Column
News from nowhere
Tales from a command economy
Once upon a time heroic workers toiled day and night, under floodlights when necessary, to get Soviet harvests in and achieve the targets dictated by their masters. Some of them fell into combine harvesters, which was a shame, and others neglected other important farm work, which in the long run was a disaster.
Fortunately those days are over, except perhaps in the modernising NHS, where NfN moles are reeling under a campaign of initiatives to make the nation healthy. There committees meet frequently to review target achievement, establish task forces to increase the numbers immunised against influenza or enrolled on smoking cessation programmes, and divert money to providing incentives to mobilise NHS staff and increase their efforts. Failure to meet targets threatens the rating of Primary Care Trusts, and ratings determine cash flows from the Department of Health, so future PCT income depends on current successes.
No account is taken of opportunity costs, so lack of maintenance of people, premises and organisations can accumulate largely unchecked, until presumably lack of maintenance itself becomes a suitable subject for targets and campaigns. What is so odd is that a discredited method of organising complex activities is deployed under the title of modernisation. Did someone mention an ‘organisation without a memory?’
Superbugs 1
Deaths from infectious diseases happen every autumn and winter, sadly (but rarely) even among children. This year, however, they have become unacceptable following a spate of media reports. Panicky people living in a ‘risk society’ will now draw their own conclusions about real and present danger to themselves and their children, and seek influenza immunisations for their offspring.
NfN predicts that the first in the queue will be parents who decline MMR immunisation on the grounds of safety. They will not be interested in the following bits of science: 1 immunisation of the whole older population will reduced the death rate by 7 in 1000; 2 most viral illnesses are not due to the influenza virus; 3 we do not know if immunisation of children against influenza will have any impact on illness or death rates.
Superbugs 2
News of the spread of multiply resistant bacteria in hospitals has now hit our TV screens, prompting NHS mandarins to appoint Directors of Infection Control to struggle with the new enemy. What happened to the infection control officers who used to police NHS institutions, checking on autoclaves and sluices and advising on hygiene methods? If they were unable to stop the Superbug menace, why should someone with a bigger title be successful?
Will the new champions of hygiene be able to reverse the speed-up of hospital care that has so dramatically reduced in-patient stays and accelerated patient turn-round on wards? Will they be able to reverse the contracting out of hospital cleaning, and improve standards? NfN doubts it, and so predicts that an even bigger title will be needed to beat the bad bacteria – enter Superbug Tzar.
