The Complete Yes Minister

Ian reiterated the sense of shock that he had felt on hearing of the independent enquiry. Indeed, I have no doubt that his shock is reflected throughout Whitehall.

Nevertheless, I was obliged to press him further. I asked for an indication that we are going to get some patients into St Edward’s eventually.

Sir Ian said that if possible, we would. He confirmed that it is his present intention to have some patients at the hospital, probably in a couple of years when the financial situation has eased up.

This seems perfectly reasonable to me. I do not see how he can open forty new wards at St Edward’s while making closures elsewhere. The Treasury wouldn’t wear it, and nor would the Cabinet.

But knowing my Minister, he may not see things in the same light. He may, simply because the hospital is treating no patients, attempt to shut down the whole place.

I mentioned this possibility to Ian, who said that such an idea was quite impossible. The unions would prevent it.

It seemed to me that the unions might not yet be active at St Edward’s, but Ian had an answer for that — he reminded me of Billy Fraser, the fire-brand agitator at Southwark Hospital. Dreadful man. He could be useful.

Ian’s going to move him on, I think. [Appleby Papers 19/SPZ/116]

[Perhaps we should point out that Hacker would not have been informed of the conversation described above, and Sir Humphrey’s memo was made purely as a private aide-mémoire — Ed.]

March 22nd

Today I had a showdown with Humphrey over Health Service Administration.

I had a lot of research done for me at Central House [Hacker’s party headquarters — Ed.] because I was unable to get clear statistics out of my own Department. Shocking!

They continually change the basis of comparative figures from year to year, thus making it impossible to check what kind of bureaucratic growth is going on.

‘Humphrey,’ I began, fully armed with chapter and verse, ‘the whole National Health Service is an advanced case of galloping bureaucracy.’

Humphrey seemed unconcerned. ‘Certainly not,’ he replied. ‘Not galloping. A gentle canter at the most.’

I told him that instances of idiotic bureaucracy flood in daily.

‘From whom?’

‘MPs,’ I said. ‘And constituents, and doctors and nurses. The public.’

Humphrey wasn’t interested. ‘Troublemakers,’ he said.

I was astonished. ‘The public?’

‘They are some of the worst,’ he remarked.

I decided to show him the results of some of my researches. First I showed him a memo about stethoscopes. [As luck would have it, Hacker kept copies of all the memos to which he refers in his diary. These give us a fascinating insight into the running of the National Health Service in the 1980s — Ed.]

Sir Humphrey saw nothing strange in this and commented that if a supply of longer tubes was available it was right and proper to make such an offer.

Bernard then went so far as to suggest that it could save a lot of wear and tear on the doctors — with sufficiently long tubes for their stethoscopes, he suggested, they could stand in one place and listen to all the chests on the ward.

I hope and pray that he was being facetious.

Then I showed Humphrey the memos from St Stephen’s about toilet rolls and the mortuary.

Sir Humphrey brushed these memos aside. He argued that the Health Service is as efficient and economical as the government allows it to be.

So I showed him a quite remarkable document from the Director of Uniforms in a Regional Health Authority:

Humphrey had the grace to admit he was amazed by this piece of nonsense. ‘Nice work if you can get it,’ he said with a smile.

I saved my trump card till last. And even Humphrey was concerned about the Christmas dinner memo:

Humphrey did at least admit that something might be slightly wrong if we are paying people throughout the NHS to toil away at producing all this meaningless drivel. And I learned this morning that in ten years the number of Health Service administrators has gone up by 40,000 and the number of hospital beds has gone down by 60,000. These figures speak for themselves.

Furthermore the annual cost of the Health Service has gone up by one and a half billion pounds. In real terms!

But Sir Humphrey seemed pleased when I gave him these figures. ‘Ah,’ he said smugly, ‘if only British industry could match this growth record.’