A one day conference in London to which a large number of people were drawn from all over the UK for the launch of the new look CHRE. A new law (yes - another one) has been recently passed to reduce the Board of the CHRE down to six members plus a chair (removing the reps from the regulated bodies), all of whom are now new to the job. The strapline for this streamlined outfit is "Building Partnerships: from self regulation to shared regulation", which in itself is extremely ambiguous, if not downright misleading.
This is an emerging feature: something is being murdered - all reference to the previous incumbents of the Board is gone. The CHRE was invented by the HPO2001 to cure what was supposed as the problem of Self Regulation. What has happened to those intervening years?
In the morning's workshops there was a little bit of time to ask a question:
Question: what evidence is there that this kind of regulation increases levels of trust between professionals and their patients?
Dame Professor Professor Dr Dr Dr: What do you mean this kind of regulation?
The Dame in question is a perfectly lovely woman with 3 honorary doctorates, 2 honorary professorships, and fellowships etc at four prestigious national bodies. What, then, reduces such an accomplished lady to such a degree of blankness?
what evidence is there that the regulation practised by CHRE and its ilk reduces real risk and increases true trust? What ground is there for supposing that the new modus operandi is actually achieving its much trumpeted aim?
Onora O'Neill's 2002 Reith Lectures happened to be close to hand, so I quoted a little to situate my concerns: some arguments against performance auditing are that it creates a huge administrative burden that damages delivery of service; that professional work cannot be measured in the same way as the financial health of a company; and, worst of all, these kinds of measures are misleading and can create perverse incentives.
Dame: The world has moved on since that was written.
Well, yes, it is 2009, but Onora O'Neill's points might as easily be seen to have grown in significance and pertinence, rather than to have conveniently faded away. Here's another quote "Our revolution in accountability has not reduced attitudes of mistrust, but rather reinforced a culture of suspicion. Instead of working towards intelligent accountability based on good governance, independent inspection and careful reporting, we are galloping towards central planning by performance indicators, reinforced by obsessions with blame and compensation. This is pretty miserable both for those who feel suspicious and for those who are suspected of untrustworthy action - sometimes with little evidence." (click here for link to OU + BBC page)
Dame: I don't think I agree with the basis of your question.
OK - it is true that anyone asking for 'evidence' these days is usually on the attack (as Onora O'Neill predicted). Lets try a different angle: "O'Neill is especially known for her universalist and cosmopolitan standpoint. She believes that institution building can specify and allocate obligations to the needy. They are to specify who is obliged to fulfill economic rights. O'Neill firmly holds that the institutions have to be made accountable. This can be done through new technologies that are ideal for achieving transparency and openness. Justice, according to her, means finding the means for the vulnerable to express legitimate consent.finding the means for the vulnerable to express legitimate consent." [quoted from 4to40 website, click for link]
A major stumbling block that separated us in that room was the idea that there was any other kind of Regulation. 'What kind of regulation', seemed to produce a hole in the fabric that threatened to pull everybody in. Is there another way to speak, a way that doesn't produce such a terrifying void? I am fond of thinking etymologically:
Regulation: "Regular 'according to a rule' is the most instantly recognizable English descendant of Latin regula 'rule' ... It goes back ultimately to the same Indo-European base as produced Latin regere 'rule' (source of rector, regent, etc) and rex 'king' (source of English regal, royal, etc). From it was derived the late Latin verb regulare, which has given English regulate [17] and may also lie behind rile 'annoy' [19], ..." quoted from John Ayto's remarkable Dictionary of Word Origins (Bloomsbury, 1990, p437)
Governing is not reducible to a universal set of principles. We knew that. So where has this wisdom gone? I think it is being murdered, murdered by the way we speak.
Thursday, 5 March 2009
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4 comments:
i was there too and attended the workshop on devolution. great i thought at last a move away from centrist ideology and what did i hear; convolution. couple that with the other session where there were exhortations by one of the speakers, in regard to the training of future health professionals, to adopt a messy approach and to resist reductionism and the solution to the equation is clear go find a black cat , some heather and a four leaved clover. luckily i sat in the back row and was able to make a swift exit
Hello Richard, thanks for posting a comment. I wonder how it will become possible to facilitate a return to decentralisation - from what I have been discovering it has taken about 30 years and some determined parliamentary acts to bring us to this particular moment. I heard Philip Pullman speaking about the wider scene last week, and it struck me that authors, poets, musicians, might be our best bet right now. Janet
i dont know about a return . certainly the development of mesh computing will add to the increase in personal autonomy, self actualisation if you like the term fuzzy logic rather than messy springs to mind. the main problem for a decentralisation process is the establishment of a common language , which can only be brought about by utilising the least common denominators in its formulation.
"Any attempt to organize the group ... under a single authority would eliminate their independent initiatives and thus reduce their joint effectiveness to that of the single person directing them from the centre. It would, in effect, paralyse their cooperation."
i think that a lot of people share the perspective that cultural initiatives are the way forward
you remind me of something I think I knew once - that decentralisation is not the simple opposite of centralisation, but a kind of partner or lieutenant to centralisation. Probably it's the wrong language, which doesn't really help. Thanks for that. I've heard others speak of the current situation as The One knowledge, The One Standard. What do you think of that?
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