Reading the high-minded Times Literary Supplement on a comfortable sofa the other weekend, I stumbled on a ferocious attack on the audit culture that is now so much a routine feature of national life, NHS included.

It was prompted by the publication of Follow the Money, a history of the Audit Commission by Duncan Campbell-Smith, commissioned by the commission itself to celebrate its 25th birthday.

Apparently it promised to buy 90 per cent of the print run to distribute to chums. An act of vanity publishing that could usefully be subjected to value-for-money audit, snorts TLS reviewer Simon Jenkins, who has made attacking over-centralisation in British governance a feature of his prolific career. Unaccountable, out-of-control, a racket for management consultancy types, concludes Jenkins.

All of which coloured my reaction to last week's Healthcare Commission review of patients' complaints (trusts must learn to say sorry more) and its annual survey of NHS staff attitudes - "one of the largest staff surveys in the world". "Patients aren't put first say half of NHS staff," as some headlines put it.

I'm sure you weren't surprised to read the full staff results and spot that absurdly negative spin which ignored good news about individual appraisal, flexible working, training, and cleanliness. Not forgetting the support that 71 per cent of staff feel they get from their kindly line manager, as distinct from remote senior managers and trust. Sure there was a downside too. But let's hope that when the Daily Beast's editor next goes into hospital to get those piles fixed he will be ignored on the ward until he's suffered a bit. That will teach him.

But what of Mr Jenkins' complaint that, since Margaret Thatcher first tried to make the NHS more efficient and Tony Blair took up the zealot's battle, audit has got out of control? Nowadays, they talk about "new localism" - but find it hard to do.

The Healthcare Commission isn't the Audit Commission, which checks value for money across local government and NHS in England and Wales. Nor is it the National Audit Office, which does the same for central government and other public bodies (including the NHS). It has its own remit: to promote continuous improvement in the service, via wider information for staff and patients.

I call some MPs with an interest in this field. Austin Mitchell, the veteran Labour troublemaker who represents Great Grimsby, sits on the public accounts committee - and is highly critical of audit in both the public and (especially) private sectors. Enron, Northern Rock, the auditors signed off on them "until they crashed", he notes.

"Our inquiries on the public accounts committee are all retrospective. It's very frustrating, you are asking questions of people who didn't make the mistakes, who didn't do the dirty deals. They have retired, got their honours or gone up in the world,'' says Mr Mitchell, who is a jolly man despite his gloom.

But audit is also all we've got, he admits. Richard Taylor, independent doctor-MP for Wyre Forest, agrees when I interrupt him watching BBC1's Casualty 1907. But he's more cheerful and approves of the Healthcare Commission's audit work, much of its data collated with the help of the admired Picker Institute.

Dr Taylor cites the commission's efforts to highlight what he regards as the mistake made when nurse training was switched from the vocational route, by other nurses on the ward, to the academic path which fails to inculcate such old-fashioned virtues as "comforting patients, so vital to recovery". He fears that medical training is now heading down a similar wrong road.

But he has a bigger worry: about the Healthcare Commission's role in handling the 140,000 complaints NHS patients make about the 380 million treatments given each year. The system struggles to cope as it is. But when the commission merges with its social service and mental health counterparts into the Care Quality Commission, the new body will lose the function of examining the 10,000 or so complaints where the patient is not satisfied with the local trust's response. "There will either be local resolution or it will go straight to the health ombudsman. There will no longer be an automatic independent opinion," protests Dr Taylor. A good point.