I wonder what the NHS will make of Baroness Young’s announcement that the Care Quality Commission wants to “do a number” on failing organisations. It’s the kind of shadowy threat you’d expect from a Martin Scorsese gangster rather than the chair of a public services regulator.

According to the thefreedictionary.com, the idiom has three meanings:
1. To damage or harm someone or something
2. To treat someone very badly or unfairly
3. To hurt or damage someone or something

None of which are likely to win Baroness Young many friends in the health service. But then, that’s not really the CQC’s job, is it? Besides, it’s an auditory relief to hear such a lively turn of phrase – aside from making good copy it’s more meaningful than the dreaded “multi-agency partnership working”, “silos” and “subsidiarity”. And it clearly wasn’t meant literally.
 
For the record, in the same half-hour speech at the Westminster Health Forum, the Baroness managed to squeeze in the words “pissy”, “bloody”, “bollocked” and, lastly, “crap”, which was  uttered an incredible THREE times. Dr Rant would be proud.
 
On a less puerile note, the need to engage with the NHS is clearly playing on Barbara Young’s mind. She sees high-profile reports like the Healthcare Commission’s review of Mid Staffs as “a bit of a blunt instrument” and doesn’t want to spend all her time “exposing poor performance”. As blunt instruments go, Mid Staffs sparked a raft of new policies and triggered a huge debate around standards in hospitals, so why shy away from high-impact exposés?
 
The CQC also wants to make the annual health check a rolling process instead of a “cataclysmic one-off event”. Managers will welcome more timely assessments. I remember asking a senior clinician how his trust had performed, soon after the results had been published. He replied by shrugging his shoulders and saying “it’s irrelevant, isn’t it?” But at least snapshots are easily understood by the public and allow comparisons to be made.
 
Getting this balance right is just one task on the CQC’s sizeable list, and it’d be good to know what readers think. Shadowy threats, “big bangs” and exposés may be uncomfortable, but don’t they also throw a spotlight onto unacceptably poor standards?

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