The Human Cost of Greater Public-Sector ‘Efficiency’

Civitas, 1 December 2006

Anyone, like the present author, who spent the bulk of their working life in the public-sector will know just how demoralising and counter-productive has been the recent imposition upon it of a managerialist culture.
Formerly self-regulating professions like medicine and teaching have been reduced to box-ticking exercises carried out by hordes of fearful and demoralised zombies desperately counting out the days before they could retire from the monstrously overblown regimes of excessive and unneeded managerial oversight to which they know their once genuine forms of service to the public have been reduced.
Like ships in a convoy forced to sail at the speed of their slowest, this cumbersome and time-consuming method of management has been imposed on schools, hospitals and universities, often in response to purely local instances of malpractice that could have been remedied more easily and expeditiously at a corresondingly purely local level.
Well, this culture of bureaucratic over-management and over-regulation has not been without enormous personal cost for those working in this sector. A glimpse of just how much it has cost them personally has been given this week by a consultant psychiatrist at the Priory Clinic in Surrey.
Best known as the refuge of burnt-out over-partied show-biz celebrities like Robbie Williams and Pete Doherty, the clinic now apparently regularly provides sanctuary for burnt-out public-sector professionals, such as doctors and teachers, whose stay is being funded, reading between the lines of a report about this matter on the BBC News website, by the NHS that has driven so many of them there.

In an eye-opening article posed on the on-line magazine Public Servant Daily, Dr Tim Cantopher writes that, while twenty years ago, the majority of his patients were business executives, today most are public servants. ‘My largest represented occupational group is doctors, followed by teachers, social workers, police officers, tax and benefit workers. Ambulance crews and members of the fire service’.
He goes on: ‘Businesses have long since recognised that it is their best employees who are at the highest risk of stress related illness and they mostly nurture and protect them…. Now it is public servants .. who are vulnerable to the pernicious effects of over-regulation…. Genuine, hard-working professionals take it all seriously…. They try to make it work, while continuing to give everything to a public that depends on them. Quarts and pint pots. It can’t be done. If they try hard enough they blow a fuse and get ill.’
What an irony it is that the private sector is having to come to the aid of these public sector workers, and paid for out of the public purse!
Dr Cantopher’s diagnosis of what has caused the increased stress and burn-out of public sector professionals and other workers is confirmed by what another doctor has recently written by way of response to the recent accusation against NHS gps levelled by government health minister, Lord Warner, to the effect they have failed to act in good faith by not having ploughed enough of their recent pay increase back into their practices.
Writing under the pseudonym of Dr Crippen, on the website, NHS Blogdoctor, this gp has replied to the charge as follows:
‘My pay has gone up approximately 25% over the last two years. That extra money has been earned by hitting government targets. The targets were set by the government, not by us, and mostly have little to do with health care, but a lot to do with “process” and bogus but quantifiable “healthcare achievements”.
‘We told the government at the outset that it is a waste of money, that the money could be better spent but, to them, “control” was everything.
‘They removed our professional autonomy. They told us what to do, and promised us piece-rate financial rewards for doing it. So we have done it, and done it more efficiently than they thought possible…
‘All targets hit. All payments made. Healthcare continues to deteriorate. So the government needs a scapegoat. Everything has gone wrong… You do not know where the money has gone. Let us blame the doctors…
‘We worked our socks off to hit your silly bloody targets. Just because hitting the targets has not helped healthcare, just because New Labour policies are a disaster, do not suggest we … are acting in bad faith…
‘This is typical New Labour. Healthcare policy in ruins. Sack some nurses. Hire some more management consultants. Close some hospitals. Hire yet more management consultants. Blame the NHS staff. Particularly the doctors. Denigrate the doctors in public. Tarnish their name. Suggest they have been “on the fiddle”. Feel free to comment on my pay. Tell me it is too high. Or to low. But do not accuse me of dishonesty.’
This heart-felt cry by a health care professional of manifest integrity is the swan song of a public sector worker who knows just how badly his vocation has been damaged by the present government. While I sincerely hope this doctor is spared the fate, I would not be surprised, and he would only have my sympathy, were I to learn in the coming months that he had been been referred to the Priory at NHS expense for a work related stress induced condition.