Friday, November 27, 2009

Inspectors On The Non-Job

Labour's huge and incompetent government inspectorates are worse than a waste of money - they are downright dangerous. Take today's scandal:
"Poor standards of care at an accident and emergency unit in one of the country's flagship hospitals may have contributed to the unnecessary deaths of over 400 patients, an official NHS investigation has concluded. Dirty equipment and an absence of leadership contributed to a death rate almost 40 per cent above the national average among emergency admissions to the 770-bed Basildon and Thurrock University Hospitals NHS Foundation Trust, inspectors said.
The unit had blood stains on the floor, dirty curtains, stinking mattresses and soiled equipment; nurses who failed to monitor, feed and give drugs to patients correctly; and a rate of pressure sores almost twice the national average. Instead of the national four-hour maximum waiting time for A&E, the trust was operating a 10-hour waiting time."
That's scandalous enough of course (especially as the description sounds all too reminiscent of various other NHS hospitals we could mention).

But the real scandal of Basildon and Thurrock Hospital is that it's literally just been rated by government inspectors as "Good", with a 13/14 mark for "Safety and cleanliness" (see here). And those inspectors - the Care Quality Commission - are the very same inspectors who've now discovered the hospital is in fact unsafe and filthy.

So WTF is going on?

On BBC R4 Today this morning, Evan Davis attempted to find out from the Commission's head, serial quangocrat Baroness Young (Environment Agency, BBC, etc etc). She made virtually no sense.

First, she said the scores on the Commission's website were out of date, even though the scores relate to 2008-09, ie the recent past. She reckoned they'd only published them because the Secretary of State had a duty to so. Then she said the Commission's inspection methods had changed and that they now involve... er... inspections. Then she said the Commission is brand new and can't be held responsible for the rubbish produced by the previous inspectorate - even though it's been published by the Commission on the Commission's website.

Obvious questions arise. If the scores on the website are useless, why should we punters believe them? What's the point of them? What should we believe? How do we know any hospitals are safe?

But when Davis tried to ask those follow-ups, the Baroness slipped into a kind of gibberish that Tyler cannot report because he simply couldn't follow it (like virtually all members of the modern commissariat, Young is immensely articulate without actually making any sense).

So there we have it - another large government inspectorate churning out screeds of rubbish that is much worse than useless.

And what does the Quality Care Commission cost us?

The Commission is another of Labour's superquangos, established in March 2009 as the amalgamation of three existing quangos - the Healthcare Commission, the Mental Health Act Commission, and the Commission for Social Care Inspection. Summing the 2007-08 spend of those three gives us a total annual spend for the new Commission of £214m (see latest TaxPayers' Alliance quango book). Let's call it £230m for this year.

The combined staff is 2700, which you might consider more than enough. But the Commission clearly wants more, and is currently advertising the following attractive new posts:
  • Head of Learning - £75k pa
  • Head of Culture and Performance - £75k pa
  • Head of Change Management - £75k pa
Amazingly, they are not advertising for a Head of Tying Up Your Own Shoe Laces, but we get the general idea.

We've blogged these hopeless government inspectors many times (eg see here). They have a long and shameful history of rating killer organisations as perfectly safe and fit for purpose - Oftsed rated Haringey Social Services as good at the very moment Baby P was dying under their watch (see here).

Things are so bad, even the chief inspectors no longer have confidence in the ratings. Baroness Young clearly thinks her organisation's ratings are useless, and earlier in the week the head of Ofsted said the same thing about their school ratings.

In Ofsted's case, it turns out that when they rate a school as "satisfactory", what they really mean is that it is failing to provide its pupils with a proper education. Which right now means that a shocking one-in-three state schools is failing.

Ofsted's Annual Report also illustrates another key weakness with these inspectors - they keep changing their minds. So nearly one-in-five schools judged to be good at their previous inspection are now rated as no longer good - ie merely "satisfactory" or inadequate. Who can place any faith in ratings that slide around like that?

So what to do?

First, abolish these massive inspectorates - they have expanded way beyond their original remit of making sure taxpayers' money was not being squandered, and they now do more harm than good (especially to the organisations they terrorise).

Second - yes it's that same old song - put power into the hands of the customers, and let the market decide who's doing a good job and who isn't. School vouchers and competing social health insurers are the only way we can seriously expect to achieve improvement.

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