The Complete Yes Minister

8 The Compassionate Society

March 13th

Having effectively squashed the awful scandal that was brewing over the Solihull project, but having done a deal with Frank Weisel on the little matter of his suggested reforms in the quango system as a price for extricating myself from the appalling mess that Humphrey had got me into, I decided this weekend to consider my various options.

First of all it has become clear that Frank has to go. He really is very uncouth and, valuable as he was to me during my days in opposition, I can see that he lacks the subtlety, skill and discretion that my professional advisers display constantly.

[The contradiction inherent in these two paragraphs indicates the state of mental confusion in which Hacker now found himself about Sir Humphrey after five months in Whitehall — Ed.]

However, having despatched the self-righteously incorruptible Frank the day before yesterday on his arduous fact-finding mission to review important centres of government — California, Jamaica, and Tahiti — I already feel a load off my mind as one significant source of pressure on me is lifted. I felt free and easy for the first time in months, as if I had actually gained time yesterday.

I am now able to draw some conclusions about the Civil Service in general and Sir Humphrey in particular. I begin to see that senior civil servants in the open structure[15] have, surprisingly enough, almost as brilliant minds as they themselves would claim to have. However, since there are virtually no goals or targets that can be achieved by a civil servant personally, his high IQ is usually devoted to the avoidance of error.

Civil servants are posted to new jobs every three years or so. This is supposed to gain them all-round experience on the way to the top. In practice, it merely ensures that they can never have any personal interest in achieving the success of a policy: a policy of any complexity takes longer than three years to see through from start to finish, so a civil servant either has to leave it before its passage is completed or he arrives on the scene long after it started. This also means you can never pin the blame for failure on any individual: the man in charge at the end will say it was started wrong, and the man in charge at the beginning will say it was finished wrong.

Curiously the Civil Service seem to approve of this system. They don’t like civil servants to become emotionally involved in the success or failure of policies. Policies are for Ministers. Ministers or Governments stand or fall by them. Civil servants see themselves as public-spirited impartial advisers attempting to implement, with total impartiality, whatever policy the Minister or the Government see fit.

Except that they don’t, do they? There’s the rub.

Because Permanent Secretaries are always trying to steer Ministers of all parties towards ‘the common ground’. [In other words, the Department’s policy — a policy they have some hope of being able to pursue uninterrupted, whichever party is in power — Ed.]

Afterthought: considering that the avoidance of error is their main priority, it is surprising how many errors they make!

March 14th

Today, Sunday, has been spent going through my boxes and mugging up on my PQs [Parliamentary Questions — Ed.] for tomorrow.

I take PQs very seriously, as do all Ministers with any sense. Although the voters are mainly aware of a Minister’s activities through the newspapers and television, his real power and influence still stems from the House of Commons. A Minister cannot afford to make an idiot of himself in the House, and will not last long if he doesn’t learn to perform there adequately.

One day a month this ghastly event takes place. PQs are the modern equivalent of throwing the Christians to the lions, or the medieval ordeal by combat. One day a month I’m on First Order, and some other Minister from some other Department is on Second Order. Another day, vice versa. [There’s also Third Order but no one knows what it’s there for because it’s never been reached — Ed.]

The Sundays and Mondays before I’m on First Order are absolute bloody anguish. I should think they’re anguish for the civil servants too. Bernard has an Assistant Private Secretary employed full-time on getting answers together for all possible supplementaries. Legions of civil servants sit around Whitehall exercising their feverish imaginations, trying to foretell what possible supplementaries could be coming from the backbenchers. Usually, of course, I can guess the political implications of a PQ better than my civil servants.

Then, when the gruesome moment arrives you stand up in the House, which is usually packed as it’s just after lunch and PQs are considered good clean fun because there’s always a chance that a Minister will humiliate himself.

Still, I’m reasonably relaxed this evening, secure in the knowledge that, as always, I am thoroughly prepared for Question Time tomorrow. One thing I’m proud of is that, no matter how Sir Humphrey makes rings round me in administrative matters,[16] I have always prided myself on my masterful control over the House.

March 15th

I can hardly believe it. PQs today were a disaster! A totally unforeseen catastrophe. Although I did manage to snatch a sort of Pyrrhic victory from the jaws of defeat. I came in bright and early and went over all the possible supplementaries — I thought! — and spent lunchtime being tested by Bernard.

The first question was from Jim Lawford of Birmingham South-West who had asked me about the government’s pledge to reduce the number of administrators in the Health Service.

I gave the prepared reply, which was a little self-congratulatory — to the civil servants who wrote it, of course, not to me!

[We have found the relevant exchange in Hansard, and reprint it below — Ed.]

Somebody had leaked this wretched paper to Lawford. He was waving it about with a kind of wild glee, his fat face shining with excitement. Everyone was shouting for an answer. Humphrey — or somebody — had been up to his old tricks again, disguising an increase in the numbers of administrative and secretarial staff simply by calling them by some other name. But a rose by any other name is still a rose, as Wordsworth said. [In fact, Shakespeare said ‘A rose by any other name would smell as sweet.’ But Hacker was an ex-journalist and Polytechnic Lecturer — Ed.] This looked like it was going to be a real political stink. And a stink by any other name is still a stink. [Or a stink by any other name would smell as bad? — Ed.] Had it stayed secret, it would have been seen as a brilliant manoeuvre to pass off an increase of staff by 7 % as a decrease of 11.3 % — but when leaked, it suddenly comes into the category of a shabby deception. What’s more, an unsuccessful shabby deception — quite the worst kind!

I stalled rather well in the circumstances:

Thank God one of my own backbenchers came to my rescue. Gerry Chandler asked me if I could reassure my friends that the enquiries would not be carried out by my own Department but by an independent investigator who would command the respect of the House. I was forced to say that I was happy to give that assurance.

So I just about satisfied the House on that one. However, I shall have to have a very serious talk about the whole matter with Humphrey and Bernard tomorrow. I don’t mind the deception, but allowing me to look ridiculous at Question Time is simply not on!

It’s not even in their interest — I wasn’t able to defend the Department, was I?

March 16th

This morning started none too well, either.

Roy [Hacker’s driver, and like all drivers, one of the best-informed men in Whitehall — Ed.] picked me up as usual, at about 8.30. I asked him to drive me to the Ministry, as I was to spend all morning on Health Service administration.

He started needling me right away.

‘Chap just been talking about that on the radio,’ he said casually. ‘Saying the trouble with the health and education and transport services is that all the top people in government go to private hospitals and send their kids to private schools…’

I laughed it off, though I sounded a little mirthless, I fear. ‘Very good. Comedy programme, was it?’

This egalitarian stuff, though daft, is always a little dangerous if it’s not watched very carefully.

‘And they go to work in chauffeur-driven cars,’ added my chauffeur.

I didn’t deign to reply. So he persisted.

‘Don’t you think there’s something in it? I mean, if you and Sir Humphrey Appleby went to work on a number 27…’

I interrupted him. ‘Quite impracticable,’ I explained firmly. ‘We work long enough hours as it is, without spending an extra hour a day waiting at the bus stop.’

‘Yes,’ said Roy. ‘You’d have to make the bus service much more efficient, wouldn’t you?’

‘We certainly would,’ I said, trying to dismiss the subject quickly.

‘Yes,’ said Roy. ‘That’s what he was saying, see?’ The man should be a television interviewer.

‘Same with the Health Service,’ Roy continued inexorably. ‘You a member of BUPA, sir?’

It was none of his bloody business. But I didn’t say so. Instead, I smiled sweetly and asked if there was anything on the radio.

‘Yesterday in Parliament, I think sir,’ he replied, reaching for the switch.

‘No, no, no, don’t bother, don’t bother,’ I shrieked casually, but too late. He switched it on, and I was forced to listen to myself.

Roy listened with great interest. After it got to Second Order he switched it off. There was a bit of an awkward silence.

‘I got away with it, didn’t I?’ I asked hopefully.

Roy chuckled. ‘You were lucky they didn’t ask you about that new St Edward’s Hospital,’ he said jovially.

‘Why?’

‘Well…’ he smacked his lips. ‘They finished building it fifteen months ago — and it’s still got no patients.’

‘I suppose,’ I said, ‘the DHSS haven’t got enough money to staff it.’

‘Oh, it’s got staff,’ said Roy. ‘Five hundred administrators. Just no patients.’

Could this be true? It hardly seemed possible.

‘Who told you this?’ I asked cautiously.

‘The lip.’

‘The lip?’

[The slang word used by drivers to describe he who knows the most — Ed.]

‘My mate Charlie,’ he explained. ‘He knows all right. He’s the driver for the Secretary of State for Health.’

When I got to the office I summoned Humphrey at once. I told him straight out that I was appalled by yesterday’s debate.

‘So am I, Minister,’ Humphrey said. I was slightly surprised to find him agreeing so vehemently.

‘The stupidity of it… the incompetence,’ I continued.

‘I agree,’ said Humphrey. ‘I can’t think what came over you.’

I blinked at him. ‘I beg your pardon?’

‘To concede a full independent enquiry…’

So that was it. I stopped him dead in his tracks. ‘Humphrey!’ I said magisterially. ‘That is not what I am talking about.’

Sir Humphrey looked puzzled. ‘But you mentioned stupidity and incompetence.’

‘Yours, Humphrey!’ I roared. ‘Yours!’

Now it seemed to be his turn to be astounded. ‘Mine, Minister?’ He was incredulous.

‘Yes. Yours. How could you drop me in it like that?’

To be fair, he personally hadn’t dropped me in it. But his precious Department had. Humphrey, however, seemed disinclined to apologise.

‘A small omission from the brief. We can’t foresee everything.’ Then his face resumed an expression of pure horror. ‘But to concede a full independent enquiry…’

I’d had enough of this. ‘I didn’t particularly want an enquiry either,’ I pointed out. ‘But if you’re drowning and somebody throws you a rope, you grab it.’

‘It was not a rope,’ replied Sir Humphrey. ‘It was a noose. You should have stood up for the Department — that is what you are here for.’

That may be what Humphrey thinks I’m here for. As a matter of fact, it’s nice to know he thinks I’m here for something. But I knew that if I didn’t stop him he would give me a little lecture on Ministerial Responsibility.

The Doctrine of Ministerial Responsibility is a handy little device conceived by the Civil Service for dropping the Minister in it while enabling the mandarins to keep their noses clean. It means, in practice, that the Civil Service runs everything and takes all the decisions, but when something goes wrong then it’s the Minister who takes the blame.

‘No, Humphrey, it won’t do,’ I interjected firmly before he could go any further. ‘I prepared myself thoroughly for Question Time yesterday. I mugged up all the Questions and literally dozens of supplementaries. I was up half Sunday night, I skipped lunch yesterday, I was thoroughly prepared.’ I decided to say it again. ‘Thoroughly prepared!’ I said. ‘But nowhere in my brief was there the slightest indication that you’d been juggling the figures so that I would be giving misleading replies to the House.’

‘Minister,’ said Humphrey in his most injured tones, ‘you said you wanted the administration figures reduced, didn’t you?’

‘Yes,’ I agreed.

‘So we reduced them.’

Dimly I began to perceive what he was saying. ‘But… you only reduced the figures, not the actual number of administrators!’

Sir Humphrey furrowed his brow. ‘Of course.’

‘Well,’ I explained patiently, ‘that was not what I meant.’

Sir Humphrey was pained. ‘Well really, Minister, we are not mind-readers. You said reduce the figures, so we reduced the figures.’

This was obvious nonsense. He knew perfectly well what I’d meant, but had chosen to take my instructions literally. It was because of this sort of Civil Service foolishness and unhelpfulness that this country is literally bleeding to death.

[We assume that Hacker did not literally mean literally — Ed.]

‘How did it get out?’ I demanded. ‘Another leak. This isn’t a Department, it’s a colander.’ I was rather pleased with that little crack. Sir Humphrey ignored it, of course. ‘How can we govern responsibly,’ I continued, ‘if backbenchers are going to get all the facts?’ There was another silence. Naturally. There was no answer to that one. ‘Anyway,’ I concluded, ‘at least an enquiry gives us a little time.’

‘So does a time bomb,’ observed my Permanent Secretary.

So I waited to see if he had a disposal squad up his sleeve. Apparently not.

‘If only you’d said we’d have a departmental enquiry,’ he complained, ‘then we could have made it last eighteen months, and finally said that it revealed a certain number of anomalies which have now been rectified but that there was no evidence of any intention to mislead. Something like that.’

I allowed myself to be diverted for a moment. ‘But there was an intention to mislead,’ I pointed out.

‘I never said there wasn’t,’ Sir Humphrey replied impatiently. ‘I merely said there was no evidence of it.’

I think I was looking blank. He explained.

The job of a professionally conducted internal enquiry is to unearth a great mass of no evidence. If you say there was no intention, you can be proved wrong. But if you say the enquiry found no evidence of an intention, you can’t be proved wrong.’

This is a most interesting insight into one of the Civil Service’s favourite devices. In future I’ll know what is really meant by a departmental enquiry. Even a full departmental enquiry. That would presumably mean that an even greater mass of no evidence had been unearthed for the occasion.

However I had to deal with the matter in hand, namely that I had agreed to an independent enquiry. ‘Couldn’t we,’ I suggested thoughtfully, ‘get an independent enquiry to find no evidence?’

‘You mean, rig it?’ enquired Sir Humphrey coldly.

This man’s double standards continue to amaze me.

‘Well… yes!’

‘Minister!’ he said, as if he was deeply shocked. Bloody hypocrite.

‘What’s wrong with rigging an independent enquiry if you can rig an internal one, I should like to know?’ Though I already know the answer — you might get caught rigging an independent enquiry.

‘No, Minister, in an independent enquiry everything depends on who the Chairman is. He absolutely has to be sound.’

‘If he’s sound,’ I remarked, ‘surely there’s a danger he’ll bring it all out into the open?’

Sir Humphrey was puzzled again. ‘No, not if he’s sound,’ he explained. ‘A sound man will understand what is required. He will perceive the implications. He will have a sensitive and sympathetic insight into the overall problem.’

He was suggesting that we rig it, in fact. He just likes to wrap it up a bit.

‘Ah,’ I said. ‘So “sound” actually means “bent”?’

‘Certainly not!’ He was too quick with his denial. Methinks Sir Humphrey doth protest too much. ‘I mean,’ he tried again, ‘a man of broad understanding…’

I decided to short-circuit the process by making some suggestions.

‘Then what about a retired politician?’

‘… and unimpeachable integrity,’ added Humphrey.

‘Oh I see.’ I paused to think. ‘What about an academic or a businessman?’

Sir Humphrey shook his head.

‘Okay,’ I said, knowing that he had someone in mind already. ‘Out with it. Who?’

‘Well, Minister, I thought perhaps… a retired civil servant.’

I saw his point. ‘Good thinking, Humphrey.’ It’s wonderful what years of training can do for you!

‘Sir Maurice Williams could be the man,’ he went on.

I wasn’t too sure about this. ‘You don’t think he might be too independent?’

‘He’s hoping for a peerage,’ said Humphrey quietly, with a smile. He appeared to think he was producing an ace from up his sleeve.

I was surprised. ‘This won’t give him one, will it?’

‘No, but the right finding will give him a few more Brownie points.’

Brownie points. This was a new concept to me. Humphrey explained that they all add up until you get the badge. This seems to make sense.

‘Right,’ I said decisively. ‘Sir Maurice it is.’ Thank God I find it so easy to take decisions.

‘Thank you, Brown Owl,’ smiled Humphrey, and left the room. He’s really quite a pleasant fellow when he gets his way, and perhaps his idea will get us out of the embarrassment of an independent enquiry actually revealing anything — whether it be something we didn’t know ourselves and should have known, or something we knew perfectly well and didn’t want others to know we had known.

Of course, I realise on reflection that there is a third, and more real, possibility — that an independent enquiry would reveal something that Humphrey knew and I didn’t know and that he didn’t want me to know and that I would look an idiot for not knowing.

Like what happened yesterday, in other words.

So perhaps it’s just as well to follow his advice, until the day dawns when I know some embarrassing information that he doesn’t.

March 17th

A long meeting with Bernard Woolley today.

First of all, he was concerned about the Cuban refugees. Naturally. I’m concerned about them too. There’s a whole row brewing in Parliament and the press about the government’s refusal to help them.

I tried to point out that it’s not my fault the Treasury won’t give us the cash.

I can’t beat the Treasury. No one can beat the Treasury.

I’ve decided to do nothing about the refugees because there’s nothing I can do. However, Bernard and I had a more fruitful and revealing conversation about the new St Edward’s Hospital that Roy had tipped me off about yesterday. It seemed at first as though Roy was misinformed.

‘You asked me to find out about that alleged empty hospital in North London,’ began Bernard.

I nodded.

‘Well, as I warned you, the driver’s network is not wholly reliable. Roy has got it wrong.’

I was very relieved. ‘How did you find out this good news?’ I asked.

‘Through the Private Secretaries’ network.’

This was impressive. Although the Private Secretaries’ network is sometimes a little slower than the drivers’ network, it is a great deal more reliable — in fact almost one hundred per cent accurate.

‘And?’

Bernard explained that at this hospital there are only 342 administrative staff. The other 170 are porters, cleaners, laundry workers, gardeners, cooks and so forth.

This seemed a perfectly reasonable figure. So I asked how many medical staff.

‘Oh, none of them,’ replied Bernard casually, as if that were perfectly obvious in any case.

I wasn’t sure I’d heard right. ‘None?’ I asked, cautiously.

‘None.’

I decided to clarify a thing or two. ‘We are talking about St Edward’s Hospital, aren’t we, Bernard?’

‘Oh yes,’ he answered cheerfully. ‘It’s brand-new, you see,’ he added as if that explained everything.

‘How new?’

‘Well,’ he said, ‘it was completed eight months ago, and fully staffed, but unfortunately there were government cutbacks at that time and there was, consequently, no money left for the medical services.’

My mind was slowly boggling. ‘A brand-new hospital,’ I repeated quietly, to make sure I had not misheard, ‘with five hundred administrative staff and no patients?’

I sat and thought quietly for a few moments.

Then Bernard said helpfully, ‘Well, there is one patient, actually, Minister?’

‘One?’ I said.

‘Yes — the Deputy Chief Administrator fell over a piece of scaffolding and broke his leg.’

I began to recover myself. ‘My God,’ I said. ‘What if I’d been asked about this in the House?’ Bernard looked sheepish. ‘Why didn’t I know? Why didn’t you tell me?’

‘I didn’t know either.’

‘Why didn’t you know? Who did know? How come this hasn’t got out?’

Bernard explained that apparently one or two people at the DHSS knew. And they have told him that this is not unusual — in fact, there are several such hospitals dotted around the country.

It seems there is a standard method of preventing this kind of thing leaking out. ‘Apparently it has been contrived to keep it looking like a building-site, and so far no one has realised that the hospital is operational. You know, scaffolding and skips and things still there. The normal thing.’

I was speechless. ‘The normal thing?’ I gasped. [Apparently, not quite speechless — Ed.]

‘I think…’ I was in my decisive mood again, ‘… I think I’d better go and see it for myself, before the Opposition get hold of this one.’

‘Yes,’ said Bernard. ‘It’s surprising that the press haven’t found out by now, isn’t it?’

I informed Bernard that most of our journalists are so amateur that they would have grave difficulty in finding out that today is Thursday.

‘It’s actually Wednesday, Minister,’ he said.

I pointed to the door.

[The following Friday Sir Humphrey Appleby met Sir Ian Whitchurch, Permanent Secretary of the Department of Health and Social Security, at the Reform Club in Pall Mall. They discussed St Edward’s Hospital. Fortunately, Sir Humphrey made a note about this conversation on one of his special pieces of margin-shaped memo paper. Sir Humphrey preferred to write in margins where possible, but, if not possible, simulated margins made him feel perfectly comfortable — Ed.]

Ian was understandably concerned about Hacker’s sudden interest in St Edward’s Hospital.

[We can infer from this note that Mr Bernard Woolley — as he then was — mentioned the matter of St Edward’s Hospital to Sir Humphrey, although when we challenged Sir Bernard — as he now is — on this point he had no recollection of doing so — Ed.]

I explained that my Minister was greatly concerned that the hospital contained no patients. We shared a certain sense of amusement on this point. My Minister was making himself faintly ridiculous. How can a hospital have patients when it has no nursing staff?

Ian quite rightly pointed out that they have great experience at the DHSS in getting hospitals going. The first step is to sort out the smooth-running of the place. Having patients around would be no help at all — they’d just get in the way. Ian therefore advised me to tell Hacker that this is the run-in period for St Edward’s.

However, anticipating further misplaced disquiet in political circles, I pressed Ian for an answer to the question: How long is the run-in period going to run? I was forced to refer to my Minister’s agreeing to a full independent enquiry.

Ian reiterated the sense of shock that he had felt on hearing of the independent enquiry. Indeed, I have no doubt that his shock is reflected throughout Whitehall.

Nevertheless, I was obliged to press him further. I asked for an indication that we are going to get some patients into St Edward’s eventually.

Sir Ian said that if possible, we would. He confirmed that it is his present intention to have some patients at the hospital, probably in a couple of years when the financial situation has eased up.

This seems perfectly reasonable to me. I do not see how he can open forty new wards at St Edward’s while making closures elsewhere. The Treasury wouldn’t wear it, and nor would the Cabinet.

But knowing my Minister, he may not see things in the same light. He may, simply because the hospital is treating no patients, attempt to shut down the whole place.

I mentioned this possibility to Ian, who said that such an idea was quite impossible. The unions would prevent it.

It seemed to me that the unions might not yet be active at St Edward’s, but Ian had an answer for that — he reminded me of Billy Fraser, the fire-brand agitator at Southwark Hospital. Dreadful man. He could be useful.

Ian’s going to move him on, I think. [Appleby Papers 19/SPZ/116]

[Perhaps we should point out that Hacker would not have been informed of the conversation described above, and Sir Humphrey’s memo was made purely as a private aide-mémoire — Ed.]

March 22nd

Today I had a showdown with Humphrey over Health Service Administration.

I had a lot of research done for me at Central House [Hacker’s party headquarters — Ed.] because I was unable to get clear statistics out of my own Department. Shocking!

They continually change the basis of comparative figures from year to year, thus making it impossible to check what kind of bureaucratic growth is going on.

‘Humphrey,’ I began, fully armed with chapter and verse, ‘the whole National Health Service is an advanced case of galloping bureaucracy.’

Humphrey seemed unconcerned. ‘Certainly not,’ he replied. ‘Not galloping. A gentle canter at the most.’

I told him that instances of idiotic bureaucracy flood in daily.

‘From whom?’

‘MPs,’ I said. ‘And constituents, and doctors and nurses. The public.’

Humphrey wasn’t interested. ‘Troublemakers,’ he said.

I was astonished. ‘The public?’

‘They are some of the worst,’ he remarked.

I decided to show him the results of some of my researches. First I showed him a memo about stethoscopes. [As luck would have it, Hacker kept copies of all the memos to which he refers in his diary. These give us a fascinating insight into the running of the National Health Service in the 1980s — Ed.]

Sir Humphrey saw nothing strange in this and commented that if a supply of longer tubes was available it was right and proper to make such an offer.

Bernard then went so far as to suggest that it could save a lot of wear and tear on the doctors — with sufficiently long tubes for their stethoscopes, he suggested, they could stand in one place and listen to all the chests on the ward.

I hope and pray that he was being facetious.

Then I showed Humphrey the memos from St Stephen’s about toilet rolls and the mortuary.

Sir Humphrey brushed these memos aside. He argued that the Health Service is as efficient and economical as the government allows it to be.

So I showed him a quite remarkable document from the Director of Uniforms in a Regional Health Authority:

Humphrey had the grace to admit he was amazed by this piece of nonsense. ‘Nice work if you can get it,’ he said with a smile.

I saved my trump card till last. And even Humphrey was concerned about the Christmas dinner memo:

Humphrey did at least admit that something might be slightly wrong if we are paying people throughout the NHS to toil away at producing all this meaningless drivel. And I learned this morning that in ten years the number of Health Service administrators has gone up by 40,000 and the number of hospital beds has gone down by 60,000. These figures speak for themselves.

Furthermore the annual cost of the Health Service has gone up by one and a half billion pounds. In real terms!

But Sir Humphrey seemed pleased when I gave him these figures. ‘Ah,’ he said smugly, ‘if only British industry could match this growth record.’

I was staggered! ‘Growth?’ I said. ‘Growth?’ I repeated. Were my ears deceiving me? ‘Growth?’ I cried. He nodded. ‘Are you suggesting that treating fewer and fewer patients so that we can employ more and more administrators is a proper use of the funds voted by Parliament and supplied by the taxpayer?’

‘Certainly.’ He nodded again.

I tried to explain to him that the money is only voted to make sick people better. To my intense surprise, he flatly disagreed with this proposition.

‘On the contrary, Minister, it makes everyone better — better for having shown the extent of their care and compassion. When money is allocated to Health and Social Services, Parliament and the country feel cleansed. Absolved. Purified. It is a sacrifice.’

This, of course, was pure sophism. ‘The money should be spent on patient care, surely?’

Sir Humphrey clearly regarded my comment as irrelevant. He pursued his idiotic analogy. ‘When a sacrifice has been made, nobody asks the Priest what happened to the ritual offering after the ceremony.’

Humphrey is wrong, wrong, wrong, wrong! In my view the country does care if the money is misspent, and I’m there as the country’s representative, to see that it isn’t.

‘With respect,[17] Minister,’ began Humphrey, one of his favourite insults in his varied repertoire, ‘people merely care that the money is not seen to be misspent.’

I rejected that argument. I reminded him of the uproar over the mental hospital scandals.

Cynical as ever, he claimed that such an uproar proved his point. ‘Those abuses had been going on quite happily for decades,’ he said. ‘No one was remotely concerned to find out what was being done with their money — it was their sacrifice, in fact. What outraged them was being told about it.’

I realised that this whole ingenious theory, whether true or false, was being used by Humphrey as a smokescreen. I decided to ask a straight question.

‘Are we or aren’t we agreed that there is no point in keeping a hospital running for the benefit of the staff?’

Humphrey did not give a straight answer.

‘Minister,’ he admonished, ‘that is not how I would have expressed the question.’

Then he fell silent.

I pointed out that that was how I had expressed it.

‘Indeed,’ he said.

And waited.

Clearly, he had no intention of answering any straight question unless it was expressed in terms which he found wholly acceptable.

I gave in. ‘All right,’ I snapped, ‘how would you express it?’

‘At the end of the day,’ he began, ‘one of a hospital’s prime functions is patient care.’

‘One?’ I said. ‘One? What else?’

He refused to admit that I had interrupted him, and continued speaking with utter calm as if I had not said a word. ‘But, until we have the money for the nursing and medical staff, that is a function that we are not able to pursue. Perhaps in eighteen months or so…’

‘Eighteen months?’ I was appalled.

‘Yes, perhaps by then we may be able to open a couple of wards,’ he said, acknowledging finally that I had spoken.

I regard this as so much stuff and nonsense. I instructed him to open some wards at once — and more than a couple.

He countered by offering to form an interdepartmental committee to examine the feasibility of monitoring a proposal for admitting patients at an earlier date.

I asked him how long that would take to report.

‘Not long, Minister.’

‘How long?’

I knew the answer before he gave it — ‘Eighteen months,’ we said in unison.

‘Terrific!’ I added sarcastically.

‘Thank you,’ he replied, charmingly unaware. It’s hopeless.

So I made a new suggestion. ‘I suggest that we get rid of everyone currently employed at the hospital and use the money to open closed wards in other hospitals.’

[As Sir Humphrey had predicted, Hacker was prepared to shut down the whole hospital — Ed.]

‘And when we can afford it,’ I added sarcastically, ‘we’ll open St Edward’s with medical staff! If you would be so kind.’

Humphrey then argued that if we closed the hospital now we would delay the opening of it with patients for years. ‘You talk,’ he said accusingly, ‘as if the staff have nothing to do, simply because there are no patients there.’

‘What do they do?’ I asked.

Humphrey was obviously expecting this question. He promptly handed me a list. A list comprising all the administrative departments and what they do — with or without patients. Extraordinary.

1. Contingency Planning Department

For strikes, air raids, nuclear war, fire epidemics, food or water poisoning, etc. In such a crisis your local general hospital will become a key centre for survival.

2. Data and Research Department

Currently this department is conducting a full-scale demographic survey of the catchment area. This is to enable the hospital to anticipate future requirements for maternity, paediatrics, geriatrics and the male/female balance.

3. Finance

Projected accounts, balance sheets, cash flow estimates depending on such variables as admission levels, inflation rate, local and national funding etc.

4. Purchasing Department

To purchase medical and other supplies, obtain estimates, review current and future catalogues and price lists.

5. Technical Department

For evaluating all proposed equipment purchases and comparing cost-effectiveness.

6. Building Department

To deal with the Phase Three building plans, the costing, the architectural liaison, and all other work necessary to complete the final phase of the hospital by 1994.

7. Maintenance

Maintenance of both the hospital structure itself, and the highly complex and expensive medical and technical equipment contained therein.

As an economy measure, this department also includes the Cleaning Department.

8. Catering

This department is self-explanatory.

9. Personnel

A very busy department, dealing with leave, National Health Insurance, and salaries. Naturally this department contains a number of staff welfare officers, who are needed to look after over 500 employees.

10. Administration

The typing pool, desks, stationery, office furniture and equipment, liaison between departments, agreeing on routine procedures.

I couldn’t tell as I read this (and tonight I still can’t) if Humphrey was playing a practical joke. Department 10 contains administrators to administrate other administrators.

I read it carefully, then I studied his face. He appeared to be serious.

‘Humphrey,’ I said, very slowly and carefully. ‘There-are-no-patients! That-is-what-a-hospital-is-for! Patients! Ill-people! Healing-the-sick!’

Sir Humphrey was unmoved. ‘I agree, Minister,’ he said, ‘but nonetheless all of these vital tasks listed here must be carried on with or without patients.’

‘Why?’ I asked.

He looked blank. ‘Why?’

‘Yes. Why?’ I repeated.

‘I don’t understand,’ he said.

I tried to rack my brains, to see how else I could put it. I finally gave up.

‘Why?’ I asked.

‘Minister,’ he said, ‘would you get rid of the Army just because there’s no war?’

A completely specious argument, and I told him so. He asked me how I would define specious. I dodged the question, and hurriedly pointed out that hospitals are different. Hospitals must get results!

At last I appeared to have shocked him. He was completely shaken out of his complacency.

‘Minister,’ he said earnestly, ‘we don’t measure our success by results, but by activity. And the activity is considerable. And productive. These 500 people are seriously overworked — the full establishment should be 650.’ He opened his briefcase. ‘May I show you some of the paperwork emanating from St Edward’s Hospital?’

That was the last thing I wanted to see.

‘No you may not,’ I replied firmly. ‘Enough is enough. Sack them all.’

He refused point-blank. He said it was impossible. He repeated that if we lost our administrators the hospital would never open. So I told him just to sack the ancillary workers. He said the unions wouldn’t wear it.

I compromised. I instructed him to sack half the administrators and half the ancillary workers. I told him to replace them with medical staff and open a couple of wards. I also told him that it was my last word on the subject.

He tried to keep the discussion going. I wouldn’t let him. But he seemed worryingly complacent about the whole situation, and as he left he said he would have a word with the Health Service unions. He held out little hope that such a solution were possible.

I’m beginning to feel like Alice in Wonderland.

[Later that week Sir Humphrey Appleby had a meeting with Brian Baker, the General Secretary of the Confederation of Administrative Unions. It seems to have taken place privately, over a glass of sherry, after another meeting in Sir Humphrey’s office. Most unusually, Sir Humphrey appears to have made no notes, memos or references to the meeting, not even in his private diary. This suggests that he regarded the discussion as potentially highly embarrassing. Fortunately, however, Brian Baker referred to this secret discussion at the next meeting of his Union’s National Executive, and his account of it appears in the minutes — Ed.]

Any Other Business:

Mr Baker reported a highly confidential meeting to the Executive Committee. He had had a talk with Sir Humphrey Appleby, Permanent Secretary of the DAA, which they had both agreed should remain completely confidential and just between themselves. Sir Humphrey had raised the matter of St Edward’s Hospital. Mr Baker had indicated that he was prepared to take a soft line in these negotiations; he felt that we had not much of a case. It could be hard to argue that the government should keep ancillary staff on indefinitely in an empty hospital.

Sir Humphrey accused Mr Baker of defeatism, and ordered him to stick up for his members. Mr Baker reported that he was initially surprised by this suggestion, until Sir Humphrey pointed out that the 342 administrators must have some workers to administer — or they too would be on the dole.

Mr Baker was surprised at this indication that Sir Humphrey might be forced to lay off some civil servants. But as Sir Humphrey had said to him ‘we live now in strange and disturbing times’.

Mr Baker asked if Sir Humphrey would support the union if we took industrial action. Sir Humphrey pointed out that he is charged with keeping the wheels of government in motion, and could not possibly countenance a show of solidarity.

Nevertheless, he hinted that he would not come down heavy on a widespread and effective show of opposition from our members.

Mr Baker wanted to know where the Minister stood on this matter. Sir Humphrey explained that the Minister does not know his ACAS from his NALGO.

Mr Baker then indicated that, if he was to cause effective disruption, he needed some active help and support from Sir Humphrey. What with the hospital empty for fifteen months and no hope of opening any wards for another year or more, he informed Sir Humphrey that our members were resigned and apathetic.

Sir Humphrey asked if Billy Fraser was resigned or apathetic. At first Mr Baker thought Sir Humphrey did not realise that Fraser is at Southwark Hospital. But Sir Humphrey indicated that he could soon be transferred to St Edward’s.

The Assistant General Secretary commented that this is good news. We can do much to improve our members’ pay and conditions at St Edward’s if there is some real shop-floor militancy to build on.

Finally, Mr Baker reported that Sir Humphrey escorted him out of the door, offering good wishes to his fraternal comrades and singing ‘we shall overcome’.

The Executive Commitee urged Mr Baker to keep a close eye on Sir Humphrey Appleby in all future negotiations because of the possibility either that he’s a traitor to his class or that he’s going round the twist.

Brian Baker, General Secretary of the Confederation of Administrative Unions, relaxing after a successful meeting of his National Executive Committee (Reproduced by kind permission of his grandson)

[Hacker’s diary continues — Ed.]

March 25th

Today I paid an official visit to St Edward’s Hospital. It was a real eye-opener.

The Welcoming Committee — I use the term in the very broadest sense, because I can hardly imagine a group of people who were less welcoming — were lined up on the steps.

I met Mrs Rogers, the Chief Administrator, and an appalling Glaswegian called Billy Fraser who rejoices in the title of Chairman of the Joint Shop Stewards Negotiating Committee. Mrs Rogers was about forty-five. Very slim, dark hair with a grey streak — a very handsome Hampstead lady who speaks with marbles in her mouth.

‘How very nice to meet you,’ I said to Fraser, offering to shake his hand.

‘I wouldn’t count on it,’ he snarled.

I was shown several empty wards, several administrative offices that were veritable hives of activity, and finally a huge deserted dusty operating theatre suite. I enquired about the cost of it. Mrs Rogers informed me that, together with Radiotherapy and Intensive Care, it cost two and a quarter million pounds.

I asked her if she was not horrified that the place was not in use.

‘No,’ she said cheerfully. ‘Very good thing in some ways. Prolongs its life. Cuts down running costs.’

‘But there are no patients,’ I reminded her.

She agreed. ‘Nonetheless,’ she added, ‘the essential work of the hospital has to go on.’

‘I thought the patients were the essential work of the hospital.’

‘Running an organisation of five hundred people is a big job, Minister,’ said Mrs Rogers, beginning to sound impatient with me.

‘Yes,’ I spluttered, ‘but if they weren’t here they wouldn’t be here.’

‘What?’

Obviously she wasn’t getting my drift. She has a completely closed mind.

I decided that it was time to be decisive. I told her that this situation could not continue. Either she got patients into the hospital, or I closed it.

She started wittering. ‘Yes, well, Minister, in the course of time I’m sure…’

‘Not in the course of time,’ I said. ‘Now. We will get rid of three hundred of your people and use the savings to pay for some doctors and nurses so that we can get some patients in.’

Billy Fraser then started to put in his two penn’orth.

‘Look here,’ he began, ‘without those two hundred people this hospital just wouldn’t function.’

‘Do you think it’s functioning now?’ I enquired.

Mrs Rogers was unshakeable in her self-righteousness. ‘It is one of the best-run hospitals in the country,’ she said. ‘It’s up for the Florence Nightingale award.’

I asked what that was, pray.

‘It’s won,’ she told me proudly, ‘by the most hygienic hospital in the Region.’

I asked God silently to give me strength. Then I told her that I’d said my last word and that three hundred staff must go, doctors and nurses hired, and patients admitted.

‘You mean, three hundred jobs lost?’ Billy Fraser’s razor-sharp brain had finally got the point.

Mrs Rogers had already got the point. But Mrs Rogers clearly felt that this hospital had no need of patients. She said that in any case they couldn’t do any serious surgery with just a skeleton medical staff. I told her that I didn’t care whether or not she did serious surgery — she could do nothing but varicose veins, hernias and piles for all I cared. But something must be done.

‘Do you mean three hundred jobs lost,’ said Billy Fraser angrily, still apparently seeking elucidation of the simple point everybody else had grasped ten minutes ago.

I spelt it out to him. ‘Yes I do, Mr Fraser,’ I replied. ‘A hospital is not a source of employment, it is a place to heal the sick.’

He was livid. His horrible wispy beard was covered in spittle as he started to shout abuse at me, his little pink eyes blazing with class hatred and alcohol. ‘It’s a source of employment for my members,’ he yelled. ‘You want to put them out of work, do you, you bastard?’ he screamed. ‘Is that what you call a compassionate society?’

I was proud of myself. I stayed calm. ‘Yes,’ I answered coolly. ‘I’d rather be compassionate to the patients than to your members.’

‘We’ll come out on strike,’ he yelled.

I couldn’t believe my eyes or ears. I was utterly delighted with that threat. I laughed in his face.

‘Fine,’ I said happily. ‘Do that. What does it matter? Who can you harm? Please, do go on strike, the sooner the better. And take all those administrators with you,’ I added, waving in the direction of the good Mrs Rogers. ‘Then we won’t have to pay you.’

Bernard and I left the battlefield of St Edward’s Hospital, I felt, as the undisputed victors of the day.

It’s very rare in politics that one has the pleasure of completely wiping the floor with one’s opponents. It’s a good feeling.

March 26th

It seems I didn’t quite wipe the floor after all. The whole picture changed in a most surprising fashion.

Bernard and I were sitting in the office late this afternoon congratulating ourselves on yesterday’s successes. I was saying, rather smugly I fear, that Billy Fraser’s strike threat had played right into my hands.

We turned on the television news. First there was an item saying that the British Government is again being pressured by the US Government to take some more Cuban refugees. And then — the bombshell! Billy Fraser came on, and threatened that the whole of the NHS in London would be going on strike tonight at midnight if we laid off workers at St Edward’s. I was shattered.

[We have been fortunate to obtain the transcript of the television news programme in question, and it is reproduced below — Ed.]

Humphrey came in at that moment.

‘Oh,’ he said, ‘you’re watching it.’

‘Yes,’ I said through clenched teeth. ‘Humphrey, you told me you were going to have a word with the unions.’

‘I did,’ he replied. ‘But well, what can I do?’ He shrugged helplessly. I’m sure he did his best with the unions. But where has it got us?

I asked him what we were supposed to do now.

But Humphrey had come, apparently, on a different matter — of equal urgency. Another bombshell, in fact!

‘It looks as if Sir Maurice Williams’ independent enquiry is going to be unfavourable to us,’ he began.

I was appalled. Humphrey had promised me that Williams was sound. He had told me that the man wanted a peerage.

‘Unfortunately,’ murmured Sir Humphrey, embarrassed, looking at his shoes, ‘he’s also trying to work his peerage in his capacity as Chairman of the Joint Committee for the Resettlement of Refugees.’

I enquired if there were more Brownie points in refugees than in government enquiries.

He nodded.

I pointed out that we simply haven’t got the money to house any more refugees.

Then came bombshell number three! The phone rang. It was Number Ten.

I got on the line. I was told rather sharply by a senior policy adviser that Number Ten had seen Billy Fraser on the six o’clock news. By ‘Number Ten’ he meant the PM. Number Ten hoped a peace formula could be found very soon.

As I was contemplating this euphemistic but heavy threat from Downing Street, Humphrey was still rattling on about the boring old Cuban refugees. Sir Maurice would be satisfied if we just housed a thousand of them, he said.

As I was about to explain, yet again, that we haven’t the time or the money to open a thousand-bed hostel… the penny dropped!

A most beautiful solution had occurred to me.

A thousand refugees with nowhere to go. A thousand-bed hospital, fully staffed. Luck was on our side after all. The symmetry was indescribably lovely.

Humphrey saw what I was thinking, of course, and seemed all set to resist. ‘Minister,’ he began, ‘that hospital has millions of pounds’ worth of high-technology equipment. It was built for sick British, not healthy foreigners. There is a huge Health Service waiting list. It would be an act of the most appalling financial irresponsibility to waste all that investment on…’

I interrupted this flow of hypocritical jingoistic nonsense.

‘But…’ I said carefully, ‘what about the independent enquiry? Into our Department? Didn’t you say that Sir Maurice’s enquiry was going to come down against us? Is that what you want?’

He paused. ‘I see your point, Minister,’ he replied thoughtfully.

I told Bernard to reinstate, immediately, all the staff at St Edward’s, to tell Sir Maurice we are making a brand-new hospital available to accommodate a thousand refugees, and to tell the press it was my decision. Everyone was going to be happy!

Bernard asked me for a quote for the press release. A good notion.

‘Tell them,’ I said, ‘that Mr Hacker said that this was a tough decision but a necessary one, if we in Britain aim to be worthy of the name of… the compassionate society.’

I asked Humphrey if he was agreeable to all this.

‘Yes Minister,’ he said. And I thought I detected a touch of admiration in his tone.