Everywhere we look it seems huge institutions are in crisis, all seeking solutions to deep seated problems, awash with talk of ‘reform.’
Top of the list has to be the Catholic Church.
A new pope faces demands to tackle the scandals of child abuse, financial links to the Mafia and Mexican drug cartels and minor worries such as gay marriage and birth control.
The police have to recover public confidence after the News International scandal and Hillsborough, along with a range of allegations about corruption and incompetence.
The press, of course, faces the consequences of industrial scale ‘phone hacking’ by Murdoch’s minions while the BBC – having produced a spectacular and memorable Olympics that reminded us of its finest qualities - humiliated itself over and over through its handling of the Jimmy Savile scandal.
Way down on its list of recent horrors would have been the sacking of London Radio DJ Danny Baker.
But his now infamous and damning on-air rant said more about the contradictions and problems within the BBC than any academic analysis ever could.
“It’s about kowtowing to the reams and reams of middle management,” Baker fumed, describing BBC management as lacking any integrity, interest in what they were managing or creativity, adding, “We dwell amid pinheaded weasels who know only timid, the generic and the abacus.”
I’ve been watching all this unfold over the past few weeks, returning in my mind to the implications of the Francis report and how we might begin to tackle the issues it raises and its recommendations.
Then Jeremy Hunt announced his nonsensical proposals that student nurses should have to spend a year as healthcare assistants, disregarding the logistical and financial problems of either creating new posts for them or getting rid of the tens of thousands of existing HCAs who would have to make way for them.
The fact there’s no evidence base to suggest this would make them better nurses doesn’t matter.
The signal is loud and clear: nurses are to blame for Mid Staffs.
The government will target us for ‘reform’ because a) the doctors would go ballistic were they scapegoated as we’re being [imagine student doctors being told they’d have to spend a year as hospital cleaners!] and b) senior managers are required to implement the other madcap ‘reforms’ in the shape of the new health and social care bill.
And therein lies the other problem facing anyone who ever thought there would be a rational approach to the Francis recommendations.
As with the Catholic Church, the police, the press and the BBC, the NHS has to rely on the same people who caused the mess in the first place to clear it up.
So David Nicholson remains in charge, the man whose denial of both knowledge of, or responsibility for, anything to do with Mid Staffs was truly sickening.
At trust level, managers continue to follow the same policies as those that brought ruin to Mid Staffs.
Nursing posts are being cut, the emphasis is on managerial concerns rather than clinical safety.
While indulging in ‘listening exercises’, managers are ignoring staff concerns and riding roughshod over their rights.
Patients are being put at the heart of the most fundamental principle governing the Coalition’s NHS at this moment – making savage cuts.
The same political structures are in place, underpinned by the same ideology.
On the back of Francis, we’ve been promised a Masterchef winning meal by those who know they’ve served up a dog’s dinner.
Danny Baker’s verdict on BBC management could so easily have been composed to describe those running the NHS as the pinheaded weasels who know only timid, the generic and the abacus steer us towards further chaos and scandal.
Chris Hart is nurse consultant and principal lecturer at Kingston and St George, University of London.
Follow Chris on twitter: @Chris898Hart