Sunday, December 03, 2006

Trust or Control?

It has finally occurred to me that society needs to make a choice. This is true in healthcare as in education, police services and many other fields. The fundamental issue is this: Do we trust profesionals to do their jobs? If so then we do not need routinely to monitor performance, targets etc unless there is a question that people or institutions are failing. The vast resource devoted to NHS monitoring and targets can be devoted to healthcare. Policemen can walk the streets. Teachers can teach.

However this may come at a cost: For the best to thrive do the worst have a chance of getting away with it: Does this allow Harold Shipmans, or more possibly racist policing or failing schools to go undetected and unimproved? I don't know, but I am sure that the solution in health lies in much more targeted monitoring with most priorities and assessment of performance being carried out at a local level by local health boards.

2 comments:

potentilla said...

The way to monitor the performance of professionals is not to set targets and protocols and oblige the professionals to stick to them using either sticks or carrots; but instead, to have their activities audited after the event by someone who has a deep understanding of the profession themselves.

Mens Sana said...

Yes, but the auiting itself is very resource intensive-do we audit everyone (the government's preference) or use a targeted approach with more audits of "at risk" individuals/institutions and rendom spot checks for everyone?