Sunday, March 10, 2013

Not really a punishment

There's a hospital trust near me who is about to get a massive fine for exceeding its C.difficile quota which has always struck me as a bit weird as surely there should be no quota at all for such infections. The problem of course is the fine, who is going to pay for it and where is the money coming from?
An NHS trust in Kent is to be fined at least £1.5m after missing its target for controlling the gut infection Clostridium difficile.
Maidstone and Tunbridge Wells NHS Trust was set a yearly limit of 49 cases of the diarrhoea-inducing infection up to the end of March.
With three weeks to go, 52 cases of the superbug have already been recorded.
The trust runs hospitals at Pembury and Maidstone and said it was disappointed to have exceeded its target.
I may be wrong, but the only way I can see a trust paying such a fine is by reducing its services (closing wards and reducing staff) or looking at other areas of its budget which might increase the chances of more infections taking hold. There's also the feeling that any fine will simply hit the people using the NHS trust and not those who are actually responsible.
Perhaps a clause put into the contract of senior management responsible for maintaining standards could be put in place saying that if they exceed their 'quotas' they get sacked or fined themselves with a sacking meaning they can no longer (ever) hold a post in public services.
It does strike me as a bit harsh, but on the otherhand if they realise that there will be direct consequences to themselves perhaps they'll make damned sure that the people they supervise are doing their jobs properly.
At least 90 patients died at Maidstone Hospital between 2004 and 2006 in a C.difficile outbreak.
Remember that the chief executive of the NHS trust, Rose Gibb, left her post by 'mutual agreement' prior to publication of the investigation's findings into this incident. And that controversy arose when the Department of Health subsequently blocked a £175,000 severance payment to Ms Gibb after a public outcry. However following a protracted legal wrangle, the High Court upheld the Department of Health's decision and denied the payment.This decision was later overturned by the Court of Appeal which re-awarded the payment. So there are no consequences at all for those responsible ultimately for killing people off due to neglect in the NHS.
There's too much of a culture of blame avoidance and not enough taking responsibility in public services, this needs to change, starting with a contractual severance clause with extreme prejudice if you get it wrong in a manner causing unnecessary deaths.
It's the only way they'll learn.

1 annotations:

Anonymous said...

We are always being told that CEOs deserve their high pay because they are 'responsible' and when they meet their self-set targets they get 'performance' bonuses, surely ALL fines etc. should be paid by these 'responsible' people, rather falling, effectively on the shareholder, customer or taxpayer who hold no such 'responsibility'?