An exemplar in how not to


An American sociologist, Harold Garfinkel, famously encouraged his students to go out and deliberately breach social rules (like being very shouty in public) to make visible the strength of these unwritten rules. When I was a student we could do this for one assignment and report how those present responded, or write an essay. I didn’t have the nerve to do the former.

The sacking of Katrina Percy (and the earlier unfoldings leading up to this) has been a kind of breaching exercise. Making visible the deep flaws in the organisation of the NHS. The internet/social media didn’t exist when Garfinkel developed his breaching experiments. These days, the ripples of (public sector) ‘rule breaching’ spread far with an unimagined immediacy. People are rightly outraged about the £200k pay off. How patients denied treatment or operations because of the cost must be feeling about this news is impossible to imagine. It’s simply obscene.

The handling of the Sloven debacle is worse than extraordinarily poor. On December 10 2015, Hunt stood up in the Commons and promised a series of measures in response to the publication of the Mazars review. The CQC so far seem to be sticking to their gig (albeit without using the powers they have effectively). NHS Improvement (NHSI) were tasked with sorting out the rot among the Sloven exec. They have bungled this task spectacularly. The wrong person was appointed to troubleshoot (alarmingly, Tim Smart has always maintained he contacted NHSI offering his help after seeing Tom question the board on BBC News). It was clear NHSI missed an opportunity to appoint a clear headed, sharp thinking, deeply experienced, no nonsense type of person.

Smart, as we know, failed to lift any stones (leaving it to campaigners and journalists to reveal the howlers that were in full view with the sending of the odd FOI request or ten), and decided the board were fit to practice. Etc, etc, etc.

What an almighty fuck up. The NHSI press statement is simply embarrassing.  I’m reminded of Shaun Picken, a trustee of My Life My Choice asking Percy: “Katrina, why didn’t you ask for help? You clearly needed it”, at the January board meeting. NHSI. You clearly need help.

I’m a lay person with no experience in public sector management (and currently on leave in Berlin for the weekend…Brilliant timing as always) but it strikes me there are some fairly straightforward things that should happen. Including:

  • Thorough scrutiny of financial irregularities around the Talentworks contract which, I’m sure, would provide evidence that Percy, supported by a bunch of longstanding exec-mates, has mismanaged public money.
  • A thorough review of the Sloven exec and removal of the remaining muppetry (Spires, Berryman, Stevens, Gordon, etc).
  • The appointment of replacement execs with mental health and learning disability expertise.
  • Full engagement with the public and a clear demonstration of a willingness to be open, transparent, honest and robust.
  • Stop relying on ‘reassurance’ and demand evidence. A reliance on ‘reassurance’ contributed to LB’s death.

Jim Mackey, Jeremy Hunt and others, you should feel ashamed at the handling of this. It’s an exemplar in how not to.

16 thoughts on “An exemplar in how not to

  1. Yes, even when away (and it’s still good to be in a different scene), nothing distracts from the awful truth. It’s unpalatable, every day. That’s why this won’t go away, for anyone affected. It must be made better. It’s possible to put right wrongs while people are still living.
    All the Trust values that NHS and other buildings have written all over the walls in their entrances .. don’t happen in practice, and we can’t let them do that. What they wrote, they must do.
    The ‘cost effective’, ‘we’re all in it together’ .. lies, can’t be accepted.
    Being fobbed off when your child is (was) away from you, suffering so much and just locked away but not ever helped, and families hands tied behind their backs, so they can’t help either. My daughter said this last week, and I find it so profoundly sad that the sibling sees this all so clearly.
    It’s the most unnatural thing in the world – and this isn’t a civilised nation as I always thought it was.
    This wouldn’t happen so blatantly to others.
    A lie can’t just be covered up anymore. Your shouting it out, is an act of the deepest love.
    You can’t just go away and shut up and betray him. And I won’t mine.
    Public mourning is part of putting this right.
    The Queen might die any day, and whatever shock the whole country feels at that time, is how we feel right now.
    Our children are royalty to us.

  2. Yes it is criminal and sadly the same maladministration is likely happening in other/most Local/Health Authorities. No doubt KP is not the first and won’t be the last to get a fat ‘pay off’ when the going gets tough!! Our services are riddled with corruption 😡😡

  3. KP is being rewarded with an obscene pay out. What message it sends out to so called “civilised nation”? Reading the NHSI Press statement makes me sick in my stomach and realisation, that there is no justice. The whole system is corrupt.

  4. the lesser of two evils as an exit strategy , millions more of public funds could have been handed over. NHSI desperately needs to appoint a spokesperson for the Trust it, looks/sounds like an appalling shambles to a lot of people , further scandal is lurking close by from all appearances. Isn’t there a duty on all who hold office on the Board to reflect on their own capabilities to continue. No shame in admitting you are not up to the job.

    • Well, if there are Trusts where real improvements were made by the people at the top, we should highlight where it has been done.
      Then ask why in particular places, no improvements happen. There has to be some public interest in this.

  5. Katrina moves on to pastures new and Sara and her family are still clawing their way through these awful injustices that are not being put right by the people we elected to govern us. Are our politicians fit for purpose?

  6. I know you’ve added ‘etc’ to Spires, Berryman, Stevens and Gordon but we must not forget their lapdog – the Lead Governor, Andrew Jackman for failing to hold the Non-Executive (or Non-Effective?) Directors to account over several years – and it appears also for playing a leading role in preventing the responsible governors from taking action. He also has, in my opinion, a massive and largely undeclared conflict of interests.

  7. A good honest review of the situation, to build on this:
    An exemplar in HOW NOT TO GOVERN…

    Why did the Governors not do more ?
    Well a handful tried and the reason they made no impact within the Trust is largely because of the design of the Governance system, designed by an idiot.

    Governors come in three flavours:
    1. Staff Governors appointed by Staff.
    2. Public Governors representing geographic areas, appointed by the Members (anyone)
    3. Appointed Governors, these represent organisation like Health Charities or the Local Council.

    So lets look at the various conflicts of interest and why its impossible to get a majority in favour if anything contentious.

    Staff Governors – basically keep their mouth shut, apart from the occasional brown nosing comments. To speak out puts them into whistle blowing territory and we know what the outcomes are.

    Public Governors – Anybody can put themselves up for election, some may be able to “Hold to Account”, this is what they are unpaid to do. But most will not peer over the parapet in case some one like Tim Smart (or the earlier Chairman) notices this and then intimidates and bullies them until they acquiesce. They may also have commercial conflicts, for instance the Lead Governor is a Director of a Building Company that works on Public Sector Contracts. Either way getting most of them to back anything scary just doesn’t happen.

    Appointed Governors – they dont have a personal position, they represent the organisation that employs them, and these organisations have commercial relationships with the Trust. So again they will not rock the boat in case there are repercussions.

    Its also worth mentioning the Chairmans Role, the same guy is Chairman of the Board and Chairman of the Governors, you couldn’t make it up. Anyone watching Smart’s abysmal performance would be left in no doubt who pays his wages. The others were no better.

    So if you wanted to have real and meaningful Governance you would not do it this way.

    To be continued…..

      • It surely cannot get any more seedy…….

        Ms Percy stands found bang to rights on being a very poor CE – Olympic class on uncaring and zero compassion …evidence of by barrel full.

        Scarily deluded around her abilities….a swimming pool full of evidence of same .

        At times could have appeared pathologically so – might have been pitied for planet size delusions around self – abilities – competence – achievements etc – perhaps all was innate – just very poor levels of empathy – and insight ?. To be pitied ? For apparent absence of awareness of self – and of others – was dangerous but unconscious – ‘just’ nil savvy ?

        But…Ms P has proved very savvy indeed – neatly castrating Tim and all the rest – while hanging in there and refusing to resign – then screwing a double max from tax payer and her very vulnerable patients – under a shameless threat of suing for more……

        Despicable. and very very scary…….

    • One other point Hashtag: “Anyone” cannot become a member. The CEO holds a veto over applications for membership so has ultimate control over who can stand for election as Public Governor too.

      • Its even more broken than I thought. So any undesirables, like anyone who has been jerked around, can be prevented from standing. Democracy not at work.

  8. So Katrina threatened to sue for more if she did not get a nice fat pay off? Is that true?

    Perhaps the bereaved families who lost loved ones while under her reign as CEO of Southern Health should be threatening to sue too.

  9. The threat of being sued – as I understand it from what they wrote – .was perceived as a potential threat by the NHS masters – if they did not act act they did – that is – award a whole years salary..

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