The Incisal Edge

From The Times On Line www.timesonline.co.uk/tol/comment/columnists/melanie_reid/article7022479.ece

Sometimes it’s the stories about the little people that, more accurately than any number of polls or policy research papers, illustrate exactly the kind of society we live in.

So let me tell you the desperately sad tale of a man named Brian Gilfillan, a 36-year-old medical records supervisor. Mr Gilfillan, a quiet, blameless soul, who lived with his parents, worked all his adult life in the records department of NHS Fife.

He cared about his job and the smooth running of the department, to the extent that he regularly worked extra hours and took work home to correct errors made by others. In other words, he was one of the sons of Martha — those who toil as anonymous, dedicated backstops for the rest of us.

One of his jobs was to ensure that there was sufficient stationery, even when his line manager, Anne Starkie, was absent. One day, however, Mrs Starkie discovered that, while she was away, he had signed her name on an order for maternity forms.

Mrs Starkie, being sadly representative of a certain type of NHS middle management, decided that this was a breach of trust. She contacted human resources, who advised her to hold an investigatory hearing. At this and a subsequent hearing, Mr Gilfillan admitted that he had “forged” her name 11 times to make sure enough stationery was available for the department.

Time, surely, for a mild rebuke, an apology and an end to the matter. But oh, no, not Mrs Starkie. It was time for a witch-hunt. She decided that his actions were fraudulent, although there was no question of personal gain. The hearings continued, and her own line manager decreed that, since it had taken “a lot of probing” to get Mr Gilfillan to accept fraud, his actions amounted to serious misconduct.

Perhaps, with a sinking heart, you can guess the rest. The wheels of the NHS disciplinary juggernaut began to turn. The hearings — during which Mrs Starkie was, variously, a complainer, a judge and a prosecutor within a short space of time — increased. Six months later Mr Gilfillan received a letter that, for the first time, raised the possibility that he could be dismissed and asked him to attend another hearing.

The day before the hearing, he gave his parents money for his digs and left for work. He never arrived. The next day, October 28, 2008, his body was found hanging from a tree in the hospital grounds in Kirkcaldy. Killed, one is entitled to conclude, at least in part, by a culture of institutional zealotry within an organisation colonised by some insensitive people.

At the inquiry into his death, NHS Fife was accused by the Crown of acting “shoddily” — which I suspect may yet prove the understatement of the year. If the matter had been dealt with rationally and proportionately, the Crown said, none of this would have happened.

Under questioning, the NHS jobsworths conceded that if Mr Gilfillan had signed his own name, or placed the letters “pp” before his lamentable line manager’s name, he would not have broken any rules. They also conceded that there was no written protocol for ordering stationery when Mrs Starkie was absent, nor had they taken legal advice on whether Mr Gilfillan’s actions constituted fraud.

In a judgment this week, after the inquiry, the presiding sheriff spoke caustically of procedural failings, fundamental errors by managers and lack of training. Mr Gilfillan’s actions, the sheriff said, were neither serious misconduct nor fraudulent, and a first warning should have sufficed.

So what does this story tell us? A depressing amount, for a start, about the NHS where bullying is prevalent — according to figures in the Health Service Journal, the problem costs the organisation more than £325 million a year — but rarely exposed like this. Many of us will know people employed in some capacity by the NHS who have been fingered by Stalin.

If Britain is broken — and I’m not altogether sure that it is, not in the way that the Conservatives would have it — then part of the fracture is because we have created a world so full of systems and structures that these things have taken on a life far more important than the people who inhabit them. We have become locked into doing process and utterly rubbish at doing humanity.

Even more worrying is that rules disempower people to the point where the human race becomes genetically weakened. The ambition is no longer to get the job done; it is to make sure that the ten commandments of management are not defiled. Stupid people can do this, so stupid people are hired.

Such attitudes are toxic to any kind of entrepreneurialism, and probably the reason why few good brains go into the public sector and too few young people, raised in such a culture, start their own businesses. In the private sector, where journalists are among millions who spend their lives “forging” line managers’ signatures to obtain stationery or short-circuit trivial red tape, we would not last ten minutes if we did everything by the rules.

But we must watch out. Mr Gilfillan’s fate should serve as warning that initiative is now officially rated as a dangerous vice.

Are these things related?

www.telegraph.co.uk/health/healthnews/7213118/NHS-managers-numbers-rise-at-twice-rate-of-doctors-report-finds.html

Numbers of senior managers in the NHS have almost doubled in a decade compared with a 35 per cent increase in doctors and nurses as ‘fixation’ with the market means health service is bogged down in red tape, a report said….