The former Granada boss Sir Gerry Robinson recently spent six months trying to reform Rotherham general hospital. The result was shown in three hours of fly-on-the-wall television on BBC2 last week. It was rightly put after the watershed: as politics it was certificate 18. At the end of each day Robinson could be seen slumped in the back of his car, his face buried in his hands. A tycoon sobbing in a limousine is the perfect icon of Labour’s health service.

The one laugh in the programme was Robinson’s conclusion that the NHS was “unmanagedâ€. Yet each frame was crammed with managers falling over each other, with clipboards, pagers, consultancy reports and meeting agendas. There were nursing managers, surgical managers, recovery managers, manager managers, chief executive managers. The one thing they did not do was manage but that, of course, was not their fault.

Through this jungle wandered a charismatic megaspecies, the consultants, whom everyone agreed were “unmanageableâ€. They were like the weather, an immutable constant. It did not matter what the NHS or its patients wanted, the consultants ruled, which enabled everyone else to be equally obtuse. They seemed to regard their first duty as to the heraldic privileges of their specialist tribe, be it paediatrician, anaesthetist or ophthalmologist.

 

We watched the consultants, often in league with “health and safetyâ€, blocking rationalisation of a system that had some of them doing three operations a morning and some seven. They demanded their own anaesthetists, who in turn demanded their own schedules. Surgeons wandered in and out of their private practices as waiting lists stretched over the horizon.

The message of Robinson’s inquiry was devastating and explains the ostensibly terminal chaos enveloping the NHS under Patricia Hewitt. The central arm of government, the Treasury, has clearly given up on NHS reform. No government, Labour or Tory, has the guts to break the consultants’ restrictive practices, the GPs’ “lifestyle†demands or the healthcare unions. The Treasury itself capitulated to the unions by rubber-stamping the ridiculously expensive 2004 NHS pay deal, depriving Britons for the first time of proper out-of-hours GP cover.

After a quarter century of seeing money piling up in the upper echelons of the NHS, and being wasted on management consultants and useless computers, the paymasters have had enough. While Thatcher hoped for reform by shoving the private sector into the NHS, Gordon Brown is shoving the NHS into the private sector.

More alarming is that internal pricing and payment-per-treatment will leave these mastodons financially exposed through loss of business to the private sector. In an attempt to favour this sector, the Treasury and Hewitt are refusing to allow NHS hospitals to cut tariffs to compete.

How this has been achieved despite five years of 7% annual real rises in health spending is no mystery. A lethal coalition of medical staff and private financiers is walking away with the money.

 

The Robinson programme showed what amounted to the collapse of the “public service ethos†in Britain. The government would ideally like to privatise not just the bulk of the NHS but the Post Office, the probation service, the jobcentre network and, it was reported last week, most care of the elderly.

It has clearly lost confidence in the capacity of public officials to administer services (as opposed to regulate and form policy in Whitehall). That this should be the work of a Labour government is ironic since the purpose is to circumvent those classic legacies of socialism: trade unions and the risk aversion of large organisations.

 

Nothing better illustrates this than the shambles at the Home Office where privatisation is of limited application. Its capacity to administer a service, be it immigration, drug treatment or prisons, has all but failed. Its boss, John Reid, has rewritten the rulebook of corporate accountability. He will take no collective responsibility for the actions of his forebears as home secretary, though he sat in the same cabinet as them. Nor will he take blame for any decision if he can prove he was “not told about itâ€. Bang goes the theory of corporate negligence.

 

The NHS sucks!! I was on a waiting list for 6months well it was over 6 but the most i was alloud on it for was 6months, i couldnt do there date even though i told them that so they put me back to the bottom :@. So my parents yelled at them and they put me back where i should be, so hopfuly i will get my opperation in March. However if i see a programe wanting people to complaine about the NHS i may just have to "acedently" let my story slip. :kink: