The truth about the monster hospitals

Today's new research which shows that one in ten people going into hospital are harmed by the experience is actually not a surprise. It confirms almost identical research elsewhere. The problem is that it is unlikely to become the political issue that it ought to be because political parties don’t know what to do with it – which of their various complaints and campaigns does it relate to, after all?

Actually, this is a key element of any non-technocratic campaign against the corrosion of our public services. The research was carried out in a large teaching hospital in the north; it would be good to compare it with a human scale institution. My guess is that the findings would be very different there.

Because the tragedy of our hospitals is that they are far too big. They rely on creaking technocratic systems, you never see the same doctor twice – which is not the ‘choice’ most people would make – and the whole system gets by without the very relationships between doctors, nurses and patients which make change happen.

The same corrosion and ineffectiveness is happening in our factory schools, merged police forces and struggling probation service. Because the technocrats at the heart of New Labour think these things are unimportant, whereas actually the ability to forge relationships is what makes professionals effective.

These monstrous hospitals have been driven partly by the need to sell off sites for capital gains, partly by the pride of consultants for ever bigger fiefdoms, partly by an unproven belief in the efficiency of big systems. There are economies of scale, of course, but they are bought at the cost of these hideous inefficiencies – mistakes, bugs, over-ordering and the sclerosis that happens when relationships are replaced by IT systems.

If you want to find an issue that really affects people’s lives, look no further.