The NHS should aim higher than "don't be evil"

When the young whizz kids in Silicon Valley set out to use new technology to make their fortunes they believed you could make money without exploiting workers, ripping off your customers or damaging the environment.

In short you could make money without doing evil. Their unofficial motto was “don’t be evil”. The public sector’s equivalent of this is “do good”.

‘An increasing number of NHS chief executives and board members have been found wanting as their values are eroded’

Business ethics have tended to focus on the private sectors pursuit of profit and the difference between those who claim if it’s not illegal it’s OK, and those who say tax avoidance, exploiting cheap labour markets and operating monopolies and cartels may not be illegal but they are immoral.

The more the public sector strives to be competitive and businesslike the more it copies private sector ways and the greater the risk of moving from “do good” to “do no evil”.

The NHS should aim higher

It has never been acceptable to fiddle the performance figures, pull the wool over the inspector’s eyes or place staff and service users at risk to save money. But an increasing number of NHS chief executives and board members have been found wanting as their values are eroded or sacrificed under the impossible pressure of delivering year-on-year efficiencies, continuous improvements in performance and budget cuts.

As the way health and care services are delivered is radically changed new ethical dilemmas emerge.

‘“Do no evil” seems a modest ambition, nevertheless it’s one that banks and multinationals have struggled to live up to’

If a service is outsourced is it no longer subject to public sector credo of “do good”? Is the trade union no longer to be recognised, opening up the way to exploit staff? Is the commitment to equal opportunities to be reduced to not breaking the law? Are big bonuses for senior managers now acceptable whilst staff wages are cut? Is it ok to offer private healthcare as part of senior managers’ remuneration packages while cutting staff entitlement to sick pay?

“Do no evil” seems a very modest ambition, nevertheless it’s one that banks, multinationals and those high-tech industries have struggled to live up to. Surely the NHS should be better than this even if it does mean it is not as “competitive”?