MTAS and other NHS websites

[Ian G Batten]

On Tue, May 15, 2007 8:59 am, vickyvicky@egypt.com said:

> The placing of an excel file in a
> public area would not have caused this degree of damage to the
> underlying data.

It might have caused a real mess if the design objectives of the system
were supposed to preclude such aggregation.   In other words, if you
designed and specified a system to prevent someone from laying hands on
all the records from the database without following procedure X, and some
bloke takes all the records and releases them anyway, not merely has
process X been broken but the whole development and test process leading
up to it is suspect.  But I doubt that level of root cause applied to the
sort of operation at work here.

[[ The rumour from the Plastic Surgery community is that MTAS is dead, and
will play no further part in the process.  See RemedyUK for more details.
]]

> AIUI the surgeons were keen to discontinue certain
> types of surgery, but were pressurised into continuing

You could argue that they were pressurised by management, but only if you
ignore the fact that the management was the senior surgeon.  From the
Kennedy report (at
http://www.bristol-inquiry.org.uk/final_report/report/sec1_chap_12_12.htm#34839)

Given that [the senior surgeon and clinical director] knew that the
solution to the problem of the PCS service (consolidating all aspects of
care at the BRHSC and appointing a new paediatric cardiac surgeon) had
been agreed in principle for some time, he chose as a surgeon to believe
that things would gradually get better, as regards increasing the numbers
of patients treated and generally improving outcomes. He also persuaded
himself that plausible justifications existed to explain the poor results
obtained at Bristol. Indeed, he would not admit that the results
generally, or his own in particular, were poor until, very late in the
day, he accepted as much as regards his operations to correct
Atrio-Ventricular Septal Defect. He adopted an approach based on optimism
rather than reality, but this is a judgment of hindsight. At the time,
there was enough room for doubt for him to persuade himself that things
would improve, whatever others might think.

To me, that sounds precisely the attitude that's been applied to MTAS:
ignoring individual warnings assuming that they were just one-offs.

> MTAS was not introduced by the medical profession. It was imposed on
> us against our will. I am only too aware of the faults in the system.
>

Well, it had the approval of all the Royal Colleges and the BMA.  It
sounds like the profession needs to consider how well its representatives
represent  it.  [[ I have a friend who's had a 15 year sabbatical, in IT,
between his house jobs in the late eighties and his MRCP last month, who
is able to bring both barrels to bear on the MTAS debacle and can relate
it to the overall MMC issues.  So I've been following it both with extra
interest and extra insights! ]]

ian