The health service mess

Screen Shot 2015-06-12 at 08.50.52Dalrymple lists the failings of the Mid-Staffordshire NHS Trust:

  • the ravening ambition of bureaucratic mediocrities
  • institutionally perverted incentives that reward those who do worst
  • the creation of a nomenklatura at the head of an apparat staffed by bullied, intimidated, fearful but unscrupulous apparatchiks
  • an inability or unwillingness to speak or write in plain English
  • intellectual dishonesty with compulsory lying on a vast scale
  • the proliferation of procedural objectives and bureaucratic tasks unrelated to reality or to the welfare of patients
  • a revolting tendency to Pecksniffian self-congratulation and self-righteousness

He calls the NHS

that vast charitable organisation for the outdoor relief of second-rate bureaucrats.

He points to the slick insidiousness of Tony Blair, who made Labour, once the party of the working class, the party of the nomenklatura. There was also Margaret Thatcher,

with her crude sub-Marxist view of the professions as exploitative monopolists. She thought the methods and disciplines of the marketplace, imposed by ‘scientific’ management but in the absence of anything resembling a market, would eliminate chronic inefficiency. This was stupid. It called into being a managerial class, cunning and unscrupulous.

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