As the government winds down towards what it hopes will be a welcome summer break (don’t bank on it), it’s been home secretary Jacqui Smith’s week.
Darzi has proved quite enough excitement for health secretary Alan Johnson’s team in a single month.
I don’t know how you feel about young tearaways being brought into accident and emergency to see the damage that a knife can do in any angry moment, as Ms Smith suggests. Experts are divided, though one subtle criticism is that it only works as “restorative justice” if the tearaway is confronted with his own victim. This is not currently planned.
But health was not entirely left out of the week’s knife crime drama because chief medical officer Sir Liam Donaldson made teenagers’ health risks the theme of his press conference on his annual report.
My own theory remains that kids take foolish and avoidable risks these days because they are over-protected when younger. Stretching a point you could say that a lot of adults bring hospital bugs in with them, so it was good to learn that Sir Liam’s report holds out real hopes of effective vaccines within five to 10 years. It means, of course, that the enemy will simply regroup and fight back - like al-Qaida.
But the post-Darzi risk which caught my eye was one I was barely aware of: the prospect of a private website, run by Neil Bacon, the doctors.net.uk medic, which will allow us to praise or damn GPs by name - all 40,000 of them.
We all favour accountability - MPs, civil servants and ministers, along with doctors and even journalists - at least in theory, though not when it comes to audited expenses. Artists of all kind have been subject to accountability for generations - they’re called reviews - ever since Shakespeare was dismissed by a jealous rival as an “upstart crow”. He got over it.
Central to the Darzi report are expanded notions of accountability and openness. Just a week ago the Department of Health’s NHS Choices website published its first report on treatment outcomes and patient satisfaction for four basic types of surgery - including hip and knee replacement.
Though there was criticism of the data, adjusted for fairness, as pretty primitive, and some death rates appeared to be up to four times higher than others, NHS medical director Sir Bruce Keogh was keen to point out that all hospitals were in the “normal” range - unlike similar exercises in the US.
But back to www.iwantgreatcare.org, which Dr Bacon, a former renal specialist in Oxford, launched on Sunday. I checked it out on day one and it was still pretty quiet. A few names on the home page included one Dr Richard Pullinger, also of Oxford (a friendly guinea pig perhaps?), who was rated 96 per cent overall - 97 per cent for “trust” - and was “really kind and patient” when dealing with a “nasty injury”.
Fine, fine. But teachers have had to put up with a UK version of the US site, RateMyTeachers, which was already causing tears in the staffroom several years ago. It’s still there and thriving (“check out the homework helproom”) and I imagine it’s still causing pain which may or may not outweigh whatever good it does. The courts stopped it in France, a more producer-oriented culture.
I know a bit about this because I blog in another life for Guardian Unlimited. You get some terrific readers’ responses on the thread, but they are usually outweighed by the aggressive and the ignorant. Free speech requires the moderator to publish all but the worst.
My last post prompted accusations that I am the “resident idiot” in the Westminster village, a stooge who is “often excessively sycophantic to the government”, and in tune with the choir sheet emanating from the Number 10 spin doctors (don’t all shout at once), though I have my supporters too.
Fresh from its own unmediated conference battles the British Medical Association was quick to condemn the idea (so it can’t be all bad).
Ministers are staying out of it, but acutely aware that even a wholesome site like doctors.net.uk has attracted swathes of abuse, creating libel problems for the site. There’s a good idea lurking here which NHS Choices has also been examining, so far without success. If transparency undermines legitimate trust, then it fails.
See this week’s news analysis for more.