Chris Lancelot on…The NHS blame game

Over the past nine years a change in attitude has occurred that is as corrosive and deep-rooted as it is malign. Politicians have begun to believe that the systems they have created are perfect: thus any failures must be the fault of individuals who should be singled out, named and blamed.

Scapegoating individuals for system failures is redolent of Stalin’s Russia, with its oppressive, centralised organisation and its show trials. This same mind-set has now crept into Britain — probably due to the government believing its own spin about the ‘wonderful’ organisations it has created.

The NHS is overspent? It’s not the fault of the system — it’s the doctors: they’re overpaid (all that quality framework money). And they refer too much, so they are both incompetent and lazy. It couldn’t possibly be the excess of managers, the built-in bureaucratic inefficiencies, or its colossally expensive IT programme, now could it?

And, of course, there’s nothing wrong with Connecting for Health’s (CfH) software, according to its head, Richard Granger. It’s the users who can’t follow the instructions. (May I remind him that decent software automatically installs itself properly, is unambiguous and, above all, runs quickly?)

CfH is also perfectly secure, allegedly. So when health workers demonstrated convincingly that its ‘secure’ patient contact details were wide open to anyone with an NHS card but no professional connection with the patient, did CfH thank them for pointing out the loophole? No, they did not. Their first response was a veiled threat to punish those who had used their NHS cards to demonstrate the existence of the problem — followed by a restatement that the whole system was absolutely inviolable.

After Shipman, what did the government do? Recognise that death certification could do with an overhaul? No. It tried to blame the very doctors who had finally exposed Shipman. That’s gratitude. Then it implied that all GPs were potentially incompetent, requiring mass revalidation.

And we all know about flu vaccine deficits, don’t we? There wasn’t enough to go round last year. Who was blamed? GPs — we immunised the wrong people, said the government.

No, there’s nothing wrong with the system: the system is perfect. It’s just us — the stupid people at the sharp end — who make it fail. I really must remember that.

- Dr Lancelot is a GP from Lancashire.

Email him at

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