Tuesday, 25 June 2013

Gammon's Law of Bureaucratic Displacement

Dr Gammon was an NHS doctor and a gifted statistician. Here are a few quotes from his study showing that increased investment has meant poorer care -

"When the NHS was established in 1948 we had 480,000 hospital beds. By the year 2000 the number had fallen to 186,000......As for staff, the number employed by the NHS has more than doubled from 350,000 in 1948 to 882,000 in 2002......between 1997 and 2002 Senior Managers and Managers increased by no less than 47.6%.... large numbers of nurses are now wholly engaged in management but are still counted as nurses. Of even greater significance is the proliferation of bureaucratic procedures involving all staff, progressively displacing their productive activity...."

"The correlation of the growth in numbers of administrators with the fall in the number of beds would then follow from a progressive displacement of productive activity of all NHS staff by the proliferation of useless and often counterproductive bureaucratic activities throughout the whole organisation. In this way, an expanding workforce and increased spending would be matched by a fall in production; the more that was put into the system the less would come out of it, a process I likened to the implosion of a black hole.... proliferation is inherent in the system itself....any attempt to modify or eliminate a procedure will add to the overall bureaucratic weight of the organisation. As with the Hydra, if you cut off one head....."

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