Gordon Brown is facing a cash crunch and the NHS budget has been so badly mismanaged that many hospitals are under threat of closure…
…is there a better explanation for this massacre of hospitals? It is quite unbelievable that government ministers can agonise in public about the appointment of a few dodgy teachers, and yet refuse to offer any public comment or justification for the irreversible extinction of dozens of hospitals, hiding resolutely behind civil servants who are themselves anonymous.
Forget the ‘porno sirs’ – the real scandal is going on in the NHS
Many years ago I had a short and happy reign as comment editor of these pages, during which it was my chief joy to sign the expenses of a brilliant but heroically under-productive colleague, whose tactic was to wait until I was full of the benignity that follows lunch and present his stapled dockets, a masterpiece of Tolstoyan length and creativity.
With mock reverence he would approach my desk, and flatten the top sheet in such a way as to conceal the bottom line. “Just sign here, minister,” he would say, in the manner of Sir Humphrey; and because I believed that this was exactly how our then proprietor would have wanted me to spend his money (or whoever’s money it was; there seems to be some confusion on that point these days), I would unhesitatingly authenticate his claim.
Like tens of thousands of people set in authority, I had no time to check the detail of his assertions. I couldn’t confirm that he had indeed had lunch with Mossad or the CIA – where did I phone them? – and there was no point: the sums were tiny, and in any case I had no reason whatever to doubt his word.
He was merely playing with that sense of mild anxiety (“sign here, minister”) that afflicts any low-grade administrator, when we are asked to put our name to something, and when we know in our hearts that we do not have the resources to check it out to our perfect satisfaction. But that is how it works in every office hierarchy; that is how business works; and that is how government works.
If you look at the number of papers to which a secretary of state must affix his or her name, you will soon realise that 90 per cent of these signatures are given on trust: in the expectation that the civil servants have got it right, and that these power-squiggles of the pen are not accidentally releasing swarms of sex fiends into the community or causing a rash of superstores in the green belt. But no matter how fast we scan and we squiggle, there is a common principle accepted by all of us in positions of nominal authority. If it is your name at the bottom of the operative letter, then you carry the can.
Yours was the hand that signed the paper; your five sovereign fingers put a king to death, or authorised the new runway, or gave a teaching job to a well-known pervert. This is the abiding doctrine of ministerial responsibility, and it is the one good thing to come out of the whole sorry business of Ruth Kelly and the “porno sirs”, as we must call them in deference to the Sun.
We may wonder how on earth relatively sensible men such as Kim Howells, the minister concerned, could have decided that a sex offender was an ideal fellow to have in the changing-rooms of the school gym. What I find wholly admirable, on the other hand, is that Kim admits that he consecrated several agonising hours to the decision, and that Miss Kelly continues to protest to anyone who will listen that she bears complete responsibility for the decisions taken in her name, and the meltdown of her department.
We have an extraordinary picture of senior ministers hugging “responsibility” like lovers, and spending most of their waking hours deciding whether this or that person should be employed in this or that school; and yet there are decisions taken every day by government that are far more important, frankly, than a handful of playground perverts, that do far more damage to people’s lives, and for which ministers take no responsibility.
I do not wish in any way to deprecate the current anti-paedophile hysteria, and if Kim sends some sex offender to our school gym, then I will be mighty peeved. But I urge you, if you can, to drag your boggling eyes away from the sex offenders, and consider the NHS. I bet I am not the only MP to have noticed a sharp and recent uptick in the number of complaints about the cancellation of operations.
Last week, it was a woman who came to see me about her osteo-arthritic elbow, and the operation that was scrubbed four times in the space of a month. This morning, I heard from a hernia patient who was told, a month ago, that his condition needed urgent attention, and who received a puzzling letter last week saying that medical thinking had undergone an evolution; he was in fact right as rain, and the operation was cancelled. In so far as his hernia permits it, he is hopping mad.
Across the country, we are seeing what happens when you fire-hose cash at the NHS without properly reforming it, and then decide to turn the tap off; and it is not just operations that are being scrubbed. This week, delegates arrived in Westminster from all over the country to attend the latest meeting of Chant (Community Hospitals Acting Nationally Together), and I am afraid the tone was one of mounting desperation. There are now 80 community hospitals under threat of closure, most of them places much loved and valued by local people, founded by them, and funded by local communities until 1948.
Many readers will already know the arguments in favour of keeping such places going: that they are especially important in rural areas, where general hospitals can be hard to reach, and above all they help to relieve pressure on the acute sector. Why are the poor NHS trusts obliged to tell patients that they are, in fact, in the pink of health, and axe their operations? Because the beds in the acute sector – where they eventually perform hernia operations – are full of people who shouldn’t be there.
And why are the beds full of bed-blockers? Because there are not enough step-down beds in community hospitals. And why are they closing even more community hospitals? Because Gordon is facing a cash crunch and the NHS budget has been so badly mismanaged.
Or is there a better explanation for this massacre of hospitals? It is quite unbelievable that government ministers can agonise in public about the appointment of a few dodgy teachers, and yet refuse to offer any public comment or justification for the irreversible extinction of dozens of hospitals, hiding resolutely behind civil servants who are themselves anonymous.
I do not say that we should lay off Ruth Kelly; just that the inquisition she faces is nothing compared with that which ought to be directed at Health Secretary Patricia Hewitt.