Cowper's Cut 219: Gray Report leaves only a graze
The Sue Gray Report finally emerged this week: it didn't contain an instant killer blow against the PM. This isn't surprising: Gray's original interim report and the journalism of Paul Brand of ITV News and Pippa Crerar of the Mirror had already got much of the picture out there. Indeed The Times reported that the PM tried to persuade Sue Gray not to publish the report, on the grounds that 'it's all out there already'.
Ahem. Even so, the report leaves a sharp, shabby picture of the Government's and 10 Downing Street's culture. There are vibrant details, such as that the karaoke machine used at one of these 'work events' was brought along by Director General for Propriety and Ethics in the Cabinet Office Helen MacNamara. Script editors for The Thick Of It would surely have rejected that as too outlandish.
A few reflections: firstly, the PM's defence of his presence at the leaving parties as 'work events' should not have obscured to him or anybody the high staff turnover giving rise to them. That is rarely the sign of a healthy or high-performing culture. Working in 10 Downing Street should be a highlight in people's careers: the rate of turnover that this report evidences proves the opposite.
This blog by former civil servant and ex-Institute For Government director Jill Rutter is a key read: full of ice-cold fury about what the cult and culture of Boris Johnson has brought into the heart of Government. Rutter writes, "The report makes really difficult reading for those who do not think a posting to work in some of the most important jobs in government is an invitation to a stag or hen do, or to behave like someone on a Club 18-30 holiday.
"The Prime Minister’s (thin) defence was that his staff were doing hard jobs and seeing the country through a pandemic. He is arguing work socialising was essential for management purposes. He could have put that exception in the rules. He did not."
Rutter rightly observes that "government press officers, who knew full well that there were parties in Downing Street (many of them happening in their own office) but repeatedly told journalists there were not, contravened the guidance on propriety in government communications by failing to be ‘open and truthful’." There have been no consequences for this deceit.
Secondly, routinely starting drinking in Downing Street at 4 pm on Fridays ('Wine Time Friday') speaks again to culture. I am about as un-puritanical when it comes to drinking as possible - but I don't routinely start at 4 pm every Friday, as the Downing Street press office clearly did.
Here, we also see naked professional incompetence: you don't need to know much about newspapers to know that late afternoon on a Friday is the point in the week when journalists will get in touch asking for comments or responses on awkward stories they have, which will lead the Saturday media. Being half a bottle of wine or more to the wind won't help anyone deal with those queries better.
Thirdly, it's repeatedly apparent that senior figures knew that holding these events took the piss out of the Government's own Covid19 regulations. We knew this already from the infamous 'Christmas parties' footage of press spokeswoman Allegra Stratton, but it is salutory to read that "Lee Cain, the then No 10 Director of Communications (a special adviser) ... emailed Martin Reynolds, No 10 official (1), and Dominic Cummings at 14.35 on 20 May 2020 stating "a 200-odd person invitation for drinks in the garden of No 10 is somewhat of a comms risk in the current environment". Cain wrote of another planned event, "I don't see how we can have some kind of party though ... it obviously comes with rather substantial comms risks".
Separately, Martin Reynolds, the PM's Principal Private Secretary, sent a WhatsApp message to a special advisor describing a journalistic inquiry as "a complete non story but better than them focusing on our drinks (which we seem to have got away with)".
The most revealing aspect was the behaviour of the Downing Street staff under review towards the cleaners and the building administrators. Gray writes of "multiple examples of a lack of respect and poor treatment of security and cleaning staff". One of the most telling signs of organisations' prevalent character and culture is how the people who do these kinds of vital, poorly-paid jobs are treated. In Downing Street's case, the answer is evidently appallingly, which won't surprise anyone with the slightest knowledge of Prime Minister Boris Johnson's character.
The Heep/Murdoch Defence
In his Commons statement on the report, PM Johnson's response was to reach for the Heep/Murdoch Defence: the last refuge of the truly desperate.
Dickens fans know that in his autobiographical 'David Copperfield', the oleaginous Uriah Heep constantly refers to his 'umbleness, and those who saw Rupert Murdoch's evidence to the phone hacking inquiry will recall his well-coached opening line "this is the most humble day of my life".
Humility doesn't come naturally to Mr Johnson, but then, neither does getting caught. (This well-reasoned blog by former Government lawyer and FT journalist David Allan Green examines how the PM got away with only getting one Fixed Penalty Notice from the infamously high-performing Met Police.)
"I am humbled, and I have learned a lesson", Mr Johnson concluded. His conduct in the subsequent debate (with a particularly witless line about the Opposition leader being 'Sir Beer Korma') proved both halves of that statement to be untrue. Surprise, surprise. A Big Dog never changes his spots.
In the press conference that followed, Mr Johnson's temper was at several points clearly close to breaking point. He finds being held to account so impertinent.
Code breaker
As if to prove how "humbled" Mr Johnson wasn't, the Mirror's Pippa Crerar spotted that he updated the Ministerial Code to make it clear that breaking the Ministerial Code no longer means a minister must offer their resignation.
Instead, the options now open to the PM “where he retains confidence in the minister” will include “some form of public apology, remedial action or removal of ministerial salary for a period.”
The covering statement clarifies that “it is disproportionate to expect that any breach, however minor, should lead automatically to resignation or dismissal.” So that's handy. You never know when you might inadvertently illegally proprogue Parliament, or suchlike.
Fictional whataboutery
Attempts to defend Partygate didn't get more pathetic than Conservative MP Richard Bacon's. In a classic of the fictional whataboutery genre, Mr Bacon told BBC News that NHS staff "let their hair down". Mr Bacon said, "You haven't gone and investigated it but there are one and a half million people who work in the NHS. I bet if you tried hard enough you could find some people letting their hair down who were working 24/7 in the NHS as well".
Bacon had, of course, no evidence for his bet. Hey-ho: you can take the MP out of South Norfolk, but you can't take South Norfolk out of the MP.
Also trying to make Partygate go away, Chancellor Rishi 'The Brand' Sunak (whose pronouns are 'low-tax, Conservative') U-turned and decided that an energy company windfall tax to help people pay their heating bills was in fact a good thing.
This move might help to relieve hypothermia demand on the NHS come the winter months: good. Although it would be a shame if it overshadowed the revelation that the Treasury spent half a million pounds of public money on focus groups and polling to help increase Mr Sunak's popularity. No cost of living crisis on Horseguards Parade, it seems.
Safety last
Ambulance and maternity services are fast becoming the canaries in the coal mine of the ongoing collapse in NHS performance and safety.
Health Service Journal covered the director of nursing of West Midlands Ambulance Service's remarks that his organisation is at risk of collapse by August. HSJ also covered the Care Quality Commission 's report on the dreadul state of ambulance services in Cornwall.
The CQC was also scathing in its criticism of Nottingham Hospitals' maternity services, citing serious staffing and cultural problems. NHS England did an about-turn from its original choice of Julie Dent to lead the inquiry into this, and asked Donna Ockenden to step in. The current inquiry's interim report will, HSJ reports, still be published.
The Sunday Times had further details on its story about the North East Ambulance Service scandal.
Workforce
This week saw a slight improvement in staff numbers, with vacancies dropping to 105,000 from the 110,000 peak in the last set of figures.
The Commons' Health Select Committe's inquiry in to NHS Recruitment and Retention had a lengthy evidence session this week. HSJ summarises some of the debate about the use value of the impending Framework 15 workforce 'plan' here, including chair Jeremy Hunt's perhaps slightly unParliamentary use of the word "bullshitty".
Mr Hunt was the subject of this more than mildly made-up bit of Mail journalism about his becoming MPs' replacement for Boris Johnson. Perhaps the Mail hasn't heard of a little thing called 'Brexit', which hijacked the Conservative Party and turned it into UKIP? Mr Hunt was against it.
Pensions specialist Graham Crossley also drew attention to another key section of the hearing. And guess where the segue from this leads?
Pensions (yet again)
HSJ also reported on the different approaches being taken by a sample of trusts to 'pension recycling' for senior doctors. This scheme means that the consultants are offered additional salary, in place of employer pension contributions. Some are actively promoting it; others believe it is unfair and will not do it.
The BMA's pensions expert Dr Tony Goldstone set matters out clearly on his Twitter account as to why he disagrees with the 'unfair' charge.
The fictional forty
The Government's imaginary 40/48 new hospitals has been a long-running theme of these columns: the subject cropped up again in Lord Stevens of Birmingham's contribution to the Lords debate on procurement this week.
Fitting in some neat blows on PPE production and medicines procurement (including the Hepatitis C lawsuit against NHSE), Stevens told his fellow Lords Spiritual And Temporal "the proposed building of 40 new hospitals ... is going to be a major piece of procurement for the Government and the NHS. It was a very welcome commitment that the Prime Minister made in the run-up to the 2019 general election on a visit to North Manchester General Hospital. As I pointed out at the time, that hospital was opened in 1876 when the then Prime Minister was Benjamin Disraeli.
"So there is a need to get on with it, but the fact is that we have only a three-year capital allocation - £3.7 billion - and that does not buy you 40 hospitals. Matt Hancock, the then Secretary of State, said back in 2019 that the first eight of them hospitals were “ready to go”, but we now see in the latest Department of Health and Social Care publication that their planned start date is “TBC”."
The Alan comeback
Our blockchain-shilling hero has been atypically quiet this week. Perhaps quiet is the new hyperactive?
In an interesting weathervane moment, The People's Partridge did not issue a supportive Tweet about Partygate and Boris Johnson being the right man for the right calls, etc etc.
Well, I suppose that Alan's a busy man: his book won't write itself. He did managed to Tweet about cryptocurrency, VAT on horse race betting and Rishi Sunak's cost of living crisis mini-Budget, though.
If Boris has lost Alan, he's lost the country.
Alan must feel as if his name is written in water: his successor, Sajid 'The Saj' Javid, this week told a conference, "as Secretary Of State For Health But Social Care, I've had the responsibility of steering ths country through the Covid pandemic".
As HSJ's editor Alastair McLellan wryly observed, "Matt who?" (Alastair's fair-minded stocktake on Amanda Pritchard's first ten months in charge of NHS England is well worth reading.)
You can't keep a good man down (or Ali Parsadoust)
Former failed chief executive at workers' co-operative Circle Health Ali Parsadoust, now a Babylonian, is on fine form in his new berth, telling investors who have seen their NYSE-listed BBLX shares drop in value from $10 to $1.
HSJ's Shruti Shresh Trivedi caught up with the latest investors' call, in which Comical Ali told the market that Babylon's GP At Hand tech-miracle is losing money on its NHS contracts because of demand. This means Ali is "going to be cautious about the growth of that book, being very frank about that”.
Of his firm's destruction of 90% of shareholder value, The People's Parsadoust said “We’re fully aware of this situation, we are all over it and we will fix it …”. Ahem.
Bollocks Of The Week
A comfortable win for Annabel Denham of the Institute of Economic Affairs for this pile of nonsense in the Telegraph.
The Attack Of The Crap Right strikes yet again, with this festival of straw men - and as ever, without any actual ideas or solutions. As campaigns go, it is deeply dull. The piece moves to conclude with the line, "Mark Twain famously wrote that “history doesn’t repeat itself, but it often rhymes”": Twain did not say this.
The Telegraph also gets the runner-up prize, for falling for this neat bit of spin from the Independent Healthcare Providers Network. Once again, the IHPN asserts that there is pertinent un-used and spare capacity in its members' power to sell the NHS: the article reports that "private hospitals could deliver 130 per cent of pre-pandemic activity, the IHPN suggested, representing an additional 389,207 completed procedures a year".
What a co-incidence that the NHS England Electoral Recovery Plan talks of the NHS provider sector doing 130% of pre-Covid elective activity. Older heads will recall that the IHPN claimed this back in 2015, and it turned out not to be true then. You'd think that a journalist would ask the question.
Cronyvirus and coronamillions update
Good Law Project boss Jolyon Maugham QC was again on the case of Pestfix, pointing out that the company had taken £114 million in profits, at a gross mark-up of 50%. Pestfix lent £59.8 million to its limited parent company, while it remains in an unresolved dispute with the Department For Health But Social Care regarding the unusability of £84.4 million worth of PPE products it supplied.
In the event of DHBSC issuing proceedings, Pestfix can simply be wound up and taxpayers' money will not be retrievable. Private Eye had seen the same thing.
Procurement expert Rob Knott spotted that Baroness Mone-associated PPE Medpro has registered a charge (debt) with a company based in the less-than-financially-transparent Virgin Islands. The details are here.
Recommended and required reading
The Financial Times reports that Big Four firm and NHS consultancy provider Ernst and Young plans to do an Accenture/Andersen Consulting, and spin off its audit business. In a related statement of the inevitable, Big Four stablemates KMPG (fined £14 million for their negligent audits of the failed Carillion) announced that they will scale back their audit clients.
The FT also had a good series of articles on the future of antibiotics.
This SAGE 'Consensus Statement On The Association Between The Discharge Of Patients From Hospitals And COVID In Care Homes' feels pre-public-inquiry-related. I feel sure that the Government lawyers will read it with interest.
The Kings Fund updated its animation about how the NHS works.
HSJ's Jack Serle spotted that Virgin Care's takeover by private equity led one CCG to not extend its contract as had been planned.
Nice Guardian piece about whether Covid19 cases are really coming down, or just getting harder to count.