Wednesday, June 25, 2008

Citizens To Be Guaranteed Excellence!

How decisions are made in the real world

Excellent news comrades!

The People's Excellence Czar and the Homeland Excellence Commissariat are set to launch the State Excellence Constitution!

For the first time, all citizens will be guaranteed* a constitutional right to excellence.

Excellence in healthcare!

Excellence in education!

Excellence in ethnic diversity targeting!

The Many not the Few!

The Future not the Past!

*State Excellence guarantees are subject to regulation by MiniTruth in accordance with standard terms of business including but not limited to Pretty Straight Guy protocols and the European convention on Democratic Accountability. Your home and family may be at risk.


The new non-enforceable NHS Consitution does sound a particularly vacuous idea, and we'd really like to know how much time and money is being spent on it (it's all too reminiscent of the fad for bleedin' obvious "mission statements" that swept through big companies 15-20 years ago).

So what of the Tories' new NHS plan?

To be frank, we haven't yet read it. But abolishing top-down process targets has to be a good idea. The real question is how the accompanying choice and competition stuff is going to work?

Lansley's been saying patients will choose hospitals on the basis of detailed performance stats, but how will that work exactly? Last night Paxman had lots of fun with him suggesting patients might be zipping around all over the country, with Salford patients choosing to have their elective surgery in Guildford - visions of chaos.

But patient choice is clearly key to improving standards, and the ability to choose Guildford over Salford ought to drive improvement in Salford. So in practice, most patients will never need to travel.

Much more important is the old information problem: how will you as a bog-standard ignorant patient actually choose among hospitals? Lansley mentioned survival rates. So if you need to be treated for, say, bladder cancer, you look up the five year survival rates for patients treated at all the various NHS hospitals (and presumably by all the individual surgeons), and you choose one.

So which one do you choose?

Obviously the one with the best rate - easy.

But what if you can't get in there for 18 months? Feel lucky?

OK, park that - pick the second best. Hmm... 17 months wait.

Right, so down among the real choices - the ones that can do you within 2 weeks - how do you decide?

Well, in the real world you ask your GP. And he says he'll get you in with Mr Singh, just like he would have done without all that other rigmarole. And he says all those stats are a mixed blessing anyway- treating bladder cancer is much more complex than bald survival rates would suggest: patients differ and survival depends on far more than just the skill of the surgeon, etc etc.

In other fields we don't really attempt this kind of thing. Rather than choosing our meat pies on the basis of a load of detailed nutritional stats, we just choose Pukka because we trust the brand. We leave it to them to select the very finest cuts of fillet steak and organic mushrooms to pop inside.

A bit like competing social insurers might work.

Kind of idea.

Must read the paper.

1 comment:

  1. Bạn cần tìm đối tác vận chuyển hàng hóa? Vậy hãy để Proship chúng tôi là đối tác tin cậy của bạn trong việc này nhé.
    Với các dịch vụ chúng tôi đang cung cấp được đông đảo người sử dụng ủng hộ như dịch vụ giao hàng tận nơi, ký gửi hàng hóa, giao hàng nội thành hà nội, giao hàng đi đà nẵng, ship hàng nội thành hcm,...
    Ngoài ra chúng tôi còn hệ thống kho bãi rộng khắp. Khi bạn cần tìm nơi cho thuê kho tphcm hãy liên hệ với chúng tôi nhé. Các chủ kinh doanh shop nếu cần sử dụng dịch vụ giao hàng cho shop online thì chúng tôi cũng sẵn sàng đáp ứng.
    Đặc biệt khi cần gửi hàng đi ra nước ngoài như là vận chuyển hàng hóa đi campuchia. Thì hãy liên hệ với Proship chúng tôi nhé. Đảm bảo đến với chúng tôi sẽ đáp ứng hết các yêu cầu của bạn.