Monday 15 February 2010

Snail mail? Fail mail

Although it is a large organisation and everyone is aspiring towards a paperless office the reality is that much paper correspondence still goes on these days. From GP referral letters to clinical queries to cheques that are sent in as payment for one thing or another. It is this latter that has been occupying me this last week although the frequent going astray of post relating to important clinical issues is arguably more important and certainly can have more of a serious consequence for the patient - as always unwittingly caught up in this calamity.
Whilst no paper system is perfect (well, no system of any sort is perfect but that's another matter) the error rate of post going astray is extraordinary. No private sector organisation would tolerate it - it could not sustain such a poor public image. Here, in the shielded environment of the state sector, the onus appears to be on the recipient to ensure his mail arrives and the slovenly internal mail system trundles along in its own inimitable, blundering way with no ability for retribution.
It is one of those instances that makes for, on the face of it, a powerful argument for private sector solutions and in this instance - an entirely non-clinical service - that might be the better solution. But the mistake is to try and recreate that solution across the board. The filthy lucre mars good medical practice - look States-side for proof, if you doubt this. Look at our own Independent Sector Treatment Centres.
The genius of the inception of the NHS in 1948 was to remove the two systems (the money and the care) from each other to the benfit of each side. Now the gap is shrinking to the detriment of both although the politicians try to make us believe that this is all 'progress'.
A system of checks ('performance management' is, I think the jargon) is of course necessary but this depends on good motivation. The simpler the system the more likely it is to work and sadly the middle management that runs thie infra-structure is bloated, out-of-touch and ineffctive. 'Performance management' does not seem to apply to them. Their number has doubled in the last decade yet their output has become more and more impotent.
Were the clinical staff to run the various services that underpin the smooth running of the organisation there would be no room for the slovenliness that loses post as regularly as happens now. It is because they are motivated by a vocation. There is no vocation for management.
'Delivering' services, targets and deadlines are a part of the management-speak culture that pervades the country. That the only things that can really be delivered are the post and the milk does not cross their buzz-word polluted minds. Doubtless there lie in a drawer somewhere voluminous files on the departmental structure of the mailroom and flow-charts outlining the 'process'. Employee appraisals may well figure in this file too and probably countless standing orders and records of staff updates.
But can they deliver my mail? Can they hell.

No comments:

Post a Comment