Bureaucratic looting continues in the NHS

The Times of 29 January led with a story about National Health Service managers who received large redundancy payments and then found employment in the service immediately afterwards. The article was at pains to point out that the individuals involved had done nothing illegal, without fully grasping that it was the very legality of the proceedings that was their most significant feature.

If one could summarise the most important trend in the British public service of the last thirty or so years, it is the de facto legalisation of corruption. A nomenklatura class has been created and fostered by government that has been allowed, on the pretext of being necessary to the efficient running of whatever branch it works in, to loot the public purse to the most obvious private advantage. This class, instead of seeking to perform its duties as efficiently as possible for as little as possible, has the incentive, and more importantly the permission, to act in precisely the opposite way. Inefficiency makes more work, more work means more responsibility, more responsibility justifies higher pay. The only slight brake on the whole process is fear of public scandal and exposure.

The nomenklatura and the political class are in a dialectical relationship. I first realised this when the chief executive of an NHS Trust in which I worked said that his job was to get the government re-elected – not to run hospitals to the benefit of patients. When, despite his efforts, the government changed, he did not fall on his sword. On the contrary, he merely changed the songs he sang. His job was too lucrative to be sacrificed to mere principle: to expect him to speak the truth rather than mouth the expedient (to his career, that is) would be like expecting truth in advertisements.

Who is to blame for the creation of a system in which acting honestly has come to be Quixotic? The principle villain of the piece, though unintentionally so, was Mrs Thatcher. Seeing, correctly, that the public service was inefficient, she thought that the solution was scientific management paid or at least promoted by results, apparently failing to realise that scientific managers are also men, that is to say with ambitions of their own, who are easily capable of fabricating results and outmanoeuvring mere politicians any day of the week. Just as managers in joint stock companies seek to appropriate shareholders’ funds, so do managers in the public service seek to appropriate public money. And Mr Blair, with all the cunning of the untalented, became the successful capo dei capi of the new class.

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