The Berwick review is a triumph of spin, by a master of the art
The Berwick Review prescribes chicken soup and aspirin where reconstructive surgery and public execution of bureaucrats and politicians is a more appropriate therapy.
Why is it that the entire NHS community has gone nuts over the Berwick Review?
Don Berwick, a former Clinical Professor of Paediatrics and Health Care Policy at Harvard, was appointed in 2010 by President Obama as Administrator of the Centre for Medicare & Medicaid Services, and then appointed by Cleggeron in 2013 to lead a review of patient safety in the NHS. He has just published his review prefaced charmingly, if somewhat naively, by a "Letter to the people of England".
With one accord the health think-tanks, professional associations, industry watchers, scribblers and bleaters have gone into overdrive. Many of them are reporting the review paragraph by paragraph with “live” reaction/learned opinion/professional analysis/popular rhubarb etc. as though they were reporting from an election or possibly a Big Brother Eviction party. A veritable Tweetstorm of bangers-on have created a tsunami of (mostly positive) reaction.
There are three reasons for this obsessive brouhaha.
Firstly, DB says to his NHS audiences (the people of England schtick is just an excuse for a damage limitation exercise of American presidential proportions) “don’t worry, you are not all wicked or even incompetent. You are good people and with good will and more effort you can triumph”.
Well that’s fine as far as it goes.
Secondly, DB is saying that the NHS is a wonderful thing and it can and should be saved. Many people who sincerely want to save the NHS are mightily relieved that Berwick has not said “The NHS? It’s all such a mess you should just bin it!”
So that’s fine too. As far as it goes.
And the third reason that le tout NHS has gone crackers over Berwick is that all those who were lazy and incompetent (and wicked) and careless of other people’s lives and cared more about their own careers than helping sick people (and those who knew all about them and who said nothing while doing less) are now able to look at Berwick and say “Oh…that’s the problem…I see….that’s what’s wrong….well that’s OK, we can fix that”.
But it doesn’t take a Donald Berwick to tell us that it’s wrong to cause suffering and death through a combination of laziness and complete moral vacuity.
And while Don’s review has one or two good suggestions for installing checks and balances that might save patients from suffering in the future, most of it says simply enough “Hey you, carers in the NHS, do better!”
And that’s fine too. But it really doesn't go far enough because among all the fine sentiments and positive spin, the Berwick review will encourage many readers to go on denying that they are the ones being condemned. And it will mean that no one at the top will fall on their sword or face the chop.
And that's not fine and Don Berwick and everyone else knows it. The government should admit their responsibility, cull a few ministers and a whole bevvy of bueaurcrats and take an axe to the top end of the beastly NHS. To paraphrase John Le Carre "things are being done to save the NHS that make it not worth saving".
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