Monday, August 27, 2007

The New Man In Charge


Dinah sent me this link to a New York Times article about Robert Sillen, a former hospital administrator appointed to reform the California prison medical system. I know FooFoo5 has opinions about medical care in California prisons so I defer to his experiences there. I'm just here to think about change and how this is accomplished.

The Times article makes a point of highlighting Mr. Sillen's brash, at times profane, change-at-all-costs political incorrectness. As a Federally appointed health care receiver he has been put in charge of recreating the correctional health care system and he has threatened to break the bank to do it. Right off the top of my head, I have several thoughts about this.

My first thought is that I think I would like this guy. A straight-shooting administrator---even a profane one---would be a relief from the polished political bureaucracy that grinds ever-so-slowly and ineffectively. If he can get things accomplished by being that way, more power to him.

My second thought is that he probably won't last very long. Bureaucracy punishes efficiency, particularly when it's carried out without proper obeisance to the powers-that-be.

My third thought was triggered by this passage: "Mr. Sillen, whose $500,000 annual salary puts him among California’s highest paid public officials, said he had never visited a prison or thought much about the penal system until a recruiter called last year to persuade him to accept what the recruiter called a “mission impossible."

Oy. Uffda.

The man charged with reforming correctional health care has never been inside a prison. When he visited a penitentiary he was surprised to find "no sinks, no phones, no faxes, no way to communicate, no nothing". What? No phone? I'm shocked! Shocked, I tell you! As they used to say in the old Lost In Space show: "Danger, Will Robinson!" He is not a clinician, nor does he have correctional experience. Does anyone besides me think this is a bit odd? What were the Feds smoking? I hope he has clinical and correctional advisors he will listen to.

On the positive side, he's stating the obvious that everyone in free society needs to hear. He criticizes "tough on crime" policies that don't take into consideration the demand for health care services that these policies require. On the correctional administrative side, he criticizes prison officials who build new facilities without regard for treatment infrastructure. These are obvious things that need to be said loudly and repeatedly so no one forgets.

I wish him well.