• Management

There have been plenty of media reports relating to both of these stories. These letters to The Guardian speak of a “culture of denial” in the NHS. This article on the BBC website speaks of the Museum “sweeping [the allegation of thefts] under the carpet.” In both cases there had been internal investigations but both reported “nothing to see here” and in neither case did the police get involved until respectively one and two years after the allegations were made by whistleblowers (in the former case internal, in the latter external). All crimes are complex to investigate, those involving medical procedures and art thefts perhaps more than most. The more time that elapses the harder this task becomes. Investigating things is what the Police does.

OK, I hear you say: the Police can’t be trusted either. Even more recently than either of the above stories, we have learned of the conviction of a Met officer, Adam Provan, for raping a 16-year-old in 2010. At the trial, the judge criticised the Met for being “more concerned with looking after one of their own than taking the accusation seriously.” The identical allegation could be levelled at the Countess of Chester Trust and the British Museum. When all investigations are concluded, they may yet be more formally. The upshot of all three crimes therefore confirms something we really knew all along: organisations are not very good at investigating themselves.

One of the fundamental management roles of any organisation, particularly one funded publicly as all these three are, is to ensure that the law is not being broken and that all the protocols, regulations and standards expected of the staff are being adhered to. Given the fact that, in these three cases, there appear to have been serious failures, one’s left asking what all these managers actually do.

One of the recurring tropes about the NHS is that it is top-heavy. I can’t pretend to be an expert, so thought I’d ask Google the question “how many NHS managers are there?”

Statistica says that in 2022 there were 35,496. In 2018, Warwick Business School offered a figure of “about 31,000”.  NHS Confederation counted 25,119 for 2018-19 and The King’s Fund 32,588 for 2018. The Lowdown proposed in 2023 a figure of about 3% of the staff in NHS hospitals which would suggest a total of about 39,000. GB News quoted a government source in October 2022 as saying that there were 36,664. By contrast, The Daily Mail suggested in 2021 that the number was 47.5% of the NHS’s 1.2m staff, so about 570,000 people, a figure that exceeds all the others combined but one which many will have accepted.

Even the reputable sources have a certain amount of wobble, which suggests a problem of definition: what is a manager? In 2015 – and the situation may still apply now – The Nuffield Trust said, in answer to the self posed question “does the NHS have too many managers?” that “NHS managers aren’t who people think they are. The public discourse about NHS managers tends to imply they are a discrete suit-wearing group, set apart from doctors, nurses and patients. But there isn’t such a neat line between ‘managers’ and ‘non-managers’. Lots of people do a little bit of management – even though they might have a full time professional role. Meanwhile, people whose job title is ‘manager’ or ‘director’ may still get involved in hands-on front-line work.”

Moreover, some feel that the NHS is actually under-managed. The Lowdown, for instance, suggested that the 3% of people employed as managers (however defined) in the NHS “is a much lower level than in the economy overall in England, where 11% of staff are employed in management roles” (however defined).

To a certain extent, we are all managers in that we take some level or responsibility for our own work. Many of us might also supervise others, however nominally or occasionally. Does that make us managers? 

The pandemic reinforced the idea that the NHS is a national institution. It’s also big. If it were a country, it would be about the sixtieth largest by GDP in the world. It employs about as many people as live in Latvia. It is the largest employer in Europe and by many measures in the top ten in the world. It could be seen as a state within a state. That is certainly the way that the presentation of the news surrounding the Lucy Letby case has left many of us feeling. We’re conditioned to trust it – when was the last time any of us argued with our GP? However, this case appears to turn on a senior doctor being treated with a similar level of disdain as we would be if we disputed a diagnosis at our 9.35 appointment. And yet Dr Stephen Brearley seems to have been proved right.

Moreover, we have been here before. As Private Eye 1605 points out, in 1993 there was a similar case, also involving murdered children and insulin, that of Beverley Allitt in Lincolnshire. The Eye says that the enquiry showed that “vital clues were missed” during her time on the ward. The piece concludes that both stories involve “an organisation keen to bury scandal and preserve its reputation [rather than acting] on the serious concerns of senior clinical whistleblowers, a tale as old as the NHS itself.”

• Opportunism

To return to the British Museum, Despina Koutsoumba of the Association of Greek Archaeologists, said on BBC R4 Today programme on 23 August that “we want to tell the British Museum that they cannot any more say that Greek culture heritage is more protected in the British Museum.” Tim Loughton, the Conservative chairman of the British Museum All-Party Parliamentary Group, retorted that this was “blatant opportunism” and that the institution is taking the threats “seriously.”

Well, not that seriously until this week: the claim that something was wrong was first made two years ago and dismissed. Mr Loughton added that “it’s incredibly rare that things go missing.” How can he know that for sure?

This isn’t, of course, really about these particular items, however many exactly there are. When the story first became public last week, the Director of the Museum described it as “a highly unusual incident.” I suggested that it was not that unusual: how does he think many of the treasures came to be in the Museum in the first place? There are about eight million objects in the Museum’s archives, only a fraction of which are or ever have been on public display. Some of these – and certainly a good deal more than the 2,000 odd that are now missing – are regarded by the BM as “contested artefacts”. The claimants prefer stronger terms.

This article on Vice.com looks at ten of “the most disputed” which include items from China, Nigeria, Iraq, India and, of course, Greece. Geoffrey Robinson QC goes even further, claiming in 2019 that “the trustees of the British Museum have become the world’s largest receivers of stolen property.”

Given how long Greece has been demanding that the Elgin marbles be returned, the country’s desire to raise the matter again now can hardly be called “opportunistic.” The Museum has claimed that “It’s universally recognised [a bold claim] that the sculptures that still exist could never be safely returned to the building: they’re best seen and conserved in museums.” It seems unlikely that the Elgin marbles will be stolen: but the implicit claim that the smaller “contested artefacts” are safer locked away in the vaults of the museum than they would be in their countries of origin has taken a bit of a knock.

• Dishonour

Boris Johnson’s resignation honours list is still a hot potato, not least because of the wretched Nadine Dorries’ refusal to jump some months after she said she would, an act of self-interested abuse of democracy which she has now been reminded about by two town councils in her constituency.

However, this may pale compared to the list which his successor, the hopeless Liz Truss, seems to have put up. This is currently being vetted by the House of Lords’ Appointments Commission and the Cabinet Office. The fact that she should be able to submit any names at all is remarkable. She has, according to The Guardian, offered 14. Her 50-odd days at the helm will go down as the most disastrous premiership in English history. As well as throwing a sackful of cobras into the financial market which resulted in interest-rate hikes that exacerbated the cost-of-living crisis for millions, she did untold harm to the reputation of her own party. Sunak should refuse to accept any suggestions from her at all.

The whole idea of a resignation honours list – which both Blair and Brown refused to submit – is in any case the kind of thing that brings our politics into disrepute. With the possible exception of Theresa May, all PMs since Wilson have left office because of electoral defeat, personal disgrace or political incapacity. Their time having ended, and on such a down-beat, what possible justification do they have for raising their allies to positions of influence in our bloated and unrepresentative second chamber?

All of her predecessors had at least one achievement of which they could have been proud. Liz Truss can have none. Does she also have no shame?

• Retribution

It appears that Wagner mercenary supremo Yevgeny Prigozhin has been killed in a plane crash north of Moscow. It’s impossible to believe anything that comes out of that country’s official news agencies at the moment but something like this was on the cards. You don’t mount what was effectively a coup against Putin and then die peacefully in your sleep thirty years later.

Putin himself spoke about the crash on 24 August, sending his condolences to the families of the dead and describing Prigozhin as “a talented businessman.” This accomplishment, even if true, seems an odd aspect of the man’s career to single out. It’s a bit like someone remembering Henry VIII mainly for being “an accomplished musician.”

US President Joe Biden said he was “not surprised” by the news of the crash. Asked by reporters if he thought Putin was responsible, he said: “there’s not much that happens in Russia that Putin’s not behind.” Why would Putin not kill him if the opportunity presented itself?

Biden might be wishing he could do the same to Donald Trump. None of his Republican rivals seem able to do much more than make a few dents in DT’s popularity ratings. As for Biden, The New York Times says that “the president is experiencing a flurry of good news on the economy, crime, immigration and other areas, but voters so far have not given the president much credit.” Terrifying and unimaginable as it might have seemed during the Capitol riots, the prospect of a Trump victory can’t be ruled out – even if he’s in prison come election day.

• And finally

• The fire that gutted the so-called “wonkiest pub in Britain”, the Crooked House in Staffordshire earlier this month, had “arson attack” written all over it. On 24 August it was announced that two people had been arrested for just this reason. Yet to be explained as the events that led to it being demolished a couple of days later.

• Japan has started discharging millions of tonnes of treated waste water from the Fukushima nuclear plant into the Pacific. This has sparked howls of protest from China, that noted guardian of environmental interests. Most scientists appear to agree that the threat caused by the tritium (which is very hard to remove from the water) exists but is negligible, certainly by comparison with some of the other punishments which we’re meting out to the oceans.

• The season of strikes continues. On 24 August, the Local Government Chronicle announced that Unite workers in 23 councils across England and Wales will start taking industrial action next week after rejecting a pay deal. The publication quoted the union as saying that it would be “escalating the industrial action throughout the autumn, with coordinated action, longer periods of strikes and more members joining the dispute.” I wonder what group or profession will be out next…