Monday, 16 August 2010

Losing it

Well, it didn't last long, did it?
The first flush of goodwill and decent policies, devolving power to the clinicians, no more top down management, etc. But now, just three months into the job Mr Lansley drops his first clanger and shows us what may be his true colours. Fines for hospitals that don't have 100% compliance with single sex accommodation by the end of this year.
Leaving aside this policy was first mooted in 1996 and that successive governments have been promulgating it so that he is jumping on the end of a long bandwagon and claiming it as his own, we are now - at a stroke - back to central control. Never mind that the fines would penalize those least able to afford them; never mind that this would in turn impact on patient care and staff morale. No, we need an ego boost for Mr Lansley and his increasingly shabby looking administration and this makes good headlines.
Don't get me wrong: single sex accommodation is absolutely the right thing for which to strive and I doubt anyone would disagree with him on this. But it doesn't just happen at the click of a finger. It needs the real estate and the staff to man it and neither of these occur overnight. And lastly, it does not need punitive measures from on high.
If a hospital has one ward for a particular speciality it will need two but these need to be built and then there needs to be more nursing staff as the male to female ratio is never exactly 50-50. Doubtless there will be fudges where a screen is built but the rest of the ward remains the same and this will constitute compliance - for in recent years clinicians and managers have become adept at circumventing daft rules by creative accounting - a skill that New Labour leaves as one of its many unwanted legacies but one that the new government seems intent on continuing. And this will be worse than useless for the problem will be perceived by the bean-counters to have been solved whereas it remains, and no further work will be done.
And fines? Words fail me. The internal market redistributing scarce monies doubtless to more middle managers to create more unhelpful rules.
Three months in and he's already losing it. I would say roll on May 2015 but we all know that it makes no difference: they are indeed all exactly the same.