Mid-Staffs and the call for moral outrage
Dan Paskins (@donpaskini) kindly informs me of this post by Telegraph commentator Dan Hodges on the Francis Inquiry report. Hodges is angry that liberals/the left/the radical left (used interchangeably) have failed to live up to his outrage standards:
And what has been the response to this institutionalised carnage [at Mid-Staffs]? Or more specifically, the response from the radical left, the self appointed guardians of the National Health Service? Nothing but deflection or silence.
On the Green Benches website, which specialises in running daily assaults on the Coalition’s health reforms, Grant Shapps found himself condemned for “playing politics with the Francis Report”. Shapps’ crime? Tweeting “PM pledges NHS compassion ahead of bureaucratic process-driven targets which ended up costing lives”. The last piece about Mid Staffs published by the Left Foot Forward web site claimed that “The government will try and blame the failure of Mid-Staffordshire NHS Trust on the NHS. The public won’t buy it”. The mostly widely read Left-wing blog, Liberal Conspiracy, didn’t mention Mid Staffs at all…………
But where, today, is the liberal outrage? Thousands of people are dead, yet from the Left there is nothing but tumbleweed. When are the tents of the Occupy movement going to start appearing in Staffordshire? When are we going to see nurses hung in effigy?
Hodges has, as Dan suggests, been reading the wrong blogs. On the day the Francis report appeared I wrote on how the only real route to the ‘cultural change’ that Francis demands is through staff (especially nurses) taking responsibility for it themselves, by institutionalising “professional pride”. My key criticism of the report’s recommendations is that, underlying many of them, is the idea that one last managerial push for quality will do the trick, despite ample evidence that the managerialist approach in the NHS, effected to the detriment of professionally autonomous safeguarding of standards, is a key cause of the problems we have today. I’ve written much more elsewhere about how such an aspiration to professional pride might be brought about, including through the revitalisation of Trades Councils.
Hodges is swiftly dismissive of my piece, and he presumbably didn’t bother to click on the link to my New Statesman piece on the Winterbourne scandal, in which I’m clear where responsibility for abuse lies:
All fair enough, but it [a Toynbee article on privatisation of care] still misses the main point: eleven otherwise law-abiding people chose to engage in the sadistic abuse of very vulnerable people. The venture capitalists didn’t make any additional money out of that abuse, and while the CQC might have stopped the abuse before it got going, that doesn’t alter the fact that these eleven people wanted to abuse those in their care.
Taking care homes back under state control, while it may be a good idea for other reasons, won’t ensure that such abuse never happen again. Nor will restructuring the CQC, welcome though that is too as one means of improving care.
What will stop such abuse, I contend, is a socialist approach to public service quality – an approach that starts with the people who deliver those public services, which empowers them to stand up for those they are serving, and makes them want to.
It is Hodges’ prerogative to ignore or misconstrue deliberately what I write of course, so let’s focus on what he’s offering up by way of solution:
If we are to name and shame the bankers, fine. But let’s name and shame the guilty nurses and doctors of Mid Staffs, and the other Killing Trusts too. If we’re up for serious, radical reform of our failing financial sector, fine. But then let’s be equally strident in our calls for reform of an NHS which is just as guilty of systemic failure.
So, having hanged some effigies to make us feel better, we should “call for reform” of the NHS. Mmm, yes, perhaps we could commission a report on how the NHS might be better managed in the future. Perhaps that chap Francis might be able to do it.
In the end, for all its bluster, Hodges’ self-righteous stance on the left’s purported silence is the real “deflection” from the serious state of the NHS. He offers nothing but the opium of moral outrage in exchange for his 15 minutes in the media sun as today’s leftie-bater of choice.
As Chris has set out – people like Hodges are simply not serious analysts (though I’m afraid Francis also falls short). Their reduction of the complex interplay between power, institutions, tradition, culture and individual agency is boiled down to that deeply conservative mixture of moral outrage about how bad people are and the conviction that if we keep an ever closer eye on them, they’ll become better, more autonomous moral souls with the correct ”compassion” level.
I’d advocate a dose of Jeremy Bentham on what effective management does to autonomy and “compassion”, but I’m not sure Hodges is up to it.
The fact that the media institutions employ people like Hodges who write polemic nonsense, and then casually dismiss more coherent attempts to explain and solve, is simply another reflection of how that complex interplay between power, structure and agency often works out badly. So rather than hang an effigy of Hodges for his crimes against sensible analysis, I’ll keep on trying to work up stuff about professional pride in the media, too.