Lord Clement-Jones remarked in 2003 of the dismemberment of the long-established Public Health Laboratory Service (PHLS),
“The suspicion is growing that the transfer plans are a pure cost-cutting measure by the Government, and yet, paradoxically, moving these laboratories to a more fragmented arrangement may cost more.”
This picture of colossal waste and disruption was normative for the command and control regime of mismanagement that is still operating. The shared services myth is still on a roll in many quarters. The thinkers and salespeople that Blair believed are still welcome.
Microbiological public health protection was merged with chemical and radiological protection agencies into the Health Protection Agency (HPA). Was this part of the same shared services error of judgement that is still extracting estates, payroll and HR staff to centralised locations remote from the people they were once able to know and serve effectively? Economies of scale may work for the mass production of certain items. For complex services requiring expertise that is easily lost, managing the flow of work efficiently is critical.
It should already be clear from pathology reforms that simple overcrowding and overworking doesn’t save money or improve quality in the broader picture.
But the inspection bodies are shy of tackling management issues that would threaten their ability to accredit widely. As long as it is documented in sufficient detail to be inspectable, bad government and management can be accredited.
The PHLS’s replacement, the soon-to-be-reformed-again HPA, has issued a 12 page Standard for Microbiology Investigation on Gastroenteritis and Diarrhoea. The development process is accredited to ISO 9001:2008. You can tell. There’s a page about equality impact assessment and quality. On page 7 the science bit starts.