Friday, January 12, 2007

In Slickness and Stealth

It took me almost all day to complete my personal tax return online. I had to work nothing out – all the figures had been done beforehand. All I had to do was insert them into a few boxes and it should have been obvious which ones because they should have had headings beside them which correspond to categories that exist in real life. They don’t. I phoned my accountant who helpfully informed me that accountants don’t complete personal tax returns online because the form is too baffling. Thanks John! He was very helpful though in the way that any fellow human might be if you were, say, tightrope walking the Grand Canyon blind-folded. He cheered me on but had little faith in my chances of surviving the experience. Against all odds I succeeded.

I think I probably went one better than ‘Sir’ Gerry Robinson, the ‘top businessman’ who was given six months and paid no money at all to diagnose what ails the NHS and fix it. No money well spend I’d say as he came up with nothing useful at all, just identified a batch of problems which Jade Goody could probably have placed her chubby little finger on at age six and still had time in a morning nursery session to demolish a plate of Penguin bars and Ken Russell’s peace of mind.

BBC 2 has devoted three evenings this week to following the perpetually perplexed entrepreneur around Rotherham Hospital where he has been fulfilling the role of ping pong ball between managers, nursing staff and consultants on Can Gerry Robinson Fix The NHS? (Answers on a postcard but anyone who puts ‘yes’ will be disqualified). The hospital was ‘desperate’ to try to reduce its waiting lists, not because it would be better if the lives of children and elderly people were not placed in critical jeopardy, but because they ‘might choose to go elsewhere’ and that would make the hospital unviable as a business (??)

In his six month stint, Robinson ‘discovered’ the great secret of the NHS which even those of us who have never used it know – it is not there to save people’s lives when they are ill or provide them with a bed when they want to have a baby or, indeed, pronounce them officially dead when they finally give up hope of ever receiving treatment. No, hospitals are like car manufacturers – there to provide jobs for health professionals and to compete for business with other hospitals. You don’t expect a hard-nosed business person to be the one regularly tossing in the cautionary pause of ‘It’s really about people’, but Robinson found it necessary to represent the ‘human’ element far more than he was obviously comfortable with. In the NHS the word ‘people’ was superseded by the word ‘target’ some time ago.

The claret-faced mentor started out all gung-ho announcing,

‘Good management is good management’,

to which I raised my glass of Cabernet Sauvignon and answered,

‘Good night and good luck.’

Donning his regulation scrubs, Robinson stalked the corridors of power that are the domain of the hospital elite – the theatres. Did he find a simulation of the best of ER or even Holby City? With a list of over 3,500 patients waiting for operations, you’d expect lots of yelling by surgeons demanding that the next case be gurneyed in and hospital porters zooming along corridors pausing briefly to try and extract a passing pretty nurse’s phone number. She would toss her hair, etc. etc. But no! The theatre floor was a ghost town of highly polished floors and neatly parked crash carts. No chance that the MRSA target wouldn’t be met here. You need people to transmit infection and there was no sign of any of those disease carrying vermin in this hospital’s engine room. Had they all exercised their democratic right to be treated at St Elsewhere?

Apparently not. Robinson telephoned Jade Goody who only had a minute because she was about to enter the Big Brother house for a triumphant return and, happily, not a hip replacement, (although she may have got one more quickly in the Big Brother house than Rotherham Hospital). As her voice, incredibly, was drowned out by thousands of screaming ‘fans’ she had to ring off but did manage to impart to Robinson that she thought the NHS was ‘half-arsed’, a sentiment he reflected in a later claret-faced moment, still in his regulation scrubs with his face mask nonchalantly slung around his neck like a proper doctor.

Robinson didn’t initially have a lot of time for Rotherham chief executive Brian James, whom he judged wasn’t doing any ‘day to day managing’. He then came to realise that he had unearthed possibly the jewel in the crown of the civil service turpitude – the single thing that has assured its longevity. In a service in which chief executives last an average of two years, James, who had risen through the NHS ranks and had no qualification other than being there, had already survived for eighteen whole months without anyone else in the hospital even knowing who he was. I can only hope he has been rewarded by a position as head of MI5 or is it 6? No matter.

Over the six gruelling months at Rotherham, Robinson seemed to alternately fight and cajole James as if he thought he was dealing with a child but then suddenly developed a bizarre respect for him. Rounding up his experience on Newsnight last night Robinson seemed to concede that there was something to be said for doing nothing, but doing it extremely well. His position shifted from thinking the chief executive was an awkward bastard to asserting that his salary should be trebled! Perhaps Brian James knows more about claret than the programme gives him credit for…

Cartoon from


groucho said...

A hospital bed is a parked taxi with the meter running

Dave Hill said...

Ace post, Noosa.

Ms Baroque said...

You've actually made me wish I'd seen a reality TV show. Almost. That's a first.

That's so pants said...

Hey Groucho - in the NHS's case it would seem to be more of a runaway train.

Thanks Dave

Ditto Ms B.

kris said...

You've managed to distil what it is to work, not only for the NHS, but local and central government as well.

They aren't interested in solutions with their endless restructures, it's just jobs for the boys.

That's so pants said...

Hi Kris

Years of experience working for local govt I'm afraid. I don't actually think it's so much a case of 'jobs for the boys' - although ten years ago I think this was a huge issue. These days I think that authorities are enamoured with the concept of 'business' solutions and have been seduced into believing that wealth = intelligence. At no other time in history has this been further from the truth.

kris said...

Dear Ms Pants. you're right about the business speak in local government.

What makes me laugh is: -

a) why do they think a business model will work in the provision of government; and

b) what the fuck do these morons know about business anyway? Never in my life have I met or heard of a loca government director with an MBA.

Local government "busness acumen? (Snort!) Think Clissold Leisure Centre!

That's so pants said...

Hi Kris

a) Desperation

b) Actually more and more of them do - they spend their time complaining that everything that is process-driven should be outcome-driven. Go figure.

Clissold Leisure Centre, like the Ocean Music Venue was never meant to be a community facility, rather a bullet point on someone's CV.