Those of you familiar with The Eagle Has Landed will no doubt have recognised the Adolf Hitler letter sticking out of Gerry Robinson's back pocket as he set out to save the NHS. And despite all that twinkling Irish blarney, you may be assured it won't have been lost on the honchos at Rotherham General Hospital as they reeled back in horror at his deadly mission.
So armed with the letter and the TV crew, it was unsurprising that he apparently managed to break through some of the traditional bureaucratic NHS log-jams. Certainly an unusual achievement, but who would want to be the one seen getting in his way?
Still, knowing that he was working with the full support of the Commissars does mean- whether pre-scripted or not- we got an authentic insight into the way they see the problems:
Problem One: Doctors. According to the Commissars, a major roadblock to NHS reform is Doctors. Not only are they arrogant and uncooperative, they are riddled with Spanish practices which allow them to work gentlemens' hours, and practise expensive old-fashioned medicine instead of cheap new medicine (eg full anesthetics for ops which these days only need locals, and consultants instead of nurse quacktitioners). Doctors need to be exposed for the self-serving luddites they are, and managed into a properly subservient role.
Gerry did an ace job, even getting one poor consultant to blurt out that the hospital managers were not worthy to manage him because they only had three GCSEs between them whereas the consultants had walls full of certificates. Might be true, but boy did it sound big-headed (Gerry himself left college- priest college- at 17 to work).
Problem Two: Managers. The Commissars want their managers to grip their organisations, rather than simply talking and strategising. Gerry showed us how the CEO at Rotherham General seemed very happy to talk the talk in terms of interminable management meetings and reports, but in terms of walking the wards and "engaging" ugh with the sharp end, he came up with every excuse in the book.
Clever old Gerry identified a specific change job he could do, and forced him out onto the floor to drive it through. And guess what- it did actually come to pass. Hallelujah, and QED.
Problem Three: Jobsworth mentality. The Commissars hunger for a workforce that will be "proactive" and come up with all those brilliant simple bottom-up innovations that they read about in management books. Twinkly eyed Gerry swept the nurses off their feet and they were soon bubbling with ideas, many of them so bleedin' obvious he was nearly reduced to tears that they hadn't been pushed through before.
Overall, for those of us who don't work in the NHS, it was a fascinating three hours, and Gerry was as always, very appealling.
But do we actually believe his conclusion? That the NHS can be managed, and that the most important thing is to hire in some better managers?
Because if that's true, then... why it means the Commissars have been right all along, and we've been wrong.
Nah. It won't wash.
Look. Here we had St Gerry of Twinkly Eyes, armed not only with a Hitler letter but also a TV crew. And all he was trying to do was simply to reduce waiting lists in one hospital which was already highly rated. Yet on my count, in six months, all he actually achieved was to cut four waiting lists. At the cost of goodness knows what adverse knock-ons elsewhere off-camera.
No. I reckon you could treble management pay- as he recommends- and you'd still have exactly the same problems we already have.
It's the system you see.
Consider this. When the Rotherham CEO was running through the day-to-day pressures on him, he didn't start with his customers. Or his staff. Or his business in any normally understood sense. No, he started with the stuff coming down on his head from Whitehall.
And as long as Whitehall is the paymaster, that's just the way it will remain.