February 28, 2010

The state sector’s big evil: it does not sack

Filed under: Secret family courts — Granarchist @ 3:59 am
It has not been a great week for the state sector. On Friday, Basildon University hospital pleaded guilty to health and safety failings over the death of a severely disabled young man. His mother, Gill Flack, called for bosses to be “held accountable” and demanded “staff sackings”. She might as well have cried for the moon.
One mother’s impotent rage is just another example of the gulf that has opened up between the state and the private sector. Not only do state sector workers enjoy more generous pensions; they also have better job security. However horrific is the offence, rarely is anyone brought to book, let alone sacked. Instead, we are fobbed off with platitudes. “Systems have been revised” and “lessons learnt”. How many lessons does it take to learn that it is not a good idea to kill people?
Sir Stanley Kalms, the former head of Dixons and one of the more unlikely past chairmen of a National Health Service hospital, discovered how extensive is the culture of job security — and at whose expense — when he threw a tea party. He had decided that staff who had served for more than 25 years deserved a reward. It proved a revelation. Neither he nor anyone in the hospital had ever seen the majority who turned up. Some were ill, others grotesquely overweight, “all no longer fit and proper people to be in a hospital”. But they were still on the payroll.
This had serious repercussions. The hospital could not afford to employ them and the nurses it needed. So wards remained short-staffed and patients inadequately nursed. “The system does not eject. It is a great evil in the system,” said Kalms.
Examples of that “great evil” abounded last week. In healthcare, social services and education, those responsible for shocking treatment of the public remain untouched and even flourish. The report on the scandal in Mid Staffordshire NHS Foundation Trust points to up to 1,200 unnecessary deaths, including four from one family alone within 18 months. Patients were left lying on the floor in their own filth, sobbing with humiliation. But not a single individual has been publicly blamed in this officially “elite” NHS organisation. Indeed, Martin Yeates, its former chief executive, has since left with a £1m pension pot, six months’ salary and a reported £400,000 payoff.
Seven-year-old Khyra Ishaq starved to death over five months. None of the five social workers involved has been disciplined, despite a High Court judge describing the case as “beyond belief”. The policeman who left two police dogs in a car on a hot summer’s day got more flak — but then he was prosecuted by the RSPCA, a far more formidable body.
It is not just the particular case. Two sets of government figures also out last week make clear that failing to “eject” and the “great evil” this causes is systemic throughout the state sector.
Take teachers, for example. We have a state education system that is failing children at every level. It fails even to teach something as basic as literacy — achieved by a lot poorer countries than ours. At 14 well over half of white boys on free school meals have a reading age of a seven-year-old or less. With figures like these, you might think that somewhere in England’s 450,000 workforce lurked the odd incompetent teacher. Well, you would be wrong — or very nearly. In the past nine years only 78 teachers have appeared before the panel of the General Teaching Council for England over alleged incompetence. Only 12 were actually suspended.
It is even worse in the NHS. Another government report out last week makes grim reading. Almost 50,000 NHS patients a year are dying while suffering from malnutrition in English hospitals. Many elderly patients arrive malnourished but studies show their condition deteriorates once in hospital.
When I spent a year investigating NHS hospitals, I saw for myself that patients, particularly elderly patients, were just not getting fed. Meals were placed out of reach or taken away before they had time to finish. Nobody bothered to help them or checked that they had eaten. One woman I spoke to had not eaten for 48 hours. “They did offer me a teacake which had been in the fridge for months. I had to throw it away.” But I never saw a nurse, sister or modern matron reprimanded, let alone threatened with the sack. In the majority of cases nobody even noticed.
Why is the state sector so timid on our behalf? It is not just the public that suffers. Failure to pull up lazy or arrogant staff demoralises those who work hard and care about their job. One teacher in an inner-city school dismissed half the staff as failing. “I would hate them teaching my children,” he said. Yet they were never censured. Indeed, they were sometimes better rewarded than those teachers who worked hard to inspire their pupils, arranged after-school clubs and stayed late.
As the tutor remarked bitterly: “Your students can go on failing but as long as you can justify it, as long as you create a folder of evidence for your continuing professional development, you move smoothly on to the next pay level.”
So why is this happening? The education council put it down to a mixture of “hard ball, soft ball”. Union pressure is the hard ball — 61% of state employees belong to a union compared with 20% in the private sector. Union pressure is not going away any time soon. In 2006 Labour received a total of £11.8m in donations, of which £8.6m came from the trade unions — 73% of the total. The recession has left Labour more reliant on the unions for funding.
Soft ball is the culture of the state sector itself. As one chief executive of an NHS hospital put it: “We are a caring profession. But sometimes we put caring for our colleagues above caring for our patients.”
A senior non-executive director described some of the managers in her trust as “not up to the job”. This did not mean she could sack them. “The NHS”, she explained, “does not like facing noise.” A manager in social services remarked: “Time and time again I have said, ‘So-and-so is incompetent’, only to be reproved — ‘Yes, but they are awfully nice’.” A modern matron complained that discipline in the no-blame culture of the NHS is a “long-winded process”. Modern management is meant to “nurture” employees. The errant state worker is offered training and supervision and given another chance. This can go on for a year. “In the meantime,” said the former matron, “patients are going through her hands and suffering.”
The easiest way of getting rid of “awfully nice” people is to promote them elsewhere. Special project work, “reconfiguring the system” or checking up on everyone else is always popular.
But there is more than culture to blame here. In the private sector you know when you have done a good job. When the government is your boss, it is far from clear. Gordon Brown, for example, is threatening to “strike off” those hospital managers at fault at the Mid Staffordshire NHS Foundation Trust. He is being disingenuous.
It was the pursuit of targets set by the government that led to a “fundamental break of NHS values”. That dislocation of aims applies across the state sector: children’s services in Haringey, north London, received a glowing, three-star report from Ofsted even as Baby P died.
Over and over again I have seen, in schools, social services and hospitals, the attention of managers wholly taken up by the demands of the centre. The flood of targets and initiatives blinds them to what is going on in the classroom or on the ward.
Making politicians look good too often has come at the expense of the public in their care. The state sector can no longer both act as a public relations machine for the government and give mothers such as Gill Flack redress. The mess-ups last week prove it


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