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Putting targets before patients

winter 2013

From triple helix - winter 2013 - Putting targets before patients [p04]

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Failures of care suggest a deeper problem

Review by Steve Fouch
CMF Head of Allied Professions Ministries

The recent report from the Care Quality Commission on Colchester General Hospital (1) adds to the depressing list of reports on failures in the NHS. This latest episode related to the falsification of appointment times and waiting list data in the Cancer Unit by senior managers to improve the hospital's league table standing. Furthermore, junior staff were bullied into silence and compliance. Some families are now claiming that loved ones may have suffered and died unnecessarily because they were kept on waiting lists longer than necessary, and the whole matter is now being looked at by the police. (2)

Following on in the same year as the Francis Report (3) into Mid Staffs, and mere weeks before the Government's response is finally published, it is a disturbing reminder of how easily the priorities of an organisation set up to care for the sick can be distorted.

Some will blame this (or the last) government's desire for targets; others, the increasing bullying culture within the NHS as a whole; others, cut backs in funding and services. In truth, all of these probably played a part in Colchester, Mid Staffs and the mounting number of other care failures being reported. Inevitably there will be renewed cries for the Government, the NHS Executive, the professional colleges and other NHS institutions to do something about this.

The concept of institutional sin is very relevant to the current state of the NHS. All human institutions are prone to a culture, a spiritual atmosphere, a groupthink, that can perpetuate either the best or the worst in human nature. It is clear that a focus on other priorities than the patient (funding, trust status, league table placing, meeting targets, etc), and failure to value the people that make up the living fabric of the institution (staff and patients) is not just wrong, it is positively demonic and must be challenged, contested and transformed at every opportunity. It is hard for any one person to stand up and do this alone and impossible to tackle what is in many ways a spiritual malady by human power alone. But it is possible to challenge and change this culture in fellowship with others, believers and non-believers alike. But as followers of Christ we have an added strength, knowing that we have with us one greater than all the authorities and powers against which we must contend. (4) This is a spiritual as well as human struggle – but with Christ with us, we can begin to reclaim the NHS to be what it was meant to be.


1. Care Quality Commission inspection report on Colchester General Hospital. 5 November 2013
2. Colchester General Hospital: Police probe cancer treatment. BBC News, 5 November 2013
4. 1 John 4:4

Article written by Steve Fouch

More from triple helix: winter 2013

  • Situation Ethics
  • Putting targets before patients
  • Countering the threat of euthanasia
  • What we can learn from the BHA
  • Universal Health Coverage
  • Caring for ourselves
  • How persuasion works
  • So you've received a complaint
  • Making medical mistakes
  • A chilling story seldom told
  • Being a burden
  • Hope in dark times
  • Faith matters in the global health agenda
  • ICMDA a worldwide family
  • CS Lewis: A Life
  • What happens after I die
  • Making Church Accessible to All Including disabled people in church life
  • Why? Looking at God, evil & personal suffering
  • Rescuing Darwin God and evolution in Britain today
  • The Big Ego Trip Finding true significance in a culture of self-esteem
  • Christians in the Firing Line
  • Spiritual Care of Dying and Bereaved People
  • Eutychus
  • When our hands are willing
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