In a move designed to increase the degree of accountability to its 'customers', the UK's National Health Service has recently created a new executive position. In the hope of finding out what this may mean for patients, we went along to interview the man at the centre of this initiative, Gerry Crumb - the NHS's new Head of Official Apologies.
UNIVERSITY OF THE BLEEDING OBVIOUS: Official Apologies - it sounds intriguing. Perhaps you could begin by outlining the responsibilities of your role?
GERRY CRUMB: Certainly, I can. It's a very exciting and challenging position. And rewarding - oh yes, it's definitely rewarding. Basically, it is my job to take the blame for everything that goes wrong throughout the NHS. I performed a similar role when I worked at the Foreign Office.
UBO: You take the blame for everything?
GERRY CRUMB: Absolutely: everything and anything. Every single mishap and mistake that occurs in any hospital, surgery or other NHS facility will henceforth be my fault.
UBO: I'm not sure I understand. Are you suggesting that it is your job to go out and deliberately make mistakes? Or have I got it wrong?
GERRY CRUMB: Sorry, my fault for not making myself clear. You see, the Government has realised that no matter what precautions they take, or what procedures they put in place, mistakes are going to be made. And inevitably, when those mistakes happen the first thing people will want to do is find someone to blame. Well, up until now the public has traditionally blamed the doctors, or the nurses, or the board of governors, or whomever. Obviously, these people have enough to contend with, without being put through hoops every time they get it a bit wrong. In fact, it's just this sort of pressure than can lead to them making further mistakes.
UBO: And this is where you come in?
GERRY CRUMB: Exactly. Whenever a doctor hacks off the wrong leg, or a nurse administers the wrong drug it's up to me to step into the breach and take the blame.
UBO: Just you?
GERRY CRUMB: Just me, yes. I have a secretary, but it's not within her remit to accept responsibility for anything.
UBO: But surely no one is going to believe that you could possibly be responsible for everything that goes wrong across the whole country?
GERRY CRUMB: Ha! What a naïve notion - as if the public gives a damn who's really responsible. As long as someone puts their hand up to it and says 'it's my fault' then it doesn't matter one jot. All they need is someone to point the finger at. Someone to say sorry. Someone to stand up in court and take the rap. Someone to be pilloried by the Sunday papers and have their name dragged through the mud.
UBO: Okay then, so how does it work in practice?
GERRY CRUMB: Well it really depends upon the severity of the incident. Let's say, for example, that someone spends two years on a waiting list for an operation, only to have it cancelled at the last minute. Well, that's a fairly mundane occurrence - happens all the time. We have a standard form letter that we send out, in which I formerly apologise, accept all responsibility and promise that it won't happen again. Of course, when it does happen again, we have another letter apologising more profusely and promising that the matter will be 'seriously investigated'. When it happens for a third time - which it invariably does - I will personally telephone the patient, assure them that the matter is being taken most seriously and intimate that I am about to tender my resignation.
UBO: I see. So what about more extreme cases - incidents which may result in more serious consequences for the patient? Let's say that a patient has had a perfectly healthy kidney removed instead of a diseased one. How would you respond?
GERRY CRUMB: Ah well the first thing we'd do is dispatch what we call a 'Fast Response Team' to the hospital. On arrival they would apologise in full to the victim -
UBO: The patient?
GERRY CRUMB: Sorry, yes, I mean the patient. They would plump his pillows up for him, buy him chocolates and flowers - maybe even take him out for a meal. Failing that, they may treat him to a day at the zoo, or a nearby theme park. Maybe a paintballing weekend - I believe they're very popular these days. Anything to placate him really. It's a damage limitation exercise, you see.
UBO: Yes, I see. Of course, the likelihood is that the patient will be far too ill to fully appreciate a paintballing weekend.
GERRY CRUMB: Yes, sorry - you're quite right. Well, in that case I would personally attend the patient myself - prostrate myself at his feet, or slash my own wrists as a demonstration of penitence.
UBO: And if that didn't appease him?
GERRY CRUMB: Oh, well - then we'd send in the helicopter gunships.
UBO: Helicopter gunships?
GERRY CRUMB: Yes, big metal things with whirly things on top. If there's one thing I learnt whilst I was at the Foreign Office is that there is no crisis too great that it can't be speedily remedied by sending in helicopter gunships.
UBO: Mr Crumb, I have to tell you that I have grave doubts about this whole scheme.
GERRY CRUMB: Well, of course you do, and I'm bound to say that I'm terribly sorry about it, and that I'm fully prepared to take all responsibility.
UBO: No, Mr Crumb, that's just not good enough; it's just too unlikely. Nobody is going to accept that it's all your fault and leave it at that, because it means that the people who are actually responsible will go unchecked.
GERRY CRUMB: Sorry.
UBO: If every criticism and complaint is fielded by you, the real culprits will just carry on as normal. There will be no incentive to improve; they will feel no obligation to raise their standards.
GERRY CRUMB: Yes... sorry.
UBO: Mr Crumb, will you please stop apologising to me.
GERRY CRUMB: Yes, err... yes...
UBO: And don't just sit there staring at the floor, Mr Crumb. There's an important point here that needs to be addressed. As long as you keep protecting these people from the consequences of their actions then there is never going be any change for the better. Doesn't it bother you that now you have been given this job, people within the medical profession will be able to get away will all manner of mistakes and malpractice, whilst somebody else gets the blame? I think this is a very dangerous new policy.
GERRY CRUMB: Well actually...
GERRY CRUMB: Well it's not really a new policy.
GERRY CRUMB: No, that's the way it's always worked. It's just that now it's been put on an official footing... Sorry.
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