The Complete Yes Minister (28 page)

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
.]

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.