We all have heroes. I don’t think it’s possible to live a good life and not have people we admire and who inspire us. That doesn’t mean we diminish ourselves. It means we recognise what it is in others that we wish to emulate.
Allyson Pollock is one of my heroes. She’s courageous, analytically brilliant, committed and, perhaps importantly, consistently right. She has an article in the Guardian this morning. In it she argues with regard to the Morecambe Bay NHS scandal and the role of the Care Quality Commission in it:
The CQC is has a legal imperative to get the market up and running by developing the systems to register more than 22,000 health and social care providers. The real story of the CQC scandal is that market-led changes are creating deficits and poor quality of care, which managers must seek to conceal in order to survive. Central to the government’s NHS reforms is the concept of a well-regulated market. Behind the CQC controversy is an assumption that if a commercially run hospital is failing it has simply not been well enough regulated. But experience from the US shows that effective regulation of large healthcare corporations is impossible: we cannot afford it, or get the data necessary to carry it out. That is why the NHS had direct management in the first place.
This is spot on.
And for those managers now complaining about being “hung out to dry” by the CQC and government I have a simple comment to make. If you endorse a market model you also endorse the concept of failure and all that comes with it. You have been described as the failure, rightly or wrongly, but someone was always going to be. It comes with the territory and was the inevitability you endorsed by taking the job. It was wrong. Maybe your treatment is wrong since the failing is systemic and is marketisation. But don’t expect to be saved when you endorse the branding of failure in a public service when in fact that option should not exist because accountability should lie with the minister, and no one else and the only acceptable expectation is success.
The trouble is the CQC was created to permit failure to cut the size of the NHS. The Morecambe scandal, in all its aspects, is what follows.
That’s why we need an NHS. A state run NHS. A democratically accountable NHS. And one without market control or involvement that always presumes failure is an inevitable option.