The War Against Incomplete Records


The War on Terror.  Bankrupting whole countries in pursuit of a largely imaginary foe. Profitable for some.  Exciting for others.

Quality management accreditation.  The inverse of exciting but also bankrupting the NHS and other victims in a War Against Incomplete Records that can have no end.

It’s treatment for a disease without a clear definition or diagnosis.  No individual result can ever be assured.  What if accreditation itself is a disease?

We could find out in the time-tested way.  A history may be hard to obtain.  This is a job that remains for an historian.  A social history will have to be pieced together from employees’ and victims’ experiences. An examination of the accreditation system can be performed by reading the documentation and listening to tales of petty non-compliances and inconsistencies between inspectors. Tests could be done by examining EQA scheme records for participating laboratories (where these are not hidden from public appraisal) and collating non-compliances from confidential inspection reports (if anyone cares to share them.) 

And follow the money is always good advice.  Just because UKAS isn’t allowed to make much profit doesn’t mean it can’t keep on expanding by market manipulation and coercion.  Bureaucracy is characterised by there being no profit or loss to inform about the market value of the service. 

What if these two wars share the goal that their foundational myths must never end?

If the cure is a disease has it any prospect of ending?

What if both wars seek to be the myth by which present and historical reality are interpreted in an attempt to secure a position of total control?

Why can users not be given a genuinely free and informed choice whether they want to pay for a logo?

The magnification of small things

It’s an option Jamie Oliver gives.

Why do some patients have to forgo treatments so that other patients can have a quality-branded tests that they might not individually be willing to pay for?

Why is the cost of the accreditation intervention not itself audited?

Why have External Quality Assurance schemes failed to maintain the records that would allow them to investigate whether there is any benefit from accreditation and whether it is worth the cost?

Why is the money paid to accreditors and their hangers-on to protect from poor quality not made plain on a public website?

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This entry was posted in Bureaucracy, Economics, History, Laboratory medicine, Medicine, Politics, Psychology, Questions, Science and tagged , , , , . Bookmark the permalink.

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