Saturday, March 04, 2006

I Am Not A Number...

Big Government always prefers "systems" to the messy ill-informed preferences of a million selfish punters.

No surprise then that our health commissars have imposed a new system of allocating junior doctors to hospitals:

"The system, part of a new training regime called Modernising Medical Careers (MMC), uses a form of “computer dating” to match applicants to places, without interviews. It aims to provide a more complete, skill-based training than in the past, with a fairer system for allocating jobs. This is designed to make it easier for young doctors to get “foundation” jobs — their first two years — in places distant from the medical school where they qualified, and remove suspicions that many posts were given on the basis of “jobs for the boys”.

You can imagine how it sounded at the commissars' planning meeting- both more efficient and fairer than that old-fashion haphazard lottery, where, as surely we all know, jobs depended solely on whether Sir Lancelot Spratt approved of your old school tie. Which is presumably how that splendid old timer Doc Crippen got his first post.

The trouble is, of course, the commissars' shiny new system doesn't actually work:

"More than 80 of Britain’s most eminent doctors...say 60 junior doctors recruited under the scheme failed to meet minimum standards of medical competence. Three quarters were trained abroad and more than half could not speak English adequately. Four have already been dismissed while others have had to be retrained at great expense to cash-strapped trusts."

At the same time, many of Britain's own best students are failing to get posts, because "selection is made on the basis of answers to an online form from MMC that puts as much weight on nebulous issues such as ability to work in a team, or leadership qualities, as it does on academic ability".

This shambles sounds very much like one more example of those pc box-ticking exercises that have been imposed on so much of the public sector. You may be sure that underlying it will be some targets for gender balance and ethnic mix. Service delivery is made secondary to hitting some numerical target.

But whatever the underlying intention, MMC is clearly another case of a system that took no account of those that would have to operate it.

Ironically, Boy David Miliband has chosen today to admit that another Big Government system imposed on us punters has been a disaster. That was the 1960s commissariat plan to force everyone into mass produced concrete tower blocks. He says "We lost the human scale with these tower blocks. It became about numbers, not about people."

Er yes, David. But the lesson is not "we commissars will do better next time": the lesson is you commissars should stop forcing your one-size-fits-all "systems" on the rest of us, and trust us to make our own decisions.

PS It was of course, the late great Adam Smith who said: "The man of system is apt to be very wise in his own conceit, and is often so enamoured with the supposed beauty of his own ideal plan of government, that he cannot suffer the smallest deviation from any part of it. He goes on to establish it completely and in all its parts, without any regard either to the great interests or the strong prejudices which may oppose it: he seems to imagine that he can arrange the different members of a great society with as much ease as the hand arranges the different pieces upon a chess-board; he does not consider that the pieces upon the chess-board have no other principle of motion besides that which the hand impresses upon them; but that, in the great chess-board of human society, every single piece has a principle of motion of its own, altogether different from that which the legislature might choose to impress upon it". Who could put it better?

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