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NHS Kremlinology

Back in the bad old days, Kremlinologists used to try to figure out what was going on in the leadership of the USSR by observing signs and portents.

During the Cold War, lack of reliable information about the country forced Western analysts to “read between the lines” and to use the tiniest tidbits, such as the removal of portraits, the rearranging of chairs, positions at the reviewing stand for parades in Red Square, the choice of capital or small initial letters in phrases such as “First Secretary”, the arrangement of articles on the pages of the party newspaper “Pravda” and other indirect signs to try to understand what was happening in internal Soviet politics.

To study the relations between Communist fraternal states, Kremlinologists compare the statements issued by the respective national Communist parties, looking for omissions and discrepancies in the ordering of objectives. The description of state visits in the Communist press are also scrutinized, as well as the degree of hospitality leant to dignitaries. Kremlinology also emphasizes ritual, in that it notices and ascribes meaning to the unusual absence of a policy statement on a certain anniversary or holiday.

Brian Micklethwait has often written of the “sovietisation” of various parts of the British State such as state schools and the NHS. To illustrate this process, take a look at the way a “major incident” at Colchester Hospital has been reported.

What major incident you ask? My point exactly: you ask, they don’t answer. Likewise “safeguarding” is repeatedly mentioned. Something needs to be safeguarded.

Late last night or early this morning there were oracular bulletins from the Telegraph and Times, all chock-full of unspecified “incident”. From the Times:

On Wednesday, the Care Quality Commission (CQC) inspected Colchester Hospital’s accident and emergency department and emergency assessment unit and told trust it had concerns over “safeguarding” there.

The major incident is likely to last for a week, and the trust has reminded members of the public to only visit A&E if they have a “serious or life-threatening condition”.

A spokesman for the hospital said the inspection was not the sole reason for the major incident being declared, although it played a role.

All clear now? There was a similarly opaque article on the AOL homepage. It has been updated since, as has the Telegraph one, I think, but the Times, like a good horror movie, is delaying the big reveal.

The BBC followed suit: “Colchester Hospital declares major incident.” The BBC did tell us what sort of general thing might constitute a “major incident” but not about this major incident. As a result everyone thinks it’s ebola and as I write this it’s the most looked-at article on the BBC website.

Stand down. It’s not ebola. The Guardian was slow to get the story but does actually tell it:

A major incident has been declared at Colchester hospital after a surprise inspection this week found patients being inappropriately restrained and sedated without consent and “do not resuscitate” notices being disregarded.

The ward concerned has been closed to new admissions, an emergency control centre has been put in place to address capacity problems, and patients are being urged to go to A&E only if they have a serious or life-threatening condition.

Inspectors from the Care Quality Commission (CQC) found that the Essex hospital is struggling with “unprecedented demand”, but the Guardian understands concerns were also raised about safeguarding issues relating to inappropriate restraint, resuscitation and sedation of elderly people, some with dementia.

Oh dear, what a let down. Just as it used to in the days of Pravda and Izvestia the secrecy concealed mundanity. It’s just the NHS in crisis again. Can’t they do anything right? The zombies they make aren’t even dead yet.

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18 comments to NHS Kremlinology

  • Paul Marks

    No First Amendment in Britain any more than there is a Second Amendment. There was a right to keep and bear arms once, just as there was once freedom of speech – but that time ended long ago.

    What can be done about it all?

    I do not know.

  • Ljh

    The Service part of the NHS relates to serving its employees, managers and state bureaucracy. Being held to account to mere patients and taxpayers is unthinkable and subversive.

  • Gareth

    Inspectors from the Care Quality Commission (CQC) found that the Essex hospital is struggling with “unprecedented demand”

    It smells of gaming the system. It wouldn’t surprise me if, by declaring a major incident, this allows the hospital to postpone operations they deem to be non-urgent without those operations being classed as late.

  • Jeff Evans

    One wonders why they have to close the ward. The appropriate response would be to suspend the offending staff members while they are sent away for “re-education” (as they used to say in China) and draft in staff from elsewhere, or, more likely, temps.

  • Natalie Solent (Essex)

    Gareth’s suggestion as to why the ward is being closed sounds very likely to me. Or it is ebola.

    Here’s another oddity. One of the problems listed in the Guardian article as necessitating the declaration of a “major incident” was that “do not resuscitate” notices were being disregarded.

    That seems the other way round from what I would have expected. Having “do not resuscitate” notices placed without the patient’s or the relatives’ consent would fit in with patients being inappropriately restrained or sedated without their consent. But that is not what it says; it says the emergency is that people are being resuscitated.

  • Jim

    Ah, the NHS. Where the medical needs of the patient comes a distant second to the needs of the staff to have well paid and undemanding ‘careers’.

  • Kevin B

    I seem to recall that while all the kremlinologists were examining the minutiae of the politburo, along came Ronald Reagan and his pals who pointed out that it’s all about the economics and according to those economics the Soviet Union was doomed. And so it transpired.

    Of course the parallel breaks down with the NHS since although this hospital has a crisis with DNRs here and that hospital has a crisis with the Scouse Stairway there and another hospital has a crisis with patients dying in corridors somewhere else, the overall economics of the NHS are absolutely fine. According to the polititians in charge. And the bureaucrats who run it. And the chap who designed the whole scheme.

    Yes, Mr Ponzi is extremely proud of his system.

  • Kevin B

    Actualy I’m doing poor Carlo Pietro Giovanni Guglielmo Tebaldo Ponzi a disservice. The NHS was more likely designed by his long lost cousin Karl Ivan Josef Leon Ernesto Ponzi.

  • Regional

    Kevin B,
    What about their cousin Tony Gordon Ken Neil Peter Ponzi?

  • Patrick Crozier

    I am a bit confused by the use of the word “incident” to describe something routine. There are probably a whole bunch of words that are routinely misused by officialdom. “Epidemic” seems to be one. “Tragedy” rather than “atrocity” would seem to be another.

    As an aside, were the Kremlinologists any good?

  • Natalie Solent (Essex)

    Patrick Crozier,

    Also the word “inappropriate” to describe anything from minor failings in etiquette to incest. Although in that case the catch-all nature of the term may not be a bug but a feature. See also: “flawed”.

    Were the Kreminologists any good? My impression was that they were often wrong but much better than random guessing. I cannot think of an example from the USSR right now, but Jung Chang’s autobiography Wild Swans provides an example from China to show why these arcane details could be successfully used to measure changes in the hierarchy. Her father was a high communist offcial who was disgraced, sent to a labour camp, and then partially rehabilitated before he died. Chang describes how her mother spent vast effort negotiating every detail of the funeral – the content and order of the speeches from former colleagues, even how big the wreaths were. This wasn’t just the action of a grieving wife. Such details would be taken by everyone to be the official assessment by the Party of the dead man’s status, comrade or deviationist, and could have a drastic effect on the fortunes of his surviving family.

  • JohnM

    If the problem is (as claimed) in a ward for old people, then why has the A & E been closed; why have routine operations been postponed ?

    There is more in this than something simple. Will someone there become a ‘whistleblower’ ?

  • Mr Ed

    I blame Fatcher.

    Sorry, just got that out of my system, rational discourse may resume. I think Gareth has diagnosed the problem accurately. The media in the UK, particularly the BBC, seem to regard the bureaucratic response to an incident as the most newsworthy matter, never mind the underlying deaths, rapes or whatever unpleasantness happens to real people. I half expect to hear that a meeting of COBRA, the Cabinet Office Briefing Room has been called, as if it made a jot of difference.

  • Mr Ed

    The BBC explain what a ‘major incident’ is

    The Department of Health says: “For the NHS, a major incident is defined as:

    “Any occurrence that presents serious threat to the health of the community, disruption to the service or causes (or is likely to cause) such numbers or types of casualties as to require special arrangements to be implemented by hospitals, ambulance trusts or primary care organisations.”

    Each individual NHS organisation must plan to handle incidents in which its own facilities “may be overwhelmed”.

    Examples of such incidents include serious fire, breakdown of utilities, equipment failure, hospital-acquired infections, violent crime and dealing with contaminated individuals.

    Presumably the hospital itself is likely to be ‘the incident’, posing a threat to anyone unfortunate to receive ‘care’ within it, but the inspection and actions arising from it may have caused ‘disruption’ to the service.

    Another slaughterhouse, from which lessons will be learnt.

  • Sconzey

    “Safeguarding” in PC-ese has a very specific meaning: the protection of children and vulnerable adults.

  • Guy Herbert

    In London we frequently have roads and other transport closed for “a police incident”. It’s just an official habit of circumlocution and euphemism (I think), but it doesn’t half sound sinister.

  • Mr Ed

    In my book, there’s only one incident worthy of the name, the Tower Bridge Incident, when the RAF’s Flt Lt Alan Pollock flew his Hawker Hunter under the top span of Tower Bridge to commemorate the 50th anniversary of the RAF in 1968 when Harold Wilson’s bunch of Brezhnev’s stooges refused to mark the occasion.

    He also ‘beat up’ a number of RAF bases in his celebration, flying inverted at 200 feet along the runway over one base. He was not court-martialled, but was retired on medical grounds.

    The only reported casualty was a man on Tower Bridge who tore his trousers.