Saturday, 2 February 2008

Monkey see monkey do - Lord Leitch's brainwave

Competency based training when used in isolation can encourage low standards and a relentless dumbing down, this article by Martin Talbot is an excellent critique of the competency based collapse in standards. John Tooke's excellent report also highlights this problem and seeks to address it by defining the role of a doctor, by this Tooke is attempting to prevent the less skilled taking over various roles which they are clearly not adequately prepared.

Skills for Health
epitomised all that is stupid and wasteful in the NHS. This scheme attempts to transform the health workforce thanks to ideas from Lord Leitch, Lord Leitch of Labour that is. Lord Leitch seems to have a rather interesting history of being very closely allied to Tony Blair and the Labour party. He has also been a major financial backer of Gordon Brown. Strangely though he has only experience of the insurance industry, so how on earth he is qualified to do a generic review on the huge topic of 'skills' is a little beyond me.

The review of all 'skills' by Lord Leitch can be read here, the report is entitled 'Prosperity for all in the global economy - world class skills'. The report is meaningless rubbish in its entirety and starts off with some good old Labour propaganda:

"How is the UK placed to respond to this challenge? We have many important strengths – an excellent higher education system where more people then ever are studying for degrees; many good initiatives on vocational training; an increasingly effective school system; and a strong record of improvement over the past decade."

More people are studying at universities for sure, however by doing this the value of a university education has been reduced and a lot of money has been wasted in dumbing down university degrees. Crucial subjects such as science, both at schools and universities, are in crisis regarding funding and numbers of pupils. While there has been a proliferation in useless subjects studies at school and at university, and the railroading through of new diplomas that universities have no confidence in. There's no doubt we need an alternative for non academic pupils, however to do this one doesn't have to decimate high level academic study. The corporatisation of education is something to be very concerned about indeed. This all comes as a direct response to the government being obsessed with only short termist direct economic gains, as Lord Leitch's review made clear 'Economically valuable skills’ is our mantra.'

The danger of this corruption of education is there for all to see. The pharmaceutical industry has shown us how scientific and human progress is held back in the name of short term profit, as trials are hidden, manipulated and suppressed; while anything that is not economically profitable to them is ignored, even if it would benefit the human race significantly. Dr Grumble highlighted this when talking about the way that a needless has demand for bottled water has been manufactured to make money. The reason for this is that politicians are backed by a few wealthy businessmen, hence they keep them happy by keeping their businesses happy, and in this way everything is becoming commercialised; everything is seen in economic terms and nothing else matters.

Medical education and education in general should be there to achieve excellence, not to satisfy the economic needs of a few wealthy businessmen. The skillification as described by Lord Leitch is as bizarre as it is stupid, it is a kind of competency based training for all workers in the country. It ignores the fact that different people have very different abilities, different levels of education and different qualifications; there are many better ways of gaining skills which do not involve his competency based methods. As with all stooge-led government reviews we have someone poorly qualified conducting a review of something huge that cannot possibly be reviewed by one person and one review; the area of all 'skills' is so enormous that all comment becomes such a generalisation that all conclusions are completely meaningless.

The end result of this government megalomania is yet more money wasted on QUANGOs and thousands of bureaucrats with no real skills of their own, and these fools are ordering around the highly trained and catalysing the deprofessionalisation across the board. Everything is top down and centralised, the state and business are fusing into one horrendous ugly beast that sees only short term economically valuable skills as important. There is a massive contradiction here, because this pursuit of short termist economic success will lead to catastrophic economic failure in the long term, the competency based approach leads to stagnation and failure; only the pursuit of excellence when the motivation of individuals is harnessed will lead to long term success for our country. Lord Leitch's vision is a fascist nightmare, standards are dumbed down and everyone is made equal by the state; there is no room for harnessing the flair and drive of individuals as everyone is controlled by the state, the able will become demoralised and progress will grind to a halt. In Lord Leitch's world anyone is capable of anything, even Lord Leitch is seen as capable of reviewing generic 'skills', what depressing irony.


Anonymous said...

Hi - stumbled across this blog quite by chance and am enjoying it!

You might like to research Taylor and Scientific Management. The profession, at least from your point of view, is undergoing a process of deskilling much like the manufacturing process did during the Industrial Revolution. It was only a matter of time before the process reached the professions - we've seen it in manufacturing, banking, retail ... pretty much across the board in all sectors of the economy: break up skilled crafts/management skills into their smallest possible tasks, train for task rather than skill et voila! Lots more jobs for less educated people at much lower salaries, who are easily replaced. Apply technology to fill in the gaps. Saves bucketloads of money and results in processes that are much more easily controlled from the centre. It does actually make sense of a sort, but only if you know where the theory comes from. And, no, I wouldn't want to put my life in the hands of a task orientated medic, rather than a skilled doctor.

Garth Marenghi said...

Hello and greetings.

The problem with this in my opinion is that medicine is very different to manufacturing et al.

Thus I don't think it can make sense as regards medicine.

My argument for medicine being so different is related to the complexity of the decision making processes involved.

A good clinician or surgeon's job cannot be broken down into parts and given to different people, because an overall understanding is needed to do all the bits well.

Each patient is a unique individual and that's what makes medicine so unique and such a human science.

Medicine can be broken up into parts, however the quality of care and service will be dramatically nailed.

Anonymous said...

Yes, Garth, you're right. But that doesn't stop the attempt. You see the evidence of deskilling and don't believe it. It is unbelievable that a government would attempt to turn the NHS into some kind of conveyor belt system ... and yet, it's happening. It started with the manufacturing sector, moved through the service industry and is now in the professions.

'Course, you don't have to believe it. You can continue to make very reasonable points about the standard of care being much lower when the person treating a patient is only trained in one area. But, it is quicker to train people in one small area than in a whole wide specialism. You don't have to pay them much more than a nurse. And the "throughput" (forgive me) is far higher than with a doctor, because said single task worker has only one thing to do; the training is far cheaper (and quicker), because they are only trained in one thing.

I know it doesn't make sense. But it seems to be your experience.

Anonymous said...

It all stinks of Freemasonary to me...

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