Monday, October 29, 2007

The NHS keeping busy

I've wondered a few times whether it would be a serious service to the British political debate if someone were to plot out the different NHS institutions and how they interact with each other. It's a real jungle out there.

Take a look at the institution for five minutes and you quickly realise how utterly absurd it is to hope that such an unwieldy and byzantine structure, both centralised and out of control, can deliver a modern healthcare system. The politicians in charge don't have a clue and, for all the excellent people in the health service, the professionals get ground down by the system. All we can do is advocate real reform and, until that happens, enjoy the sheer strangeness of it all. Here are some things about the NHS that have been amusing me recently.

The Chief Executive of Christie Hospital NHS Foundation Trust has a podcast

Inspiring. I haven't watched through the archive yet. I'm not sure whether I should be pleased that they're trying new things or horrified that they're spending their time producing these little promo videos which I'm almost sure no one will be watching.

Chesterfield Royal Hospital NHS Foundation Trust are using Mr. Eugenides as a model for their promotional material

He looks scared.

This may not seem notable but all the other pictures in hospital accounts are so posed its nice to see this one so poorly composed. A document that looks professional generally reflects well on the organisation producing it. Unfortunately, many public bodies take that principle a little far and have clearly put more time and money into their annual reports than is sensible. The Public Accounts Committee is, naturally, the role model they should be looking to emulate.

Quango titles are special

Here are some favourites of mine, all from the Department of Health, which is only surpassed by the Home Office for number of quangos:

  • United Kingdom Xenotransplantation Interim Regulatory Authority. Despite its title suggesting it is a stop-gap solution this body has been in place since at least 1998.
  • National Radiological Protection Board. Lead-lined presumably. This was phased out in 2005 so either its been merged with some other organisation with much moving of desks or we're all in serious radiological danger.
  • Advisory Committee on Borderline Substances. This sounds too silly for words.
  • Advisory Committee on Hepatitis. Filling the role that used to be filled by the sober best friend before society went to the dogs.
  • Advisory Committee on Clinical Excellence Awards. Hard to parody.


Dave Cole said...


The UK Xenotransplantation Interim Regulatory Authority ceased to exist on 12 December 2006. It's guidance can be found here: Xenotransplantation, for the record, is transplanting from non-humans, such as pigs, to humans and offers potential in organ transplantation and skin grafting. Given that it dealt with xenotransplantation regulation and was time-limited, its name seems strangely accurate.

The National Radiological Protection Board was brought under the HPA on 1 April 2005 and now covers both ionising (which it did before) and non-ionising radiation (which it didn't, therefore rationalising things a bit). That division is at Nevertheless, its name was fairly accurate.

As to the Advisory Committee on Borderline Substances, if you'd bothered to read the webpage (, you'd see that there are some products which have a medicinal application and a non-medicinal application; the ACBS is there to allow non-drug, non-appliance medical-use products to be provided on an NHS prescription. In other words, it is a check on spending.

You mention the Advisory Committee on Hepatitis and say that it is "[f]illing the role that used to be filled by the sober best friend before society went to the dogs". That is alcoholic hepatitis; at a guess, this committee deals with the 14 other types of hepatitis as well. Why don't you have a look at the minutes of their latest meeting at and tell me if you think
a) they are a committee
b) they advise
and c) that advice is on hepatitis.

The Advisory Committee on Clinical Excellence Awards advises (check) on awards (check) given to individual consultants (OK, not there) for clinical excellence (check) above what is normally expected in the job. Can I suggest you write to the consultants listed here ( and tell them that the people who gave them their awards are 'beyond parody'?

Just because you don't have expert knowledge (or in most cases can't be bothered to look up long words) doesn't mean that all organisations in the Government are useless. The five you've chosen seem reasonably worthy, apart from the fact that only three of them are still around.


Matthew Sinclair said...

My criticism is of the NHS's "unwieldy and byzantine structure, both centralised and out of control". If you want to take issue with my analysis explain how this, the third largest organisation in the world, is a sensible way of delivering healthcare.

You've taken my amusement at quango names far too seriously. I don't doubt that all these bodies have a worthy purpose and are accurately titled. I never suggested otherwise. I was just having fun to ease the pain of navigating the maze of the NHS' organisation.

Mountjoy said...

In NuLabSpeak interim means forever ... except in the case of the UKXIRA!

This should be a scoop - First Quango Wound Up Ever.

Matthew Sinclair said...

I like the spirit Mountjoy but unfortunately they get wound up all the time. They just then get set up again with a new name and much shuffling of desks.

Anonymous said...

Glad you find it so bloody amusing, as one who had to give up work for 2 years, and fly back from Australia to care for a parent who was given MRSA I'm a good deal less easily amused. Thats 2 years I earned nothing, paid nothing into the mortgage, pension fund, savings/investment accounts, or even had a bloody holiday on the Costa del wherever. Multiply that by all the other mugs who have had to do the same and its no wonder the UK is going down the financial gurgler. Thank God I had an Aussie passport and could leave that third world dump again. And the sad thing is, it was once such a wonderful place before the apathy of its inhabitants allowed it to disintegrate into a morass. Rant mode OFF :)