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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.]

Any Other Business:

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.

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