Why I’ve had enough of performative public service posturing

On 26 January, my GP referred me to a clinic at Charing Cross. A letter arrives from Charing Cross telling me that the referral will be “reviewed” by 26 March.

I know what the GP’s letter said and it was straightforward. How it can be “reviewed” is beyond me.

Of course, it is not being “reviewed” at all. This is a neat fobbing off. The GP’s missive was replied to on receipt. That enables the hospital managers to say it was dealt with immediately, which is good for the statistics.

After that, I’m in the lap of the gods. I could be given an appointment in June or July, whenever. Who cares? The GP’s referral was processed. The fact that the hospital’s reply said nothing of any consequence is neither here nor there. This is about massaging the numbers.

Nice word “reviewed”. It’s carefully chosen. Clever and weaselly. It’s a holding description. Note: what it does not say is when I will be seen. But hey, my GP has been responded to and that’s all that counts.

Presumably, the hospital if challenged will say that the person who sent the “to be reviewed by 26 March” letter is a qualified practitioner. So, within 24 hours of receiving the GP’s referral I was in the capable hands of a medical professional. Except I’m not at all – not until I have fulfilled an actual appointment. Bear in mind, too, that doubtless what date I receive will be subject to the possibility of cancellation.

To hell with it, why not say: “We’ll see you in August”?

It’s genius. Likely, the same person who devised this ruse, who came up with “reviewed”, also dreamt up the triage system for A&E. You turn up, are told to take a seat, then someone, a triage nurse, sees you and tells you to retake your seat – for four hours. Except the figures show you weren’t sitting there for four hours without seeing anyone, you saw the triage nurse, an expert, soon after arriving.

Somewhere in the dark recesses of NHS management, there must be a unit dedicated to obfuscation and delay, and how to achieve them, while at the same time, manipulating the stats.

It’s the same as when one of my sons had their mobile phone stolen on a Friday night from a club in Brixton. The following afternoon, my phone went off. It was an inspector (inspector!) from the Met who was following up on the reported theft. My son had given him my number. He was out, getting a new phone and could not be reached. So I would have to do.

How did my son know it was stolen, is it possible he could have mislaid it, or it dropped out of his pocket? I replied I had no idea, but he had said to me “it must have been taken”. Ah, he did not actually know, then? He didn’t feel it going, didn’t see someone with it?

The inspector sounded elated. I realised what his game was, that he was phoning around on a Saturday afternoon trying to boost the area’s reported crime totals.

My son’s phone was going to be logged as “missing” instead of stolen. He didn’t deny it.

That an inspector was doing this said it all. Rather than pursue criminals he was tinkering with the numbers on his screen. It was pathetic and a total waste of his ability and experience.

It just shows that in the current public service (or perhaps further back, doubtless Sir Humphrey in Yes, Minister would recognise and applaud both initiatives) an appearance of performance matters more than the real thing.

Generally, in the private sector, this can’t happen. There is usually an alternative provider. If you’re not happy, you can go somewhere else.

Not always. The utilities and train services behave in a similar fashion. That’s because they can, because they know there is not a suitable other operator or it’s a hassle switching accounts, same as the banks.

They’re now not bothering to say why a particular train is cancelled because, let’s face it, the explanations were often risible. On a recent trip on the West Coast Main Line, the announcer simply said the train was cancelled. They apologised, so that’s alright then.

We’ve reached a dreadful impasse with our public services where we know so much is wrong, but we lack the firepower and the willpower to fix it. So instead, we’re stuck on a downward slope where actual achievement continues to reduce while deceit and frustration increase.

No politician will dare say so or tackle the problem, not head-on. The NHS tops by far every opinion poll as to what matters most to voters. It’s broken, implemented in a time when people did not live so long, when there were not expensive treatments and there were not so many people. It’s not fit for today’s Britain.

The service’s wholesale reform ought to be the number one topic in the forthcoming election – if the polls are correct. Yet, no political leader will touch it or if they do, it will be in the slightest of fashions, saying again we must pay more attention to expenditure and manage more efficiently. This is not enough, and they know it.

A public-private model is required. But no politician dares to go near, for fear of being accused of “privatising” the totemic free-for-all health service.

Instead of instilling genuine transformation, the brightest government managerial brains are employed dreaming up new ways of cooking the books.

I look forward to my review by 26 March. Mark my words, I will be contacted on 25 March.