Quality vs quantity.

It is one of those trite and reflexive attitudes that we should always be improving quality. There is little talk of increasing quantity. In fact, quantity is often derided, "mass produced" being somewhat of a negative term.

Often, quality comes at the expense of quantity. I remember going to a public hospital in India and seeing their largest building, the Institute of Neurology, and being told of their expensive CT scanners. A lucky few got the benefit of these things, whilst thousands died for the lack of the simple things. The money that paid for the high status items could have helped many more people if it was used on the diseases that affect millions. One CT scanner costing 3 million dollars could be used to treat 6 million children with antibiotics for childhood pneumonia, the biggest killer of children in poorer countries. Treatment even by simply trained health workers cuts deaths by 27%. Thus we could see a few pretty CT pictures for $3 million, and probably improve our diagnosis of certain things by a bit, for a few people; or we could save 1.5 million children instead.

Basic treatments should be comprehensively available for all before public spending on higher levels of treatment.

We forget that before the onset of mass-production, only the very rich could afford most of the things we take for granted. It is romantic to think of a agrarian society with cottage crafts and artisans, but those who live in the poor villages of India are closest to this, and they want out! If they can they migrate to the cities. Are they duped? I don't think so. It is arrogant to think they are duped while we are wise. No, they just want what we take for granted.

It is mass production (quantity) that allows us the choices we have, to work with our brains instead of our hands. Machines are our slaves now instead of people. And most of our ancestors were slaves, not kings, as would be our lot in a more "natural" society.

I remember being part of an organisation that ran around preparing and collating reports, planning for strategic continuous quality improvement, months and months of work was done, reports produced, plans for continuous interviewing of clients, staff and stakeholders, with lots of meetings for good measure, for a GP clinic to begin. Finally it started operating. On the first day they saw ONE patient. The same day I saw 40. I suppose they would have seen their one patient in a very quality way though.

Endless rounds of bureaucracy and papers call for more quality and end up being a huge quantity of waffle, people running around trying to measure, monitor, report, consult, implement and review. Imagine what we could do if this workforce of paper shufflers could be liberated to do productive work instead!