In fact, I hate the whole concept of accountability. For me accountability is the root cause of the problems in almost every industry, even banking. For me accountability is synonymous with blame, and blame is only useful to victims.
"Whoa, that's a bit uncaring" I hear you cry. And on the face of it, yes it is. After all, the victims of a lack of accountability in the NHS are patients, and the victims of a lack of accountability in banking are... pretty much everyone.
The problem is, the victims of accountability exist too, in huge numbers. They are patients, they are everyone, and they exist because no-one in their right mind wants to be blamed. In a system of accountability though, someone has to be blamed.
Don't get me wrong, accountability doesn't preclude blaming the system, but the process of getting to that stage almost invariably goes via individual blame, and usually the process of individual blame is levied against people with power.
People with power, also happen to be people with a lot to lose. That's because, if you are found to be accountable, there almost always has to be a punishment. That punishment usually impinges upon your quality of life, and that of your family.
The reason for this is often cited as natural justice. The victim has a right to some form of redress, some salve for the suffering inflicted upon them by the accountable. It's a compelling argument, but one that actually causes more harm than good.
The fear of redress, of blame, of personal suffering as a result, is what makes accountability such an anathema to those with power. At least those who are likely to be held accountable that is. And those people will naturally seek to avoid its harsh glare.
In doing so, the people seeking to avoid accountability create ever more victims. The fear of justice creates ever greater crimes, as it were. Especially in a system where many can see its flaws, but only a few are likely to have to pay for highlighting them.
This is particularly true where the accountable are called upon to strike a balance between competing objectives. In the public sector these competing objectives almost invariably involve targets, quality, and delivering value for money.
So, I don't really want to see accountability in the NHS, I want to see results. If someone is getting the balance wrong between targets, quality, and value for money, I want them to fix it. I don't need them to be punished, and I don't want them to fear redress.
The victims of their mistakes may disagree with me, but the victims of them hiding those mistakes to avoid accountability should totally agree.