Thursday, 28 October 2010

The guilt of the sum is greater than that of all of its parts?

Once again this week the tragic case of Baby P(eter) is on the news screens of the UK and once again the Press screams about individual’s incompetence as the failing(s) but it may miss the collective target in terms of overall responsibility.

Imagine if you can a situation in the UK where a group of GPs work closely with a group of health visitors in a practice setting. Over the years they develop a rapport where each knows the strengths and weaknesses of each other and also they know their patients.

Their social intercourse on a daily basis means that little snippets of information are passed between them. For example there might be a family of concern about whom a conversation similar to this might take place en passant:

"Hello Northern Doc, you mentioned the other day that child X had condition Y."

"Yes I did. What of it?"

"Well did you know that their Mum was assaulted last week?"

"No, I did not. Who by? "

"Her new partner

"Who’s that?"

"Dicky W*nker. "

"Really? Didn’t he do time a few years back for indecent exposure to minors in the local park?"

"I didn’t know that Northern Doc but I am now on the case. . . "

A simple sharing of information like that combined with follow up by those concerned might just lead to the exposure of a Schedule 1 sex offender who had been beneath the radar for years.

Now the Party does not do information sharing between professionals although it wants you to share all of your information between Party members via the Summary Care Record. Information is often the key to protecting children but information in isolation is often useless.

Protecting children, and the elderly, is like a jigsaw puzzle. If you hold a small piece of the jigsaw in isolation you do not see the whole picture. The ability to share the pieces may give you an increased chance of seeing the whole picture.

Which is why the Party took away our health visitors and reorganised the way in which we now work. What used to take one conversation like the one above now takes several phone calls and days of waiting just to identify the responsible individual. Having identified them you then have to find them to actually talk to them and share the information.

The current state of NHS health visiting means that trying to complete the jigsaw as a GP is hampered by the NHS adopting so called “silo working”.

The sum, here the protection of the individual, is greater than all of its parts, for all of the parts are usually there. They, as usual, are not shared. So the sum fails but the individuals are blamed. They are blamed for the failings of those who instituted the sum.

The sum was devised by our politicians and all their little local commissars. It was they who ultimately employed all those who failed and it is they who also dictated their terms of engagement.

Praise be to the Party for they are once again all wise (after the event). The problem with the Party is that when the system fails all fail for they cannot without the system.

The depressing thing is that it is said it will happen again. Unfortunately it will and all of the NHS reforms of the last 13 years have made it easier than ever to happen for they have destroyed the information sharing that is vital if these tragedies are to stand a chance of being avoided.

1 comment:

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