(CAR DOOR OPENS)
- What is it today, sir? - The Ministry.
All morning on Health Service administration.
A chap just now on the radio
said the trouble with health, education and transport
is that people in Government go to private hospitals
and send their kids to private schools!
Comedy programme, was it?
And go to work in chauffeur-driven cars!
Think there's something in it, sir?
If you and Sir Humphrey went to work on a number 27...
Quite impracticable!
We work long enough hours as it is, without having to wait at bus stops.
- You'd need more efficient buses. - Certainly would.
Yes, that's what he was saying.
Same with the Health Service. You a member of BUPA, sir?
- Anything on the radio, Roy? - "Yesterday in Parliament".
Don't bother...
(RADl0) Mr Lanford, opposition member for Birmingham,
asked the Administrative Affairs Minister, James Hacker,
about reducing administrators in the Health Service.
(HACKER) We have already achieved a reduction of 11.3%
in administrative staff
and are actively pursuing further economies.
(LANF0RD) Would you explain how his assurance to the House
squares with this minute from his own department?
(REP0RTER) Then Mr Lanford dramatically produced a paper.
(LANF0RD) I quote, "If admin staff were reclassified
"from administrative to technical..."
(MPs CHEERING)
"...and the comparison changed from the financial to calendar year,
"then the figures will show a fall of 11.3%. "
Would the Minister care to comment on this shabby deception?
Bit of a googly, sir.
(HACKER) I... er... I... erm...
I have no knowledge of the document you're brandishing.
(LANF0RD) I shall give the file reference to the Minister
in exchange for an assurance of a full independent enquiry.
(JEERING)
(HACKER) I will give that assurance.
(REP0RTER) The House read the Scottish Fisheries' Bill...
That's a bit rough, innit? "A full independent enquiry"!
- You were dropped in it there. - I think I got away with it.
Lucky they didn't ask you about that new hospital, sir.
They finished it 15 months ago, and it's still got no patients.
The DHSS can't afford to staff it.
It's got staff, 500 administrators.
- Just no patients. - Who told you?
My mate Charlie, a driver for the Health Secretary.
- I'm appalled! - So am I.
The incompetence of it!
I can't think what came over you.
I beg your pardon!
- A full independent enquiry. - Humphrey, that's not what I meant.
- But you mentioned incompetence. - Yours, Humphrey, yours!
- Mine?! - You dropped me into it?
We can't foresee a small omission from the brief, but a full enquiry?!
I don't want an enquiry, but if you're drowning and thrown a rope...
That wasn't a rope, it was a noose!
You should've stood up for the department!
I prepared thoroughly for yesterday's Question Time,
but nowhere was the suggestion you'd juggled the figures so I'd mislead the House!
You wanted the figures reduced? So we reduced the figures!
- Yes, but not the administrators. - Of course not.
- That's not what I meant. - Minister, one isn't a mind-reader!
- You said reduce them, so we did. - And another thing:
How did this get out? Another leak?
This isn't a department, it's a colander!
How can we govern responsibly, if backbenchers get all the facts?
- The enquiry gives us some time. - So does a time-bomb!
- Is there a disposal squad? - Disposal squad?
Couldn't we get the independent enquiry to exonerate us?
- Do you mean rig it? - No, no, no, no!
Well... yes.
Minister!
It depends on who the chairman is.
- He absolutely has to be sound. - Sound?
He will know what is required. He will perceive the implications.
He will have a sympathetic insight into the problems.
In short, he will be "sound".
You mean... bent?
No, of course not!
He will be a man of broad understanding...
How about... a retired politician?
...and unimpeachable integrity.
Yes, I see what you mean.
- A businessman? - Oh, really!
- An academic? - No, no, no.
- Who've you got in mind? - Perhaps a retired civil servant.
- Good thinking, Humphrey. - Sir Maurice Williams.
Might not he be too independent?
- Well, he's hoping for a peerage. - Not through this?
No, but the right finding will earn him Brownie points!
- Brownie points?! - They all add up towards the badge!
- Well, Sir Maurice it is. - Thank you, Minister.
Thank you... Brown Owl.
Oh!
Good morning, Bernard.
- Two points... the Cuban refugees. - Not that again?
It's about our refusal to do any more for them.
It's not my fault, it's the Treasury. You can't beat the Treasury!
I shall say nothing.
One more public humiliation and I'll become a political refugee myself!
- And the other point? - The alleged empty hospital.
As I warned you, the driver's network is not wholly reliable.
- Roy's wrong. - Thank heavens for that!
- How did you find out? - The private secretaries' network.
And?
In fact, there are only 342 administrative staff at the hospital.
The other 170 are porters, cleaners, laundry workers, cooks, etc.
And medical staff?
Oh, none of them.
- None? - No!
We are talking about St Edward's Hospital?
Yes. It's brand-new and fully-staffed.
Unfortunately, there were cutbacks,
so there was no money for medical services.
A hospital with over 500 non-medical staff and no patients?
- There's one patient. - One?
The deputy administrator fell over scaffolding and broke his leg.
Good God!
Thank heavens I wasn't asked about this! Why hasn't it got out?
It's been contrived to look like a building site,
and so far no one's realised it's operational!
You know, scaffolding, skips, the normal thing?
Normal?! I'd better look at it before the opposition does.
Yes, it's surprising the press haven't found out.
Fortunately, most journalists are so incompetent,
they wouldn't know today is Wednesday.
It's actually Thursday, Minister.
Let's sit down there.
Why is your Minister interested in this hospital?
He's greatly concerned that it has no patients.
- It takes all sorts. - Yes.
- Evening. - Good evening.
How can there be patients when it has no nursing staff?
- Thank you. - Splendid.
- Sir Humphrey? - Thank you.
We've found at the DHSS that it takes time to get things going.
First of all, you have to sort out the smooth running of the hospital.
Having patients around would be no help at all.
They'd just be in the way.
- Tell him this is the run-in period. - Yes, yes, the run-in period.
How long is the run-in period going to last?
My Minister's agreed to an independent enquiry.
- You know what I think about that. - Yes, I know, but...
...we are going to get some patients into St Edward's...
...eventually?
Aren't we?
It's possible.
Certainly our present intention.
In a year or two.
Probably... when the financial situation has eased up a bit.
Not till then?
How can I open 40 new wards when I'm closing everywhere else?
- Treasury wouldn't wear it. - My Minister may want to shut the place.
Impossible! What about the unions?
- Are the unions active there yet? - Good point.
Remember that firebrand agitator at Southwark Hospital?
Billy Fraser, odious man. Could be useful.
Time he was moved on.
The Health Service is an advanced case of galloping bureaucracy!
Oh, certainly not galloping!
A gentle canter at the most.
- Instances flood into this office. - From whom, Minister?
MPs, constituents, doctors, nurses, the public.
Trouble makers!
- The public?! - They're the worst.
Listen to this.
"Stethoscope requisition: Due to current situation,
"it is not possible to issue the extra stethoscopes applied for.
"We can, however, supply longer tubes for your existing stethoscopes."
- Well? - Doesn't that strike you as odd?
- If they have long tubes... - No, no.
No, not longer stethoscopes, MORE stethoscopes.
If they had really long tubes,
the doctor could stand in one place and listen to all the chests.
What about nurses' uniforms?
"Apparently the latest consignment of nurses' coats
"is made of a see-through material; nurses issued with these
"are requested to report to the Director of Uniform Surveillance
"who will assess the extent of the problem."
- Nice work if you can get it. - Humphrey, I'm serious!
"Please note that the soft toilet rolls are for patients not staff.
"It would appear that staff have been using the soft toilet rolls
"for one reason or another."
"St Stephen's Mortuary will be closed over Christmas.
"During the holiday, medical staff are to cooperate
"in keeping pressure off this department."
A very civil and reasonable request.
You think the rest of the year doctors work hard to keep it busy?
These are a few isolated examples.
The Health Service is as efficient as the Government allows it.
Nonsense! The figures speak for themselves.
In ten years, the number of administrators has risen by 40,000.
The number of hospital beds has fallen by 60,000.
The annual cost of the Health Service has gone up by £1.5 billion!
If only British industry could match this growth record.
You think spending more money on fewer patients
so we can employ more administrators
is a good way of spending the taxpayer's money?
Certainly.
This money is solely to make sick people better.
No, no, no, Minister.
It is to make everybody better.
Better for showing the extent of their care and compassion.
You see, when money is allocated to the Health or Social Services,
Parliament and the country feel... cleansed.
Purified. Absolved. It is a sacrifice.
Dreadful claptrap!
After the sacrifice, nobody questions what happened to the offering.
- The public does care if it's misspent. - They care it's not seen to be misspent.
That's not true. Look at the uproar over mental hospital scandals.
My point exactly.
Those abuses had been going on happily for years.
Nobody was concerned what was being done with their money.
- What outraged them was being told! - A cynical smokescreen!
Do we not agree there's no point in a hospital run solely for the staff?
- That's not how I would express it. - It's how I would.
Indeed.
- How would you express it? - At the end of the day,
one of a hospital's prime functions is patient care.
One?
Until we have the money for nursing and medical staff,
it's a function we can't pursue. In 18 months or so...
- 18 months? ...we can open some wards.
No, it's got to be now.
I suppose we could form an inter-departmental committee
to examine the feasibility of monitoring a proposal
for admitting patients earlier.
- How long would that take to report? - Not long.
How long? About 18 months...!
I suggest we get rid of all the staff there
and use the money to open closed wards in other hospitals.
When we can afford it, we open St Edward's with medical staff.
Do that and you'll delay the opening for patients for years.
You talk as if the staff have nothing to do!
- What do they do? - Really, Minister!
There's a large number of extremely busy departments.
Firstly, the Contingency Department for fires, strikes, air raids,
nuclear war, epidemics, food or water poisoning.
In such a crisis, the hospital is a key centre for survival.
Then, the Data and Research Department,
conducting a full-scale demographic survey of the catchment area.
We have to anticipate the future requirements for maternity,
geriatrics, paediatrics and the male/female balance.
Thirdly, there's Finance - projected accounts,
balance sheets and cash-flow budgets.
Then, the Purchasing Department for purchasing medical equipment,
examining estimates, looking at price lists and catalogues...
Purchasing what?
Everything, Minister.
Everything from brain scanners to Brasso! May I continue?
Be briefer.
Would that I could, Minister, but you need to understand.
Fifth, the Technical Department for evaluations.
Sixth, the Building Department dealing with Phase 3 plans,
costing and so forth for the final phase to be completed by 1994.
Then, there's Maintenance, Cleaning and Catering,
Personnel in charge of leave, National Health Insurance, salaries,
as well as staff welfare officers to look after the 500 employees.
- And finally, Administration. - Administrators!
More administrators administrating other administrators!
This is important work, Minister.
The typing pool, stationery, office furniture and equipment.
- Liaison between departments. - Are you being serious or not?
- What do you mean? - There are NO patients!
That is what a hospital's for. Patients!
Ill people! Healing the sick!
But all these vital tasks must be done with or without patients.
Why?
- Why? - Why?
I don't understand.
How else can I express it? Why?
Would you sack the army because there's no war?
Completely different! A hospital must produce results.
We don't measure our success by results but by activity.
Those 500 people are seriously overworked!
The full establishment should be 650.
May I show you the paperwork?
No, Humphrey. Enough is enough. Sack them!
Out of the question, Minister.
We need administrators or the hospital will never open.
- Sack the ancillary staff. - The unions won't wear it.
Sack half and use the money to get doctors and nurses,
and open some wards!
No, Humphrey, that's my last word. My last word!
You may go!
Very well, Minister. I shall have a word with the unions.
- But I don't hold out much hope. - Go!
That seems to be everything. Thank you for coming.
Thank you very much.
Very good meeting.
- Got time for a drink? - A quick one.
The usual? Make yourself at home.
Thank you.
What are we going to do about St Edward's?
St Edward's Hospital?
Not much of a case. Can't fight you on it.
What do you mean?
We realise you can't keep ancillary staff on in an empty hospital.
Isn't that a bit defeatist?
What?
- Surely, you can stick up for them? - You want us to...?
It's not just your workers, you know?
The 342 civil servants must have some workers to administer.
- Civil servants are never laid off. - We live in disturbing times.
You mean, if we take industrial action, you'll support us?
My dear Brian, I am the Permanent Secretary.
My task is to turn the wheels of government.
I couldn't possibly countenance any such action.
But... if there were effective opposition from the ancillary workers,
the civil servants would have to stay.
And the Minister?
The Minister doesn't know his ACAS from his NALGO.
I haven't got much of a case.
Hospital empty for 15 months, wards not open for another year.
Pull yourself together. Think of your members' wives and children.
Their... cats... budgies!
They're resigned to it by now.
Is Billy Fraser resigned to it?
Yes... but he's over at Southwark.
Do you want to bet?
You mean...?
Well, that's a different matter, with some real shop-floor militancy.
You see? Unity. Solidarity.
- Thanks for the drink. - Thank you, Brother.
Please give my kind regards to our fraternal comrades.
# We shall not We shall not be moved #
Minister, this is Mrs Rogers, the chief administrator.
- Nice to meet you. - Billy Fraser, committee chairman.
- How nice to meet you. - I wouldn't be too sure.
This is 'F' ward.
(RACKET OF TYPEWRITERS AND PHONES)
(PHONES RING INCESSANTLY)
And this is 'J' theatre.
- How much did all this cost? - With radiotherapy... two and a quarter million.
- It's appalling it's not used! - No, a very good thing in some ways.
Prolongs its life, cuts down running costs.
But there are no patients!
But essential work has to go on.
Aren't patients essential work?
Running an organisation of 500 people is a big job.
But if they weren't here, they wouldn't be here!
This is wrong. It won't do.
Either get some patients or I'll close it.
- Well, in the course of time... - Not in the course of time. Now!
Get rid of 300 staff, get some doctors and get some patients!
Without those 300 people this hospital wouldn't function!
And it's functioning now?
Minister, it's one of the best-run hospitals in the country.
It's up for a Florence Nightingale Award.
- What, pray, is that? - "The Most Hygienic Hospital".
I've said my last word. 300 staff must go.
- 300 jobs lost?! - Surgery with a skeleton staff?!
Don't do any surgery. Do varicose veins, piles... Do something!
- You mean 300 jobs lost?! - Yes, I do.
A hospital is a place for healing of the sick!
It's employment for my members, and you want to sack them.
Is that your compassionate society?
Compassionate to patients rather than your members!
We'll come out on strike.
Very well, do that.
Who can it harm? Do, please! Strike, the sooner the better!
Take the administrators with you. Then we shan't have to pay you.
- How about a drink before home? - Yes. Thank you, Minister.
- That went well at the hospital. - Yes, Minister.
- I wasn't standing any argument. - No, Minister.
Threatening to strike! Played right into my hands. Cheers!
Aren't we missing the news?
0ur diplomatic correspondent says the US is pressuring the UK
to take Cuban refugees.
The Government has made no comment.
Got no money.
All workers in London hospitals are to go on strike at Friday midnight.
Right... What?!
A row has blown up at St Edwards
over the proposed laying-off of 170 ancillary workers.
We spoke to activist Billy Fraser.
We're striking against unemployment.
We can bring London's hospitals to a complete standstill.
There'll be no blood transfusions, no cancer treatment, nothingl
Till we have the compassionate society.
- How can you do this to patients? - It's Mr Hacker that's doing it.
But you're inflicting terrible sanctions on the innocent public.
I'd like to take this opportunity to assure the general public,
every stone will be left unturned in a search for a settlement.
Have you seen the news? You said you'd talk to the unions!
- What are we going to do? - We have a more serious problem.
Sir Maurice's independent enquiry about the department.
It's unfavourable to us.
You said he was sound!
I know, but he's also working as chairman
of the Refugee Resettlement Committee.
There are more Brownie points for refugees than enquiries!
Precisely, Minister.
We've no money to re-house the refugees.
- Minister? - I don't want to talk!
It's Number 10...
Hello, Ji...
Yes. Quite.
I see.
Not at all. Thank you.
They've seen Fraser on the news.
They want a peace formula soon!
Sir Maurice says he'll be satisfied only if the UK will house 1,000 refugees.
But we haven't the money. Or for 1,000 hospital beds...
- How many refugees? - 1,000.
1,000 refugees? 1,000 beds!
Minister, that hospital is for sick British not healthy foreigners!
- There's a huge waiting list. - Didn't you just say
Sir Maurice's enquiry was likely to come down against us?
- That's a... - That what you want?
I see your point, Minister.
Bernard, reinstate all the workers at St Edward's.
Tell Sir Maurice we can offer a new hospital,
with accommodation for 1,000 refugees.
Tell the press it was my decision and that everybody's happy.
- Do want to give a quote, Minister? - Why not? Say...
"It was a tough decision, but a necessary one.
"If Britain is to retain the name of..."
- "The compassionate society"? - Thank you.
"...the compassionate society." Got that?
Yes, Minister.
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