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The blame game, and the people who play it

The Jobbing Doctor is ashamed by the Mid Staffordshire hospitals scandal. Ashamed, and angry.

I have never been as ashamed to work in the National Health Service as I am now. It is now 40 years since I passed what were then called 'A' Levels securing a place in a prestigious university. The rest of my life has been spent studying and working in an organisation I completely believed in.

And now it has come to this.

I suppose it is easy to look backwards with rose-tinted spectacles and enjoy the good days; we have a capacity to blot out the awful moments, but they were certainly there.

Always, however, there were some basic tenets of working in an organisation where you knew that the patients were at the centre of what you did, and the decisions made were always on the basis of patients' clinical need. Not any more, it seems.

I have been leafing through some of the detail that is in the report of the Mid Staffordshire hospitals inquiry. I was aware of a lot of the report before, but it doesn't make easier reading a second time through. How can anyone clinical be at such a low ebb as to accept what was going on with the patients? What were the doctors and nurses doing to put up with such appalling care?

This is what I feel ashamed about, and there is little that I can do, except to comment from the position of a Jobbing Doctor who does not have any links with Staffordshire.

Political response to this report has been entirely predictable, and it boils down to ‘Central Choice, Local Blame'. We have the whole Government propaganda machine bursting into action, and these days that is a fearsome organisation. Their job is to apportion blame, and make sure that it lands at the door of those furthest away from their decisions. Preferably those who are no longer in post.

And so it has proved to be.

I actually feel that we need to look at the reason that this is happening, and why this came to pass: in my view it is political decisions that have enabled this to happen. The ethos and strategy of a whole organisation is set by those who determine the policy. Policy was decided in the Prime Minister's office, promoted by a series of so-called 'special advisers' whose overriding function was a break up of the NHS into manageable and privatisable chunks, and also to the break the power of the professions.

Government wanted to emasculate the doctors and nurses, and they have largely succeeded: They also wanted to embark on the latest and biggest project to enrich big business and to fleece the taxpayer: the break up of the NHS. The list of tools used is too long for a short piece like this.

The law of unforeseen consequences applies here. I don't really believe that ministers and politicians actually wanted to see the events of Staffordshire taking place. But they can't say that they weren't warned. The inevitable end-result of putting the financial imperative first is that managers will ensure profits and financial success by cutting staffing. This happened at Staffordshire. With the ensuing results.

The NHS is a people-rich service. The public need health services in order to see doctors and nurses. When they are sidelined, and their roles are dumbed-down to underqualified people, and decisions are made purely on monetary terms, then events like the fiasco at Staffordshire are inevitable. They will happen again, elsewhere.

It has taken cosy meetings on Number 10's sofa to make me ashamed of my job.

The blame lies there.

Jobbing Doctor