday
clinical practice. In the past many health professionals have watched as
board
agendas and management meetings have become dominated by financial
issues and activity targets. The government's white paper on the NHS in
England outlines a new style of NHS that will redress this imbalance. For
the
first time, all health organisations will have a statutory duty to seek
quality
improvement through clinical governance.” (1)
I was doubtful about clinical governance, (2) although pleased that
financial
matters were to be thought less important than clinical ones.
In the Guardian of 23 January, secretary of state Patricia Hewitt was
reported
to be demanding that financial management be once again put ahead of
clinical objectives. By 26 January, apparently responding to the earlier
story,
strong financial discipline was to be a “prerequisite” instead of “top
priority”. I
fail to understand the difference.
Chris Ham wrote a recent editorial (3) asking whether private finance
would
really help the NHS. He wrote an earlier editorial, (4) about an earlier
set of
reforms, in which he asked the question that all governments refuse to
ask.
That question is, “What is the purpose of a national health service?”
Until this
question is answered, we will stagger from crisis to crisis, pressure
groups
forcing the government to give in on expensive but dubious therapies,
while
the government imagines that all they need is the next big restructuring
to
get things right.
It didn’t work for clinical governance, and it won’t work for
whatever comes
next. The sort of courage needed to even ask, let alone answer, the
question
does not go with the need for re-election.
1 Scally G, Donaldson LJ. Clinical governance and the drive for
quality
improvement in the new NHS in England. BMJ 1998;317:61-5
Rapid Response:
Clinical Governance, 1998-2006: RIP
With these words, we were introduced to the idea of clinical
governance:
“A commitment to deliver high quality care should be at the heart of
everyday
clinical practice. In the past many health professionals have watched as
board
agendas and management meetings have become dominated by financial
issues and activity targets. The government's white paper on the NHS in
England outlines a new style of NHS that will redress this imbalance. For
the
first time, all health organisations will have a statutory duty to seek
quality
improvement through clinical governance.” (1)
I was doubtful about clinical governance, (2) although pleased that
financial
matters were to be thought less important than clinical ones.
In the Guardian of 23 January, secretary of state Patricia Hewitt was
reported
to be demanding that financial management be once again put ahead of
clinical objectives. By 26 January, apparently responding to the earlier
story,
strong financial discipline was to be a “prerequisite” instead of “top
priority”. I
fail to understand the difference.
Chris Ham wrote a recent editorial (3) asking whether private finance
would
really help the NHS. He wrote an earlier editorial, (4) about an earlier
set of
reforms, in which he asked the question that all governments refuse to
ask.
That question is, “What is the purpose of a national health service?”
Until this
question is answered, we will stagger from crisis to crisis, pressure
groups
forcing the government to give in on expensive but dubious therapies,
while
the government imagines that all they need is the next big restructuring
to
get things right.
It didn’t work for clinical governance, and it won’t work for
whatever comes
next. The sort of courage needed to even ask, let alone answer, the
question
does not go with the need for re-election.
1 Scally G, Donaldson LJ. Clinical governance and the drive for
quality
improvement in the new NHS in England. BMJ 1998;317:61-5
2 Goodman NW. Clinical governance. BMJ 1998; 317: 1725-7.
3 Ham C. Turning around NHS deficits. BMJ 2006;332:131-2
4 Ham C. Where now for the NHS reforms? BMJ 1994;309:351-2.
Competing interests:
None declared
Competing interests: No competing interests