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Posts Tagged ‘ethic of care’

9 Key Findings in the Executive Summary

In February 2013 the final report of the public inquiry into the management and poor practices within the Mid-Staffordshire Health Trust was published; consisting of an Executive Summary and three volumes of more than 1000 pages. The reason for the size of this report was the intense public and political interest into the way in which the operations of a public body, the healthcare trust, had failed to promote patient care and had seemed to create a climate where abuse and neglect of patients, particularly the elderly, was commonplace under a management that was more focused on financial performance and the status of the organisation than supporting and sustaining a culture of professional care. The background to the setting up of the inquiry can be found here on WikiPedia  and there is a huge range of commentary and resources which can be found by using the search terms “Francis Report” and “Mid Staffordshire Health Authority Inquiry”. One year on from the publication of the report there is much literature on what has changed as a result of the inquiry and now seems a good time to review the main findings and the recommendations of the committee of inquiry from the perspectives being developed in this blog. After this overview the next post will look at “progress” one year on from the publication of the report and how this exemplifies the issues discussed below.

The key to the Francis report was the disconnect between a managerial focus on finance and organisational status and the public expectation of professional and ethical care for all patients. This latter was overlooked, and sometimes suppressed, in an environment focused on organisational efficiency in order to achieve “Foundation Trust” status. Both the nature of this status and the Mid-Staffordshire Trust’s concern to gain this status are well described in the report, and the key issues clearly elucidated in the Executive Summary.

Francis’ 9 key concerns with the running of the Mid-Staffordshire Health Trust are summarised below. (more…)

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Readers of this blog will know that I have discussed an outline of the alternatives to conceptions of “public value” developed by and from the work of Mark Moore in the US and the promotion of this work in the book “Public Value: theory and practice” edited by Moore and Benington (2011). My key criticism of this approach remains that the “public value” defined by Moore and others is not “public” in the sense that publics are engaged in deliberating and defining public values and that there is an underlying acceptance that those engaged in government and public services as senior managers are best placed to form and articulate these debates and, ultimately, determine what “value” is placed on public services. Another strand of this argument could be characterised as “you can have too much democracy!” where political thinkers are putting forward ideas that support restrictions on democratic processes and criticising their application in given circumstances e.g. Berggruen and Gardels (2012), who argue that intelligent governance should replace liberal democracy as it faces crises in terms of funding and legitimacy. Similar perspectives are put forward in Michael Lewis’s “Boomerang: travels in the new third world” (2011)

As I have noted before, this approach is driven by ideas from neo-conservative economic theories and their focus on markets and financial values and “market forces”. This influence is carefully explored in Ben Fine’s work in critiquing the term “social capital” and his key arguments apply here. (more…)

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