Three weeks into the new government and as perhaps we should have expected, the media are still expecting Labour to have already cleared up the shocking mess left behind by the Conservatives. And asking how this or that would be paid for – something the media rarely did with the Tories. What’s emerging very strongly is how chronic these messes are, in nearly every area of responsibility, and in my view it’s outrageous that the Tory BBC has platformed the previous incumbents so they can defend their record (defending the indefensible). Last Sunday Laura Kuenssberg interviewed former Chancellor Jeremy Hunt specifically for this purpose. He had the temerity to suggest that things were really not so bad as the government was portraying them, wheeling out his usual cherry picking fibs, such as the one that the UK is ‘the fastest growing economy in the G7’. Everyone can see all around them the evidence of a stagnant economy and broken public services. Indeed, the Tory was challenged on BBC’s Any Questions when they trotted out this ‘things aren’t so bad’ line: the rejoinder was ‘you just don’t get it, other Conservatives, too – how bad things are’. A £20m black hole in public finances will be bad enough for most.
From Ofgem to Ofwat and Ofcom, it will be clear that the Conservatives presided over an ideologically laissez faire avoidance of regulation – none of these regulators have done their job yet their CEOs and senior staff are disproportionately remunerated. What a marvellous job – a regulator who doesn’t actually regulate. A good but shocking example, given the importance of health and social care, is the scandalous state of the Care Quality Commission, recently uncovered by an investigation and interim report requested by Health Secretary Wes Streeting. Systemic failures have been identified and it’s not credible that the previous administration was unaware of them. ‘Wes Streeting said the Care Quality Commission was in such deep crisis it was not able to do its basic job reliably. His warning came after an interim report by the public care doctor Penny Dash found the CQC was plagued by low levels of physical inspections, a lack of consistency in assessments and problems with a faltering IT system’.
One in five health and care providers has not received a rating and others haven’t been inspected for years, leading to big question marks hanging over ratings that have been allocated. Mine was an area inspected some years back in a large mental health trust, but I found that they only did half of the job. Worrying. As Streeting recognises, the public must have confidence in this system and not be left wondering if, for example, they’ve made the best choice for their relative in the case of care homes. Streeting again: “When I joined the department, it was already clear that the NHS was broken and the social care system in crisis. But I have been stunned by the extent of the failings of the institution that is supposed to identify and act on failings. It’s clear to me the CQC is not fit for purpose’. What a damning judgement and what does it tell us that the CEO resigned during the time changes were being implemented. This surely is a key problem with many of these quangos (applying much more widely than ‘only’ regulators’): CEOs and senior management not up to the job and whose inadequacy pervades the culture of the organisation. Who recruits them and on what grounds? The old boy network will be one factor.
And what planet is the former CEO, Ian Trenholm, on? An article in a June issue of Civil Service World has him speaking about his imminent departure ‘after having delivered on the organisation’s “complex” transformation ambitions. ‘During my six years leading CQC, we have made important changes to the way we work in order to help improve care and keep people safe. We are now in the final stages of delivering an ambitious transformation programme – this month saw the delivery of the last big milestone in a complex and challenging programme of work’. What a way to dress up failure: the chair even said Trenholm had led the organisation towards its ambition of being a ‘smarter and better regulator’. Such eulogies are completely at odds with the findings of the investigation report.
Another quango seriously found at fault is the Criminal Cases Review Commission, which failed the wrongly convicted Andrew Malkinson so badly and failed to apologise for this even when he walked free from the Court of Appeal. ‘The Criminal Cases Review Commission twice prevented Malkinson’s case being considered again by the court, even though it knew from 2009 that DNA implicated another then unknown man. It also declined to do further forensic testing and never once looked at the original police file. These facts were known to its chair, Helen Pitcher, when Malkinson was exonerated last summer, but it took her another nine months before an apology came. Conceding that the Commission had “failed” him, Pitcher said she had not been able to say sorry before seeing the findings of an independent review of its handling of his case’. What kind of pathetic excuse is this from yet another clearly over-promoted quango head?
An independent report into the CCRC’s handling of the case detailed the many mistakes made during the course of Malkinson’s three applications. The new government is not, unlike preceding administrations, prepared to sit back and let this kind of incompetence continue: Justice Secretary Shabana Mahmood has said Pitcher is unable to fulfil her duties as chair. But it’s also emerged (so much for focus on the job) that Pitcher has been holding eight other jobs besides chairing the CCRC. One of these is chairing the Judicial Appointments Commission, seen by some as a clear conflict of interest. Two others are directing a property business and being a non-executive director at United Biscuits. She (and the no doubt many others in this position) must get up in the morning having to seriously think which role they’re occupying that day.
Inflated salaries are another issue amongst this group of often revolving doors, mutual backscratching brigade of chairs and CEOs. On discussing a new position, a Radio 4 Today programme presenter was heard trotting that old cliché that you have to offer a high (aka grossly inflated) salary to ‘get the talent, the right person’ etc. What rubbish: if ‘talent’ had not been so highly rewarded in the first place we wouldn’t be in the mess we are now, whereby the chief/worker pay ratio is so pronounced. Numerous media chiefs and presenters are definitely in the frame here when they’re not seen as doing a good job. It will take a while but we need to engender a culture where people are paid adequately for what they do but not excessively. And what about the multiple jobs syndrome, as in the CCRC case discussed above? The high profile scandal of thefts at the British Museum lifted the lid on this tendency, chair George Osborne having several jobs, meaning that they can’t apply the necessary attention and oversight to each one. How many examples are waiting to be uncovered?
All these issues have come into play during speculation about who should replace Simon Case, the compromised Cabinet Secretary who took sick leave during the stage of the Covid Inquiry when he should have appeared. He will apparently ‘step down’ in January: in my view he should have been removed on discovery of his various manifestations of wrong doing and this should not be his choice to make. But you could not make it up: one of the individuals thought to be in the running for this position is none other than Melanie Dawes, the woman who had been so feeble for so long at Ofcom. ‘She gave an interview to Civil Service World last year which touched on the difficulties of juggling parenthood with a big job, and how Grenfell had helped give her a “very deep belief in the importance of good, effective, proportionate regulation”. Again, like Trenholm discussed above, another having a strangely inflated view of their abilities and achievements – she has not regulated.
Going back to the NHS, two pieces of news have been obvious to some of us for some time, but not, it seems, to some cynical policy makers. One is the dangers associated with online medical consultations. We could have told them this and did, but they pressed ahead, resulting in many conditions being missed or misdiagnosed. ‘Patients have died after describing their symptoms to a GP in an online form rather than at a face-to-face consultation, the NHS’s safety investigations body has revealed. Online consultations with GP surgeries involve risks to patients’ safety and have led to sometimes serious harm and even death, an investigation by the Health Services Safety Investigations Branch (HSSIB) found’.
When this first started a few years ago, quite a few GPs wrote to newspapers about their concerns, stressing that with in person consultations they could see so much more, for example the gait and demeanour of the patient in front of them. NHS England saying ‘every GP practice must also offer face-to-face appointments where patients want or need them…Keeping patients safe is a priority for the NHS’ is yet another indication of how out of touch some of these quangos are: it’s often not about what the patient ‘wants or needs’, it’s about what that GP practice offers. It can still be very difficult to get a face to face appointment. I’m old enough to remember when GPs made home visits: back then we’d never have anticipated that getting a face to face appointment at the surgery would be an achievement!
The second bit of NHS news is the glaringly obvious issue that ongoing health problems are a drag on the economy. ‘With extended life expectancy Britain has wound up an increasingly sick nation – and experts say that this is as bad for GDP as it is for our health. Experts say that the UK must move towards disease prevention to save the economy and the NHS’. Never – who would have guessed this? Of course it’s been damned obvious for a long time but during the last 14 years the Tories have chosen instead to demonise through the benefits system those unable to work because of health issues which have not been addressed.
These are shocking findings for a so-called developed economy: ‘Long-term sickness is the main reason why economic inactivity in the UK rose to a record 9.4 million – or 22.2% of adults aged 16 to 64 years – in February 2024, costing the economy £43bn a year. And at least 80% of the health inequality outcomes in the UK are driven by chronic yet potentially modifiable diseases. Only 9% of men and 16% of women born today can expect to reach pension age in good health’. This is a great idea, a ‘pre-NHS’ – truly devoted to prevention. It would take a lot of organising and funding but it would be worth it.
‘Prof John Deanfield, who was asked by the government last year to set up a taskforce to identify radical new approaches to prevent cardiovascular disease and reduce pressure on the NHS, has had enough of tinkering with the current health system. Instead, he has recommended the creation of not a parallel NHS, but a pre-NHS. He envisages a system of one-stop health clinics in offices, football grounds, leisure facilities and supermarkets where people can have their health assessed, treatments prescribed, their progress monitored and motivation coached – all without having to go into the traditional medical system and, ideally, keeping them so healthy they don’t need to’.
We’ve had a few weeks off but now it’s time (should you choose) to focus on the next round of Tory infighting – yes, their ill-fated leadership campaign, illustrating just how deeply the barrel has been scraped to produce the candidates. They didn’t actually take much ‘producing’ as most have tried for the leadership before and failed. Parliamentary sketch writer John Crace observes: ‘The good news, though, is that the Conservative fun factory is back up and running. As in fully dysfunctional. The even better news is that this time the fun comes with no personal jeopardy to the country. Because whatever the outcome, none of it really matters. The Tories are no longer – for the next few years at least – a danger to anyone. Except themselves. They are an irrelevance. They now exist purely as entertainment for entertainment’s sake. An amusing diversion for lovers of political theatre’.
James Cleverly, a prime contender, gave his usual car crash interview last week on the Today programme, refusing to answer questions about one of his fellow competitors declaring support for Trump. Challenged about the timing of the leadership contest coinciding with the US election, Cleverly, clearly puzzled and irritated, kept saying he/we did not have a vote in the US election and that they could not let this election have any effect on what the Conservative Party needs to do. I did have limited sympathy for this viewpoint, since the BBC and Radio 4 in particular seem obsessed with the US election. Cleverly also posted a tweet with a photo showing himself wearing braces (is this supposed to convey authority?), his hand hovering over a pile of papers and a lackey looking on. Anyone impressed by this kind of thing surely needs to give their heads a wobble.
Meanwhile, numerous deluded Tories continue to believe that their party can still be a force to be reckoned with. Last week Tobias Elwood actually alluded to ‘our great party’ and how it can be rejuvenated. ‘But our great party must want to be led, and, more fundamentally, agree what it now stands for and where it sits in the political spectrum – so that our next leader can build on solid foundations, allowing the party to advance and rebuild trust with the nation. Edmund Burke, the philosophical founder of conservatism, stressed the importance of reform and renewal to “conserve” our shared values. After years of political turmoil, we must reaffirm what those values are. Our strength has consistently been our broad appeal to the nation, with tolerance and respect within our ranks – united around the fundamental belief in opportunity, enterprise and responsibility…’
You’d have thought he would have realised that the election result illustrated that there was manifestly not a ‘broad appeal to the nation’. Describing a meeting at the Carlton Club organised by Rishi Sunak for those who lost their seats, Elwood describes the atmosphere as ‘Far from being a wake, there was a clear sense of resolve that many of us were not done. Bruised, yes – but energised to fight another day. Churchill would have approved – given that he lost his seat on more than one occasion’. Seems more of an indication of denial and delusion. Isn’t it likely that the British public have decided for good and all that they don’t want to be governed by such a lot of self-interested and fundamentally dishonest charlatans?
Now we’re well and truly into the holiday season, the topics of mass tourism and the role of AirBnb in the worsening housing shortage have moved centre stage. Several times a week we hear news of protests taking place – not here (yet) but in Ibiza and Majorca, for example, and now Barcelona is enacting a total ban on Airbnbs and short term rentals in response to the accommodation shortage for local people. It’s shocking that the boom in short term rentals has caused rents to rise by 68% in the past ten years, while house prices have risen by 38%. It’s also staggering to learn that the city has 10, 101 apartments for short term rental, licences which will not be renewed. But there will probably be some backlash and illegal activity. Feelings are running high: locals in Barcelona have taken to spraying diners with water from water guns to protest against the deluge of tourists, 12m last year and one anti-tourism demo attracted a crowd of 3,000. It will be interesting to see how this situation develops as people will take holidays, local economies do depend on the income, yet the socioeconomic problems continue.
Finally, I was ‘tickled pink’, as they used to say, by hearing on Radio4’s The World Tonight an interview with Sarah from Talking Pictures Tv, which apparently specialises in legacy tv shows. She said she ‘couldn’t get enough of Dixon on Dock Green’, the 1960s police series starring Jack Warner. What nostalgia – Jack Warner standing under a street lamp at the start of each episode is etched on the memory: (tipping his helmet): ‘Evenin’ all….. ya know, it’s a funny old world.’ Perhaps I should tune in some time!
Politics and mental health - the missing link? 