BUREAUCRACY OVERTAKES WORTHY LOCAL SCHEMES
15:00 - 18 October 2007
Buried deep in West Dorset there is an organisation founded and sustained by a remarkable individual, which goes by the name of the Bridport and Lyme Bay Health Alliance.The alliance is one of those volunteer bodies that looks after our interests unseen and unrewarded. I met its founder last week, and he explained to me how it helps people using the health service locally to influence the way it is constructed.
The alliance operates through continuous discussion with a network of other voluntary bodies, so it gets a feel for what features of the local NHS are worrying pensioners, those with particular disabilities, and so on.
It then works with the people responsible for planning various aspects of the NHS to ensure that, as far as possible, the services match the requirements of those who are using them.
As I sat there listening to this explanation, it struck me how subtle and useful a role such intermediation between a vast bureaucracy and its patients is.
Of course, it all depends on the intelligence and sensitivity with which the task is carried out. It needs to be done by someone who is alive to the way that bureaucracies work and who has a huge knowledge of the NHS.
If you advertised a post with those attributes you would probably have to pay a lot of money, if, indeed, you could find anybody with the relevant qualities and experience.
But here was somebody doing it for the love of it, a genuine social entrepreneur.
So you will imagine that the next part of my story is the pleasant tale of how the efforts of this admirable group are now to be recognised, how we are to replicate this splendid pattern in other parts of Dorset and the rest of Britain, and how a grateful nation has bestowed accolades on the unsung hero and his colleagues.
Alas, the story does not have this happy ending.
Instead, a new national scheme has been invented. In place of such local effort, there is to be a county-wide arrangement.
Committees have been established. Working groups are working. Talking shops are talking.
I have no doubt there either is or shortly will be a significant bureaucracy established purely for the purpose of promoting this new "links" scheme.
I am equally sure that, in due course, you and I will be called upon to pay some considerable amount to fund the replacement of the little, voluntary, local effort by this national scheme.
So it is, by slow degrees, that things which spring up naturally, are costless, human in scale, and do genuinely good work, are replaced by things which are more remote, potentially costly, more bureaucratic and, I fear, all too likely to be less effective.
If one did not laugh, one would have to cry
Buried deep in West Dorset there is an organisation founded and sustained by a remarkable individual, which goes by the name of the Bridport and Lyme Bay Health Alliance.The alliance is one of those volunteer bodies that looks after our interests unseen and unrewarded. I met its founder last week, and he explained to me how it helps people using the health service locally to influence the way it is constructed.
The alliance operates through continuous discussion with a network of other voluntary bodies, so it gets a feel for what features of the local NHS are worrying pensioners, those with particular disabilities, and so on.
It then works with the people responsible for planning various aspects of the NHS to ensure that, as far as possible, the services match the requirements of those who are using them.
As I sat there listening to this explanation, it struck me how subtle and useful a role such intermediation between a vast bureaucracy and its patients is.
Of course, it all depends on the intelligence and sensitivity with which the task is carried out. It needs to be done by someone who is alive to the way that bureaucracies work and who has a huge knowledge of the NHS.
If you advertised a post with those attributes you would probably have to pay a lot of money, if, indeed, you could find anybody with the relevant qualities and experience.
But here was somebody doing it for the love of it, a genuine social entrepreneur.
So you will imagine that the next part of my story is the pleasant tale of how the efforts of this admirable group are now to be recognised, how we are to replicate this splendid pattern in other parts of Dorset and the rest of Britain, and how a grateful nation has bestowed accolades on the unsung hero and his colleagues.
Alas, the story does not have this happy ending.
Instead, a new national scheme has been invented. In place of such local effort, there is to be a county-wide arrangement.
Committees have been established. Working groups are working. Talking shops are talking.
I have no doubt there either is or shortly will be a significant bureaucracy established purely for the purpose of promoting this new "links" scheme.
I am equally sure that, in due course, you and I will be called upon to pay some considerable amount to fund the replacement of the little, voluntary, local effort by this national scheme.
So it is, by slow degrees, that things which spring up naturally, are costless, human in scale, and do genuinely good work, are replaced by things which are more remote, potentially costly, more bureaucratic and, I fear, all too likely to be less effective.
If one did not laugh, one would have to cry
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