Assessment is not the answer.

// 18 June 2008

Anyone who’s been through or worked in the state education system over the last decade and a half or so will be familiar with New Labour’s testing obsession, and with its outcomes: stressed children and pressurised teachers, the suppression of creative, independent thought in favour of repetitive box-ticking and further marginalisation of the schools which fail to “perform” thanks to the publication and prioritisation of league tables.

Sadly, it looks as though they’re about to apply the same disastrous practice to nursing:

The health secretary, Alan Johnson, wants the performance of every nursing team in every ward across England to be measured, with the results published on an official website.

Johnson said he wanted to promote friendly rivalry between wards over which nursing team could achieve the highest score. Trusts might decide to offer a reward to the top nursing team, but that would be a matter for local management.

The government wants to publish each trust’s overall nursing quality score, to inform patients when they are choosing where to be treated. The scheme will be piloted and first results are likely to emerge next year.

Yes, you read that right, instead of receiving the pay, support and working conditions they deserve, nurses are going to be subject to the same competitive, stress-inducing (and no doubt paperwork intensive) monitoring systems that teachers have to endure while trying to get on and do their job. But it’s ok, folks, because it’s all in the name of our favourite false friend, choice. As if choice is any replacement for quality care…

Now, of course anyone doing any job should be monitored to make sure they’re doing it well. But Johnson’s project reminds me of transport secretary Ruth Kelly’s latest scheme to sort out congestion and accidents on my local main road, the A14: a multi-million pound information system to inform drivers of congestion ahead so we can “choose” a different route. Rather than tackling the causes of the problems in our public services, the government just wants to be seen to be doing something, and uses individualism and choice as its nifty excuse.

In the case of nursing, we all stand to lose out. Struggling hospitals – and workers – don’t need public humiliation, they need funding and support.

As in many traditionally feminine sectors where workers put up with poor wages and working conditions in their desire to do a job that helps others, nurses are being let down by a society that values the production of wealth above all else, and by a government that cares more about the rhetoric of choice and far-from socialist concepts of competition than the people who are actually willing to get their hands dirty.

Comments From You

Mary Tracy9 // Posted 18 June 2008 at 10:40 pm

This is a very good post, very well written. And the topic definitely needs more coverage. Congratulations!

Louise // Posted 19 June 2008 at 7:35 am

If we have problems on NHS wards its not because of nurses, but more because the government prefers to spend billions on armed conflict rather than on its own people. Well done for pointing out the sheer stupidity of paper work in education (I’m a teacher). The league tables system has lead to cheating on a grand scale and has turned us into bureaucrats rather than educators. We need a sensible reform !

tom hulley // Posted 19 June 2008 at 9:50 am

Beautifully explained, as usual, Laura. There is an interesting book, called ‘In Stitches’, about targets etc in the NHS. It is written by a doctor in casualty (the real thing not the programme!).

Here is a link:

Shea // Posted 19 June 2008 at 11:42 am

Amen to that sister! Yet more rabid free marketeering from the NuLab chimps.

Sparklematrix // Posted 19 June 2008 at 3:09 pm

Remembering that most nurses do a year’s access course followed by a three-year diploma or a four-year degree course. It is a profession not a fucking ‘smiling’ contest. Yes, I have met some seriously ‘face ache’ nurses in my times but no more than any other front line hospital staff. It’s patriarchal and deeply sexist, it’s because nursing is still viewed as a traditionally female occupation and females are seen as the nurturers and the caregivers who smile all the time to gain approval. Patronising little shits

What’s next? “Have a nice day” as you wheel someone down to theatre for a mastectomy? Alternatively, as someone else said elsewhere “I’m sorry but your mother only has 6 hours to live” *fixed grin*.

Yes, I am a RN who left the profession because of patriarchal bullshit such as this.

Thanks for the post Laura.

Cam // Posted 26 June 2008 at 2:12 pm

Appalling. As a nurse in the states I’ve done my fair share of jumping through hoops to ensure that statistics are intact but I’ve never seen such a blatant disregard for the things that matter. Nursing isn’t about testing, competition, or paperwork it’s about caring for the entire individual in a way that doctors are incapable of. We are the intermediary, more often than not, that is responsible for patient advocacy when a voice needs to be heard. Above all else, this is a clear indication that your government its collective head up its ass when it comes to ways of measuring nursing care. If you want to measure true nursing performance, it should come directly from patients and families. They’re asking for assessment from the wrong side of the problem.

I fully admit that it’s not much better in the states. Here we have “magnet status”, which means the nurses at a particular hospital have reached a point where they’ve attended lots of meetings. You don’t see the American Medical Association (*shudder*) undergoing such nonsense in defense of their profession. But then, as a predominantly male profession why would they need to, right?

The irony of my commenting on this at all? I’m in the process of trying to gain licensure in your country. I’ll be sure to bring my lucky testing rabbits foot along, just in case.

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