Newspaper article The Journal (Newcastle, England)
Half-Baked Idea Is Bound to Fall Flat Once out of the Oven; Columnist
Byline: Barnard Trafford
IN Norton Juster's charming children's novel, The Phantom Tollbooth, there's a place called the Half-Bakery. It's where all the half-baked ideas come from.
Our Government's own Half-Bakery is working overtime at present. Its latest product is some kind of scoring system for surgeons, a notion doomed to turn out flat as a pancake.
As with many ministerial bright wheezes, at first it sounds a reasonable idea. Surely any fool can measure how good a surgeon is? Just count how many patients die on the table, how long they survive afterwards, how frequently they've had the wrong leg chopped off, even how many hours surgeons work (me, I'd rather have one poking around in my brain at the start of the day rather than at the end of an 10-hour shift, if neurosurgeons do them).
Of course, it isn't as simple as that. The surgeon's job is to get the knife out and do the removal, the transplant, I'll just issue Fawlty-style the left big the reconnection, whatever. But the nursing care thereafter might be completely out of his or her hands, whether it's brilliant or useless. You'll find There was a story, allegedly in Australia, about a hospital that couldn't understand why more patients died in intensive care on a Thursday afternoon than in all the rest of the week. Careful monitoring uncovered a simple answer.
The Thursday afternoon cleaner had difficulty finding an electrical socket for her vacuum-cleaner, so she pulled out an innocuous-looking plug for the half-hour it took her to whip round the floor.
Unfortunately, it turned out to be the power-supply for all the lifesupport machines down one side of the ward.
I'm not convinced the tale's true, but it serves to illustrate my point. There's more to the success of an operation than how good the guy with the knife is. To attempt to rank surgeons risks reducing what they do to a crazily simplistic measure.
It's like paying policemen only according to the arrests they make rather than counting successful prosecutions or crimes prevented, both of which would be much harder to measure. …