The Sketch: A sea of administrative drivel

Now, let there be no more talk of Alan Johnson leading the Labour Party. It's all over. But that probably applies to the Government, too. Both are swamped, submerged, barely visible in an angry sea of administrative drivel.

Alan introduced a glorious revolution that will remake Britain's central institution. The organisation that has, he told us, shared our joy and comforted our sorrow.

Related articles

• Pick your own surgeon – a new future for the NHS
• Leading article: The right medicine, but far too mild a dose
• Steve Richards: The abiding lesson of the NHS is that people still look to the state in their hour of need
• Niall Dickson: Well-informed patients will make better decisions
• How the changes will affect patients
• Search the news archive for more stories

And what was this once-in-a-generation change in the NHS? "An increasing focus for GPs" would be, he said, "improving the health of individuals". Doctors are to be told to concentrate on making people better? He dreams the impossible dream. To that end, he promised he would improve the Quality and Outcomes Framework with a "clinical dashboard" to provide data published in annual "Quality Accounts". He promised "an unwavering, unrelenting, unprecedented focus on quality". That's new? Why?

When they talk like this it's because they haven't anything to say. The big idea is "to bring clarity to quality". In other words, more reporting, more data collection, more clipboards, more stopwatches, more faked results, false accounting and impenetrable managerial swill.

New medical directors, supported by clinical advisory groups, will "support the strong clinical voice elevated through the Review". And "a new Quality Board" to provide leadership".

He promised more freedom and more obligations. No new targets, but all the old targets. The highest respect for staff, but (treating staff with casual contempt) his "new expectations of professionalism redefine their roles as practitioners".

The constitution lays down rights but I don't think they're legally enforceable (the NHS only has to "have regard to the constitution" – a different thing from being legally obliged to do what the constitution stipulates).

Do you find all that lights a tall fire in the mind? I see it as kindling for the revolution. There's only so much of this the British public can take. Our mandarins should be careful because they'll get no notice of it. A sudden, massive, metastasising civil disobedience against "the rights and responsibilities of a newly-enhanced accountability". Anyone got a light?

More from Simon Carr