JOYCE MCMILLAN for The Scotsman, 18.4.09
A DECADE AGO – or perhaps a little less – I was invited to a place in the quiet, suburban heart of West Germany to talk to a group of regional civic servants about the changes taking place in the system of British government, notably the coming of devolution. They weren’t glamorous types, these officials from the region of Hesse; most of them were bookish-looking men in sports jackets, and there were relatively few women.
But as they broke up into groups, and began an exercise in producing suggested solutions to imaginary service delivery problems, I began to notice something attractive and unfamiliar about their body language and style of argument. It was simply that they didn’t look nervous, or afraid of saying the wrong thing. Their eyes did not slide anxiously from side to side, looking to see which way the most powerful members of the group would jump; they seemed to focus on the problem, rather than on the institutional politics of the situation, and in no time at all came up with some pretty convincing answers.
They seemed, in other words, fundamentally different from their British counterparts of that time, already destabilised by a decade of permanent institutional reform, in which old yardsticks of service and effectiveness had been constantly replaced by new systems and language, imposed by an increasingly unsympathetic generation of mamagers. And now, we in Britain seem to have become resigned to a situation in which such frontline workers routinely see management, their attitudes, and their culture of instinctive bureaucratic self-protection, as an obstacle to the real delivery of the services they are supposed to provide.
And so I suspect that I can’t have been the only person to feel a despairing lurch of recognition, on Thursday afternoon, when I heard the news that NHS whistleblower Margaret Haywood, who filmed under cover for the BBC’s Panorama programme in the Royal Sussex Hospital in Brighton in an effort to expose lamentable standards of nursing care for the elderly, had been struck off the register of qualified nurses by the establishment watchdogs at the Nursing and Midwifery Council, on grounds of breach of patient confidentiality, and of prioritising her filming activities over proper patient care.
Now there is no question that Margaret Haywood had a case to answer, on both counts. Yet there were massive extentuating circumstances, both in Ms Haywood’s previous unsuccessful efforts to raise concerns through official whistleblowing channels, and in the BBC’s rigorous approach to obtaining consent from every individual shown before transmission. And to millions, the NMC’s decision to impose the harshest penalty at its disposal will therefore seem to epitomise everything that has gone wrong, over the last generation, in a British public sector now riddled with this kind of knee-jerk authoritarianism and blank-eyed rulebook management.
Time and again, in recent years, I’ve heard committed public sector employees describing how they are being driven to depression – or premature retirement – by a culture in which regulations that were initially intended to protect service users, are increasingly used by management to marginalise dissent and silence internal debate. And the results – well, I think we can see them in legions of decisions as poor as the one the NMC made on Thursday: decisions which can’t see the wood for the trees, and which are dominated not by the common-sense application of serious principle, but by the blinkered pack mentality of full-time bureaucrats and overpaid elites, whether private-sector bankers, or public-sector bosses.
Now of course, as we live through these final decaying months of New Labour rule, many people will tend to cling to David Cameron’s view that what we need is “change”; and that when we get a new party in power and new faces in Downing Street, all these abuses will somehow become things of the past. But in truth, it seems to me that both of the major UK parties have been equally complicit in creating the culture of bad, coercive management that now weakens many parts of the British public sector, and – so it seems – major parts of the private sector too. The Thatcher and Major governments of the Eighties and Nineties wasted money on introducing pseudo-market structures where they were clearly inappropriate; and in their instinctive hostility to public employees, they deliberately created the vacuum of trust into which so many layers of pettifogging management have moved, to monitor and badger frontline workers. The Blair and Brown governments have made matters worse by throwing money at these flawed structures without challenging them, and by putting extra regulatory weapons in their hands.
And now, at this point of crisis in the nation’s affairs, neither major UK party – nor, for that matter, the SNP – seems to have even the ghost of a serious policy for rooting out this culture of control-freak overmanagement, and enabling our essential public services to re-focus on their substantial goals and activities. The Tories say that we should cut public spending; although under current conditions, that would almost certainly mean management protecting their own positions, while slashing front-line workers and service delivery, with desperate consequences for the most vulnerable in our society. Labour says nothing much at all, except that the Tories are wrong.
And none of them, heaven help us, seems to possess that indispensable tool of effective practical politics: an analysis which would fully explain to us how we reached this point, where a nurse can be struck off for trying to expose the systematic neglect of her patients, while those responsible for the neglect go largely unchallenged; and which would therefore give us some idea of how to go about fixing structures which are so obviously unfit for purpose, and which – under current economic pressures – may soon become too badly broken to survive.