March 9, 2013

The thing that struck me about this article (on A&E failures that led to a fleet of ambulances being out of action) was the prospect of the trust in question being fined for its failures.  How, I wonder, will that help?

So I tweeted the link, and said that in my opinion

Fines are a stupid response to A&E failures – more resources and better management might actually fix them

but I was immediately challenged (I love twitter!) with

Ah.  Well, let’s think about that.

It seems to me that the reported failures in hospital care are down to two main possible causes: bad management and lack of resources.  So if you haven’t got enough money to hire enough staff (so they’re too busy to do all the stuff that needs doing) or to pay them a decent wage (so they’re too stressed or too sleepless from overtime or second jobs to do all the stuff that needs doing), then fining the organisation isn’t going to help.

I mean, obviously you wouldn’t want to GIVE money to failing trusts just FOR failing, because that would encourage people to game the system by failing deliberately.  But equally you don’t want to take money from failing trusts just FOR failing, because sometimes the failure will be caused by LACK of money.

I don’t know how to fix the NHS, but making sure it has the resource it needs, and having some kind of community oversight of the management to keep them on the right track  (like school governors oversee schools) seems to me to have a better chance of fixing it than fines.

As for the banks… well, they’re supposed to be about competition and capitalism, red in tooth and claw.  I’d out-compete the bastards.  Take RBS properly into public ownership and then give it to a quango on the BBC model, with instructions to (a) take deposits from anyone who can prove their identity (and, note, their identity, not their credit-worthiness – unless you’re going to reintroduce the Truck Acts, and don’t get me started on THAT one!)  (b) pay them 5% on the money deposited, which you make by (c) lending to small and medium sized enterprises, and the individuals wanting to buy houses, at a reasonable rate, fixed for the life of the loan.  Competition would suck deposits into the BBC Bank unless the other banks upped their offering accordingly, and a management with pay dependent on doing their actual job (and not on pretending they were in a casino) would make better decisions about lending.

But what do I know?

Um… that something isn’t working, and we ought to try something different?


This post is the fifth of ten posts I intend to write between now and Red Nose day.  I have now reached my £50 fundraising target :a big thank you to everyone who donated (and pre-emptive thanks if you just haven’t got round to it yet)


Note: edited 11/3/13 – corrected category of entry from “uncategorised” to “red nose day” and added item (b) the proposed rate of interest for the “BBC bank”, renaming the lending priority to (c).

One comment

  1. The Right compare Apples and Oranges Again

    I’m not sure how any form of analogy can be drawn between the two scenarios. It is a case of apples and oranges.

    The NHS Trust’s problem was clearly due to a lack of resources. Why? A shortage of cash!


    A fine is not going to achieve anything, a disproportionate one at that when compared to those levied on the banks!

    In relation to the banks, the fines were levied for behaviour that if not criminal ( as a number of commentators have indicated, several are listed below) was verging on criminality.


    The only rational conclusion that can be drawn is that the tweet from Malry was a poor attempt at a “gotcha”. There you go, but what can you expect from someone who plays Englebert Von Smallheusen to Tim Worstall’s “Herr Otto Flick”!

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