Stories today, and over the weekend, illustrate how the problems with public sector management undermine attempts to keep hospitals clean and hygienic and control scandalous levels of hospital infection. There is no reason to trust politicians to deliver high quality healthcare. Control needs to be returned to professionals and patients with decentralisation, competition and an end to political management as set out in our report Wasting Lives: A statistical analysis of NHS performance in a European context since 1981 (PDF).
Lack of accountability
In the Byzantine public sector it is rare enough that there is a single organisation and person clearly responsible when things go badly wrong. When that does happen there is often, briefly, accountability to the public. However, it doesn't last as the issue doesn't stay in the public eye for very long. After the breathtaking loss of personal information on millions child benefit claimants the head of HMRC, Paul Gray, did resign. This was hailed as a triumph of accountability. However, he kept getting paid his £200,000 salary and was quickly engaged in a new project advising on, somewhat ironically, "transformational government".
Now it emerges that despite a payoff of half her annual salary Rose Gibb, the NHS Chief Executive who oversaw Britain's worst superbug outbreak with over 90 deaths, is launching a legal claim for even more. Gibb was responsible for shockingly poor management and hygiene conditions at the Trust. Her own leadership style was cited as a significant factor in the Healthcare Commission report (PDF) on the crisis. She should consider herself lucky that she received any payment; a company director responsible for such dire safety standards might face a substantial jail term under corporate manslaughter laws.
Gordon Brown and Alan Johnson haven't spent their careers working in healthcare. They've spent them as politicians. However, healthcare professionals have to, in the end, respond to the politicians' priorities. They're the ones holding the purse strings.
Deep cleaning is a classic example. From the day it was announced experts, including the Lancet medical journal and the companies hired to actually carry out the deep cleans have suggested that could make a minor contribution at best and could prove an expensive gimmick; a poor substitute for good hygiene delivered by effective management.
Sure enough, the critics of the scheme appear to have been proved right. The Mail on Sunday has reported that one hospital has suffered a C. difficile outbreak just days after it was deep cleaned.