More Summer Reading!

I’ve been digging around in book shops recently and I managed to pick up a second hand book which might be of interest to readers of this blog.

‘NHS plc’ was published in 2004 and was written by Allyson Pollock. I read quite a lot of Pollock’s work some years ago and what always struck me was that although Pollock undoubtedly knows exactly what goes on in the NHS, she was rather mealy mouthed when it came to admitting the full horror of it all. I always attributed this to Pollock being a policy advisor and therefore maintaining a discreet silence regarding patients’ being maimed and killed – I also was under the impression that Pollock had a background in social policy and such researchers very often do have trouble admitting just how much blood there is on the carpet. But I discovered yesterday that Pollock is actually a Top Doctor – she’s a Consultant in Public Health Medicine and has been since 1986. Since Jan 2017, Pollock has been Director of the Institute of Health and Society at Newcastle University. Prior to that she was Head of the Public Health Policy Unit at UCL and Director of Research and Development at UCL Hospitals NHS Foundation Trust. Pollock set up and directed the Centre for International Public Health Policy at Edinburgh University (2005-11). Before then she was Professor of Public Health Research and Policy at Barts and London School of Medicine and Dentistry, Queen Mary, University of London. Her earlier career is not mentioned on her wiki entry – but guess what can be discovered if one reads ‘NHS plc’? That Allyson previously worked at Sin City – St George’s Hospital Medical School! She mentions that she worked there ‘before’ New Labour’s 1997 election victory. As she has been a consultant since 1986, presumably she was a consultant at St George’s. So she was there at some point in the 90s then – when the madness and malpractice that I have detailed on this blog prevailed there (see post ‘St George’s Hospital Medical School, 1989/1990’), under the ‘leadership’ of the dreadful Sir William Asscher…

Allyson Pollock is best known for her work on the gradual privatisation of the NHS with the associated imposition of a ‘business culture’ and the introduction of ‘new public management’ techniques. Her work on this is very, very good. I have never been able to fault her analysis of what this process has resulted in or her historical detail of the steps by which it has taken place. But reading ‘NHS plc’, it is clear why Pollock’s work never details the chaos and tragedy that is happening in the NHS, although she obviously loathes the privatisation agenda and could add considerable weight to her argument if she was prepared to go public on the excesses of the NHS. It is because Pollock is only telling half the story. The bit that Allyson Pollock just won’t mention is the contribution of the Top Doctors themselves to the mess.

Throughout ‘NHS plc’, Pollock paints a picture of a medical establishment that always does and has always done the best for NHS patients and which has been forced off course by the privatisation agenda – an agenda which Pollock suggests that nearly all Top Doctors have fought against for noble reasons. She does name the occasional sinner, the odd Top Doctor who has encouraged and personally benefited from privatisation, such as the odious Dr Chai Patel. Pollock describes Patel as a ‘millionaire doctor’. He is far from the only one Allyson as you well know. Patel of course notoriously ran a huge chain of private ‘care homes’ which were eventually exposed as being riddled with the most dreadful abuse and neglect of patients – it was this that forced him to step down from his role as a Dept of Health advisor on the care of the elderly. Among Patel’s business interests was his acquisition and expansion of the ‘Priory Group’. That is the Priory Group that currently employs two of Allyson’s former colleagues from St George’s and the associated psychiatric unit Springfield Hospital, Dr Robin Jacobson and Dr Adrienne Key! Likewise Allyson names a few of the biggest scandals that there have been in the NHS – scandals so big that she can’t avoid naming them, such as the Bristol Children’s Heart Surgery Scandal or Harold Shipman. There is not a mention of the fact that actually the NHS for a very long time has been dogged by scandals in which patients suffered greatly and were known to be suffering but no-one acted. According to ‘NHS plc’ the problems only began when Thatcher’s administration began privatising the NHS, a process which escalated under New Labour. It is New Labour into whom Allyson really puts the boot – she hates them.

Whilst Allyson highlights the idiocies that that Tories imposed upon the NHS in the name of the ‘internal market’, she makes no mention of why they were able to convince voters at the time that this might be a good idea. It was actually because there was a great deal of dissatisfaction with the NHS. I can remember the debates very well – the allegations made again and again were of Top Doctors who were so fucking arrogant that they would not listen to patients or respond to their needs. It wasn’t simply a case of affluent patients wanting a private room or special treatment, although that was indeed Margaret Thatcher’s personal interpretation. There had been for example massive dissatisfaction among women concerning the way in which many of them had been treated whilst giving birth, which led to practitioners like Michele Odent establishing private practices to which middle class women swarmed. There was the emergence of ME and the Top Doctors’ complete refusal to accept that this might have a physical cause – seriously ill people were dismissed as suffering from ‘Yuppie Flu’. People with an interest in alternative medicine also fumed at the way in which they were mocked and belittled by Top Doctors. I’m of the opinion that much ‘alternative medicine’ is indeed ineffective, but if one is a Top Doctor faced with anxious patients enquiring about such matters, taking the piss out of them to their faces is not the best way to proceed. The London surgeon Michael Baum was interviewed on TV regarding alternative medicine and he explained that patients enquiring about this were usually middle aged women wearing ethnic weave clothes who read the ‘Guardian’. That’s the sort of observation that is best made to one’s friends in private, not made on prime time TV – it caused massive offence and actually did him a lot of damage (which was unfortunate, because some of Baum’s opinions are worth listening to). I remember an episode of ‘Any Questions’ in which the biggest cheer from the audience was given to a Tory MP who when talking about the Tories reforms of the NHS, had robustly said of hospital consultants ‘they’re not God, they’re just guys doing a job’. People had really had a bellyful of the Top Doctors by the mid to late 1980s and that feeling was exactly what the Tories utilised to sell the voters their agenda for the NHS. Allyson mentions that ‘some’ hospital consultants were ‘downright arrogant’, that they were not ‘directly accountable to anyone’ and that team working was ‘often poor’, but she does not get anywhere near to admitting the extend of the greed, the bullying, the autocracy, the abuse of their positions and the overall preservation of their own vested interests that did – and still does – go on.

The attitude of the Top Doctors to patients was exemplified by the ‘reviews’ that the Top Doctors who fancied themselves as thespians used to put on themselves in medical schools at Christmas. Those stage shows were essentially a series of sketches in which the Top Doctors patted themselves on the back and sneered at patients for all being a bit ignorant or neurotic. I attended two such Christmas Reviews whilst I worked at St Georges – they were virtually identical and basically served to consolidate what someone the other day termed the ‘professional superglue’ that causes NHS staff to close ranks in the face of malpractice or patient harm.

Allyson mentions the concession to accept ‘pay beds’ that Bevan made when establishing the NHS. Bevan of course admitted that he was forced into doing this in order to get the Top Doctors to accept the idea of the NHS. (The Top Doctors REALLY objected to the idea of the NHS.) Pollock I note doesn’t quote Bevan’s most famous words – that in order to overcome the Top Doctors’ objections to the NHS he would ‘stuff their mouths with gold’. Allyson tactfully states that Bevan had accepted the existence of pay beds ‘in order to secure consultants’ participation in the new free health care system’. Pollock mentions that in 1975 Barbara Castle abolished pay beds – and my God wasn’t that one of her biggest battles – but her decision was later reversed and ‘by the 1980s pay beds were justified as an income earner for hospitals’. I don’t remember the Top Doctors objecting to their re-introduction Allyson – in fact when you and I were working at St George’s there was plenty of private practice going on. To be fair, some of the Top Doctors doing it were re-investing their earnings into their research programmes and of course there was a limit placed on the amount that medical academics were allowed to earn through private practice. Which was why so many Top Doctors didn’t want academic posts… Some of Allyson’s non-academic colleagues at St George’s were known to be very rich indeed as a result of their private practices.

Again and again Allyson portrays these very wealthy people with interests in private practice who ignored the wrongdoing of their colleagues as selfless barefoot doctors. She maintains that when ‘concerned NHS staff’ critiqued public-private partnerships they were dismissed by Gov’t as ‘self-interested’. However did anyone come to that conclusion? So who were the concerned NHS staff that Allyson was talking about? The cleaners? The canteen staff or the porters? The Angels perhaps? No, it was the BMA and the NHS Consultants’ Association.

There are plenty of clues in Allyson’s book as to what the beef of the Top Doctors really was. It was not that the Top Doctors were taking a principled stand against privatisation. It was a power battle. The Tories wanted to flatten the BMA in the way that they had flattened the NUM because the BMA were causing havoc behind the scenes and that’s what much of the obsession with imposing a business culture and managerialist practices on the NHS was all about. Unfortunately the Tories tried to fight the Top Doctors by giving huge power to an equally toxic group of people – NHS senior managers. The Tories were well aware of the damage that the likes of Dr Dafydd Alun Jones and Gwynne the lobotomist were inflicting upon the NHS and it’s patients, but their solution was to give as much power to the likes of Alun Davies and Martin Jones. It was not a good idea and for years now a full-on battle has raged between these two groups who are substantially made up of shites. Top Doctors who do have integrity are not going to be told what to do by Martin which is why so many of them are now leaving the NHS and good managers aren’t attracted to working in the NHS because most of the other managers there are like Martin. A few years ago I was friends with a newly qualified law graduate who landed himself a job in the management offices of Ysbyty Gwynedd. He memorably described Martin and co as ‘corrupt as fuck and thick as shit’. Of course, when the Betsi Cadwaladr University Health Board was first established, they had an excellent CEO, Mary Burrows, who was very bright and genuinely committed to improving the dire state of the NHS in north Wales. Mary was effectively hounded out by the Top Doctors and Martin et al. The last thing that a bunch of unscrupulous, abusive Top Doctors lining their own pockets want is a high calibre senior manager. Which is why you don’t tend to find such creatures in the NHS.

Allyson writes of the battle that the BMA had with Ken Clarke regarding GP fundholding and describes how the BMA were ‘defeated’ and ‘would never again challenge the Gov’t on matters of principle’. Allyson is being somewhat economical with the truth here. The BMA continued to fight Gov’ts tooth and nail, but they adopted a new tactic. Instead of presenting themselves as Top Doctors Who Knew Best overtly confronting the Gov’t, they constructed themselves as People Who Cared About The Disadvantaged – which is exactly the way in which Allyson presents herself! ‘NHS plc’ is full of warm words for the BMA – except towards the end of the book, in which Allyson accuses them of selling out, upon the appointment of a particular Chief Exec. Allyson wrote that book in 2004. In 2007 the BMA famously screwed the Gov’t over regarding the negotiation of the GP out of hours contract which was so favourable to the Top Doctors that one of the BMA negotiators described it as ‘a bit of a laugh’. It was this that led to enormous problems concerning GP out of hours provision. But Allyson’s heart must have melted at some point because in 2014 she was appointed as a Member of the BMA’s Council! She is still there.

Pollock’s own attempts to categorise herself as a barefoot doctor are interesting. She mentions going to dinner with a merchant banker before the election of New Labour to discuss PFIs (I wonder why Allyson was doing that?) and describes how the dinner was held in the ‘bank’s private dining room’ with ‘black coated waiters’ who ‘served lunch that lasted almost three hours’. Allyson compares that dining room with the ‘hospital canteen’ at St Georges and how she ‘could not help thinking of the rows of terraced houses in the impoverished community of Tooting from which St George’s mainly female, mainly black ancillary workforce was drawn’.

I remember those rows of terraces in Tooting as well – I lived in one of them. As indeed did many of the female, black workers of St Georges. So what did the Top Doctors of St Georges think about those workers and the other people who lived in those terraces? Well, one Top Doctor described the midwives as being ‘really thick especially the black ones’. Another Top Doctor told one of the researchers about a ‘really scummy family who live in Garrett Lane’ (Garrett Lane was one of the most deprived parts of Tooting.) A medical student was ostracised because he lived in a shared house in Garrett Lane. It wasn’t only living in Garrett Lane that made one persona non-grata – I attended a departmental meal in a restaurant in Wimbledon during which the wife of a senior registrar refused to speak to a junior doctor after she was told that the junior doctor lived in Brixton. Many of the Top Doctors at St Georges lived in Wimbledon or Clapham or further afield in affluent areas. I only knew of one Top Doctor who lived in Tooting who, as a result of having a number of young children from a series of broken relationships, didn’t have the sort of disposable income that his colleagues had and could only afford to buy in Tooting. He resented living there – although his house was a good deal better than everyone else’s – and he complained at length about the lifestyle enjoyed by another Top Doctor from Kings, who was sufficiently loaded that she was having a house built to her own specifications with a matching bathroom for each bedroom. That was Professor Linda Cardosa – I didn’t ever see her house which caused so much envy, but if any readers did do e mail me and tell me all about it. Should anyone ever see Prof Cardosa on a BMA protest supporting a pay claim I suggest that they ignore her.

As for merchant bankers – the brother of one of the researchers in the dept in which I worked at St Georges was a merchant banker. One of his bonuses was bigger than the annual salary of his sister’s boss. This caused much gnashing of teeth, but no-one used it as evidence that merchant bankers should be paid less – they used it as evidence that they should be paid as much as merchant bankers. As for the merchant banker’s sister – she grumbled at length about her own salary although it later emerged that some sort of ‘special arrangement’ had been made for her so she was earning much more than all the other researchers anyway. Not that she needed a higher salary than everyone else – she drove a Mercedes, but ‘only an old one’ which her father had given her and when she had enough of living in the inner city her parents allowed her to live rent free in the cottage on their estate in Surrey which had previously been inhabited by the gardener. I’m only surprised that mum and dad didn’t supply her with a butler as well.

Not all of my former colleagues at St Georges were as spoiled, as fuckwitted, as snobbish and as shallow as this, but one didn’t have to work too hard to find people who were. There were a lot of them cluttering up the place. The source of their discontent was the fact that so many of them did come privileged backgrounds and they had friends and family who were earning even more than Top Doctors did. So many Top Doctors, despite being among the most highly paid people in the UK, managed to convince themselves that they were very hard done by indeed. It is this phenomenon that propels the BMA and it’s campaigns. The notion of ‘public service’ does not enter into the equation.

In ‘NHS plc’ Pollock is also very critical of NHS organisations selling off buildings and land – the ‘NHS estate’ – to raise money. Such sales are often a very bad deal for the NHS and are effectively fleecing the tax-payer, but the example which Pollock provides is yet another reflection of Pollock’s sleight of hand. She refers to the proposed sale of Springfield Hospital and the accompanying proposed deal with a private care company. Springfield Hospital was an appalling place, in a dreadful state of repair with completely inadequate facilities. It was in no way suitable to be housing mental health patients in the late 20th century. The care was dreadful, abuses of patients were rampant (see post ‘Some Very Eminent Psychiatrists From London…’) and eventually there was a public inquiry after a series of murders there. I do not know what the facilities and care standards at the establishment where it was proposed to transfer the patents to were like, but no-one could defend Springfield Hospital. This example reminded me of the articles that ‘New Statesman’ ran back in the 80s concerning the closure of institutions like the North Wales Hospital Denbigh. Those articles accused Thatcher of selling off the ‘homes’ of patients – I really don’t think that the readers of the ‘New Statesman’ would have wanted a home like Denbigh. Of course, the first Health Minister to propose closing the asylums was Enoch Powell – after visiting Denbigh, which appalled him. Pollock compliments Powell for his ‘political inspiration’ behind the 1962 Hospital Building Plan, but she doesn’t mention a word about him wanting to close institutions like Denbigh and Springfield.

Again and again Pollock lays the blame for notorious NHS shortcomings on privatisation. She rightly mocks the deals that were done with celebrities like Lloyd Grossman which resulted in private companies being contracted to provide hospital food that turned out to be awful. But hospital food was known to be awful before privatisation – it was, like British Rail sandwiches, a byword for dreadful food. Whilst I was imprisoned in the North Wales Hospital Denbigh by Dafydd Alun Jones Brown worried about my diet – because he knew how bad the food was in institutions like that. In Denbigh most patients lived on chips – the fare was so grim that chips were usually the most edible thing on the ‘menu’. One patient at Denbigh who was actually receiving regular visitors – unlike most people who had simply been illegally imprisoned and abandoned in there – got her daughter to bring her meals in. Things were no better in Springfield in 1991 where Pollock’s fellow Top Doctors worked. One inpatient was a young South Asian woman who, for religious reasons, was being given meals that differed from everyone else’s (they certainly couldn’t have managed that at Denbigh). So Springfield could therefore tick the ‘catering for a multicultural community’ box – but this young woman was delivered a meal each day which no choice offered or no say in what it was. On one occasion a meal was delivered which for dietary reasons she could not eat (one of the ingredients upset her stomach). She explained this to the vile abusive ward manager – an Australian called Stephanie whose standard method of communication was to shout and swear at patients – and was simply told ‘you’ve got to have it, these meals are costing us a fortune’. The young Asian woman went without dinner that day. This was before there had been any implementation of the idea of privatising NHS catering.

Pollock writes some scathing passages about the dreadful neglect of the elderly in the private sector – again this is endemic and she is quite right to draw attention to what is going on. But this was happening before NHS privatisation was on the agenda. As far back as the 1970s I knew of a notorious nursing home in the Somerset town in which I went to school. It was owned and run by a nurse who had been sacked from Taunton hospital and it employed schoolgirls as ‘nurses’ (my friend worked there – at 15 years of age she was passed off as a ‘nurse’). Every Top Doctor in Bridgwater knew about that home – they’d have never allowed their own relatives to end up there but no-one put a stop to it. When I went to university in Bangor in 1981 I found out about a very similar establishment in Menai Bridge. The man who owned the nursing home was a drunk and the ‘matron’ in charge was a nurse who had been sacked by the C&A Hospital in Bangor – after she was found having sex with a male patient in his bed on the ward. This was common knowledge, as was the neglect to which the residents were subjected – Dr D.G.E. Wood had some patients there and visited regularly. No-one had the place closed down. Furthermore Chai Patel is not to the only Top Doctor who owned care homes with questionable standards. Brig-y-Nant in Bethesda was owned by Top Doctor Dr K. Shah, a mate of Dafydd’s (see post ‘Hippocratic Oath or Hypocritic Oaf?’ for details of my encounter with Shah). Shah’s wife ‘managed’ Brig y Nant and I heard allegations from one former care assistant that not only were ‘difficult’ elderly residents dumped in baths of cold water, but when injuries were sustained, one doctor would always be called to deal with the problem – a Dr K. Shah.

Something else that Allyson attributes to NHS privatisation is the silencing of whistleblowers and the appearance of dodgy publications in the BMJ. I can kill two birds with one stone here. Back in the 1980s I remember reading an article that a particularly courageous doctor had penned for the BMJ. He was a GP from Devon and he wrote an account of how he had been called out to visit a patient in a nursing home and had arrived to find residents tied to their chairs with pairs of nylon tights and what he described as a ‘sloppy’ young woman on duty. He attended to his patient and as he prepared to leave he was stopped by an old lady who asked him if he was a doctor. When he said yes, the old lady pulled her skirt up and showed him severe, extensive scalding over her thighs. The old lady told him that someone had poured a kettle of hot water over her legs. This nursing home was owned by a local Top Doctor. A few days later the GP heard that the old lady who had been scalded had died. He was so worried about standards at this home that he contacted the coroner regarding his concerns. The coroner told him that there were no concerns at all regarding the home. The GP discovered that the coroner was a business partner of the Top Doctor who owned the home. The GP contacted the GMC and was told to take a running jump. So he penned an article for the BMJ to let the world now exactly what was possible on Planet Care Home. Was this caring and diligent GP supported in his efforts to expose this scandal? Not at all. In the next issue of the BMJ there were a number of letters published from other Top Doctors, all pompously declaring that the BMJ was not the place to air allegations about one’s colleagues. But that was not the worst thing that appeared in the BMJ in the 80s. On one occasion they debated Homosexuality. One old bigot wrote in and stated quite categorically that homosexuality does not exist ‘in the animal kingdom’ and that it is most definitely a perversion of Man. I’ve got news for that particular high-flier – homosexuality DOES exist in the animal kingdom as any zoologist will confirm. Such was the shite that the BMJ felt able to publish in days gone by.

As for whistleblowing – Allyson’s off in fairyland regarding this: ‘formerly doctors could and did speak out in the interests of their patients’ and ‘in the past doctors were free to speak out – in fact they were under a moral obligation to do so – if they felt it was in the interests of their patients’. Of course Allyson – that is why, for many, many years pre-NHS privatisation, Dr Dafydd Alun Jones et al were able to break the law, sexually exploit patients, sell drugs to addicts, lie on oath, illegally imprison people in Denbigh, conceal a paedophile ring and threaten and bribe people with many, many people knowing and no-one blew the whistle on any of it. In fact your own colleagues at St Georges and Springfield knew of at least some of what was going on and documented it – but told each other that I was ‘extremely dangerous’ and should be referred to the forensic services ‘for containment’ after I spoke to them about it. Other people who knew what Dafydd and co were up to included Dr James Earp from Leicester (see post ‘An Expert From England’), Professor Robert Bluglass (see post ‘Enter Professor Robert Bluglass CBE…’), The Medical Ombudsman for Wales Professor Robert Owen, Dr Chris Mawson (see post ‘Doctors Who Disappeared From The Medical Register’) and Dr Chris Hunter (see post ‘The Night of the (Dr Chris) Hunter’). Dr Mawson and Dr Earp did not, unlike the others, suggest that I should be banged up without trial in a secure hospital, but not one of them raised the alarm regarding what was going on.

‘NHS plc’ also takes aim at the various inspection regimes that have been introduced in recent years, such as the CHI (Commission for Health Improvement). Pollock describes such inspectorates as ‘ineffectual’ and mentions that the review teams are ‘inevitably less qualified and less experienced than the hospital staff they were inspecting’. Which is true and it is insulting to good hospital staff. But those inspectorates have been a Godsend to Top Doctors who aren’t doing what they should be doing – such as in Mid-Staffs. Or indeed in north Wales. Dangerous troubled services have passed inspections with flying colours. But it has always been thus – the Mental Health Act Commission were actively colluding with Dafydd and Dr Tony Francis (Dr X) in north Wales to conceal their criminal activity before privatisation was underway.

There is a glaring contradiction in Pollock’s writing, in that among her attempts to portray Top Doctors as helpless pawns in the face of power-crazed Gov’ts there are actually plenty of indications that she knows just how powerful swathes of the medical establishment are, including her own colleagues and the institutions in which she herself has spent her career as a senior member of staff. She clearly explains how the London teaching hospitals and medical schools are invested with prestige and status enabling them to attract high calibre staff, which in turn gives them huge influence even over Gov’t policy – just like Allyson and her Public Policy Units based in those medical schools have sometimes enjoyed.

Allyson mentions the idea to close Guys and St Tommy’s that was put forward some years ago – but she admits that the notion pretty soon died a death because of course Tommy’s is the hospital that serves Parliament. No, no-one’s going to shut down the most elite joint in town with plenty of friends in the Palace of Westminster. Allyson also mentions the enormous power and influence that Great Ormond Street Hospital has, due it’s legacy from J.M. Barrie and it’s very successful fundraising arm. She explains that in 2000, Camden and Islington Health Authority along with the Medical Director at UCL Hospitals Trust, planned to integrate all paediatric services across the area, but that GOSH disagreed with this plan, ‘was in a powerful position to put it’s own priorities before patients needs or planning’ and was successful in ‘silencing debate’.

Yet elsewhere in her book, Pollock holds up GOSH and it’s satellite hospital Queen Elizabeth Hospital for Children as being all that is best about the NHS. Queen Elizabeth Hospital was linked to GOSH and a number of consultants at GOSH had shared appointments with Queen Elizabeth. Allyson explains how Queen Elizabeth served the severely disadvantaged area of Hackney where some of the poorest children in the UK lived. She states that Queen Elizabeth was a ‘model of how a hospital in a severely deprived inner city area should be run’, that it was ‘accessible, open and caring with exceptional expertise’ providing a ‘superb service to needy children’. My post ‘Ian Brockington’s Mischief’ mentions that Dr Robin Skynner, who had links with Top Doctors who were concealing child sexual abuse, was the Physician in Charge of the Dept of Psychiatry at Queen Elizabeth between 1965-70.

As for GOSH – that was the hospital that employed the negligent doctor who contributed to the death of Peter Connelly in the ‘Baby P’ case a few years. GOSH has also just been at the centre of the Charlie Gard storm. And I doubt that either of those cases had much to do with privatisation.

Another inconsistency in Pollock’s book concerns Richard Smith, the former editor of the BMJ. He’s mentioned in Pollock’s acknowledgements section as one of the people who have ‘inspired’ her. Yet Smith is named elsewhere in the book as a baddie who jumped ship in 2004 and joined United Healthcare as CEO.

There are clues in the text as to what irks Pollock so much about New Labour as well as the root of some of her inconsistencies. Pollock seems to get to meet some very grand people. Not only did she dine with a merchant banker whilst her heart remained with the St Georges canteen in downtown Tooting, but she had an audience with Geoffrey Robinson in his capacity as Blair’s Paymaster General who afterwards invited her for a drink on the terrace of the House of Commons – although obviously she really wished that she was having a cup of char at a cleaner’s house in Garrett Lane – and she even met Gordon Brown when he was Chancellor. She described them as being on a ‘charm offensive’ and wanted to be ‘seen to be listening’. Pollock also thought very highly of Blair’s first Secretary of State for Health (1997-99) Frank Dobson – ‘a well-liked and competent Minister’. Not many other people shared that opinion – Dobson was widely perceived to be well-meaning but a bit gullible and dim (‘Private Eye’ named him ‘Dobbo’). The NHS continued to go pear-shaped and Dobbo’s scalp was demanded. There was another perceived problem with Dobbo as well – he rolled over for the Top Doctors…

Now although the Top Doctors are a very conservative bunch, they really didn’t like Thatcher and she didn’t like them. Thatcher loathed the professions (as well as academics) and very much saw them as being conspiracies against the layman. So the Top Doctors were most glad to see the back of Thatcher – I remember loud cheering breaking out in St George’s when she resigned. But the Top Doctors are not a bunch of lefties no matter what the Daily Mail says about them. However I suspect that when Blair was elected, Allyson and her fellow Public Policy/Public Health specialists may well have thought that their boat had come in. A Labour Gov’t that wasn’t socialist, with an authoritarian streak, wedded to the notion that Policy Experts should tell the plebs how to live. Which is probably why Allyson broke a leg in her efforts to meet Blair’s Ministers. A similar phenomenon occurred among HE specialists committed to widening participation – Blair maintained that he was going to pursue this policy and educational sociologists all got very excited, but of course he didn’t listen to any of them and a lot of them ended up very miffed. I suspect that Allyson fell into the same trap. Indeed, she makes it clear in her book that she feels that New Labour discredited and intimidated it’s critics, including her. Which they probably did – but then the Top Doctors discredited and intimidated those of us who discovered that their colleagues in north Wales were concealing a paedophile ring. At least Blair didn’t try to frame Allyson for serious crimes or state that she would end up in an institution for the ‘criminally insane’ as dear old Dafydd and Bluglass did with respect to me.

For all her griping though, Allyson knows that the Top Doctors can pack a punch if they are able to successfully construct themselves as the defenders of the NHS in the face of Bastards In Government. She reminds us of the lesson that no politician has ever forgotten – the election of Top Doctor Dr Richard Taylor in Kidderminster, who unseated the Labour MP David Locke. Taylor of course did this by running on a ticket of opposing hospital closures. Pollock mentions another similar event as well – the election of retired Top Doctor Dr Jean Turner in Glasgow in the wake of plans to close Stobhill Hospital. Pollock states that the Gov’ts announcement in 2003 that there would be no closures of smaller local hospitals after the election of Taylor and Turner was ‘a notable acknowledgement of the power of popular mobilisation’.

No Allyson, it was an acknowledgement of how bloody-minded the BMA are – they were fighting ALL hospital closures, including hospitals which were unsafe and harming or killing patients. They didn’t admit that any hospitals were doing this and they didn’t even work behind the scenes to raise standards – they did what they have always done and told the Gov’t ‘touch us and we’ll brain you’. Which indeed they did.

As all good Top Doctors do when they wish to ram home their arguments, Allyson makes references to popular media images of Top Doctors. We are told that the ‘frantic atmosphere in ‘Holby City’ is quite typical of the acute hospital today’. Which is rather like saying that the ‘Carry On’ films with Hattie Jacques giving terrified weedy men bed-baths and Barbara Windsor wearing an Anne Summers style nurse’s uniform whilst her bra flies off were an accurate depiction of life in an NHS hospital in the 60s. There is one big difference between Holby City and ‘an acute hospital today’ – in Holby City the staff never make mistakes and the complex cutting edge surgery is always successful, unless it’s an utterly hopeless case and the patient’s chance of life was unfathomably slim anyway. And from the episodes that I’ve seen, a lot of the surgeons are proud of their upwardly mobile journey from their disadvantaged childhoods – in one episode a female surgeon called Jac even revealed that she’d grown up in care and had been sexually abused. Er, no, as we know from the fate of the kids who grew up in care in north Wales, Jac would not be a heart surgeon, she’d be banged up in Denbigh with everyone calling her a dangerous liar. That is if she hadn’t actually been found dead in suspicious circumstances after having given evidence against the paedophiles that were employed in her children’s home.

Pollock also makes reference to a film called ‘As Good As It Gets’, which she appreciates because it makes some barbed points about US privatised healthcare. It stars Jack Nicholson. As of course did ‘One Flew Over The Cuckoo’s Nest’. Which was a film that one of Pollock’s colleagues at St George’s, the occupational health physician Nicky Mitchell-Heggs, had a real problem with. Mitchell-Heggs had previously been a psychiatrist and maintained that ‘One Flew Over The Cuckoo’s Nest’ set out to deceive because it was modelled on an asylum from the 50s but pretended that such places were still in existence. Which of course they weren’t. Indeed not Nicky – at Denbigh the patients didn’t wear uniforms and there was no piped music. But all the other ingredients were there – a lobotomist, Nurse Rached aka Janice Davies, sane people imprisoned and drugged up because they had dared challenge corrupt Top Doctors and staff terrorising and blackmailing vulnerable people by threatening to release confidential info about them. Except that Denbigh also had a psychopathic psychiatrist sexually abusing the patients who was also concealing the paedophile ring that his mistress facilitated. And those were the two people from whom Mitchell-Heggs and her colleagues were taking evidence regarding my ‘dangerousness’ so she must have known that they were there…. Mitchell-Heggs’s online profile describes her interests as theatre, opera and ski-ing! It’s those self-sacrificing Top Doctors again who fight tooth and nail for the NHS. I also seem to remember reading that both Mitchell-Heggs and her husband now run private practices.

In the initial pages of ‘NHS plc’ Pollock explains that she isn’t able to cover everything in a volume of that length, so there are some areas that she hasn’t commented upon. Such as mental health and learning disability services. Which is just as well considering how bloody shameful these ‘services’ are and were when she wrote that book. She also mentions that she doesn’t cover groups of staff such as cleaners, canteen workers, security officers and porters. In other words those staff who are treated and paid appallingly, whose presence is generally ignored by the Top Doctors and who are actually the very staff who have suffered most as a result of NHS privatisation.

At the beginning of her book, Pollock gives a long list of acknowledgments and names the people who have ‘inspired’ her. They include Dr Richard Taylor, ‘all members of the NHS Consultants Association’, ‘members of the Medical Practitioners Union’, ‘Brian Potter formerly of the Scottish BMA’, ‘Sir Sandy Macara at the BMA’ and Richard Horton of the ‘Lancet’. She mentions ‘many others’ to have come ‘to the aid’ of the Public Policy Unit which she was directing when she wrote ‘NHS plc’. Pollock pays tribute to the ‘special stalwarts of the NHS including Charles Webster, the former official historian of the NHS’. I mention on the front page of this blog that a number of people have written ‘histories’ of psychiatry in north Wales. These histories are at their best highly sanitised and at their worst have about as much historical accuracy as a Barbara Cartland novel. One of those ‘histories’ was written by a Bangor University lecturer called David Hirst and I’m fairly sure that it was his book that was co-authored or assisted in some way by an ‘NHS historian’ called Charles someone. I’m fairly sure that it was Charles Webster. I’ve been googling to try and clarify this but all traces of that book have vanished from the internet. I wonder why – after all it was proudly on display in Bangor University for years, so it definitely exists….However I note that David has co-authored with a number of the Top Doctors from the Hergest Unit! He arrived in Bangor to begin his work in ‘social policy’ in 1973 – Christ almighty, Gwynne and Dafydd were in full swing then, they will have been lobotomising and subjecting people to ‘aversion therapy’ if they dared to be gay til the cows came home. And of course Bryn Estyn was still under the direct management of the Home Office and the systematic sexual abuse of the boys there will have been well-embedded by then. Fancy publishing anything about that lot then David?

Pollock makes several mentions in her book of a man who has acquired superhero status in the eyes of any Top Doctor who wants to pledge their commitment to the NHS – Julian Tudor Hart. Tudor Hart is very elderly now, but he is one of the few Top Doctors still practising who was practising before the establishment of the NHS. He has written about just how grim things were in those days – Tudor Hart worked in south Wales among people experiencing very great poverty and hardship. I am interested in Tudor Hart, because although I do completely accept his account of how dreadful it was to fall ill or have an accident before the establishment of the NHS, he does seem somewhat blind to some of what goes on in the NHS. He is an intelligent man and a keen scholar, so like Allyson Pollock he will know. And being a man of his age from Wales, he will know what Gwynne the lobotomist and Dafydd got up to as well. Tudor Hart has been very rude about Ivan Illich and sees Illich as someone who simply plays to an audience of privileged middle class rebels, which is pretty much what the psychiatric establishment used to say about Thomas Szasz. There is truth in that argument – one had to be affluent to afford sessions with Thomas Szasz – but it ignores why the work of people like Illich and Szasz caught the imagination of so many. It was because of what folk like Gwynne the lobotomist and Dafydd were actually doing to them – people didn’t find it very helpful. There is also another factor about Tudor Hart that I cannot forget. He worked in the same practice as Dr Brian Gibbons, the former Health Minister for Wales. Who when I told him that I had evidence of the Top Doctors and managers in the Hergest Unit participating in criminal activities wrote me a letter saying ‘this correspondence is closed’. At the time the Hergest Unit had the second highest suicide rate for women in England and Wales.

I can only conclude that Allyson Pollock is one of the most articulate, useful PR mouthpieces that the Top Doctors possess and that she, along with the rest of the Top Doctors, are not very happy that Gov’ts are no longer commissioning their ‘research’ and seeking their ‘opinion’ on which to base policy.

As Corporal Jones of ‘Dad’s Army’ fame might have said – ‘It’s the Top Doctors. They don’t like it up ’em’.

 

There is one Top Doctor in particular who certainly doesn’t like it up ‘im – David Healy. I’ve been interested to note that since I reviewed his appearance on ‘Panorama’ the other day and observed that the voices of patients were noticeably absent from that programme and that whilst the Top Doctors scrap amongst themselves global capitalism continues to screw up healthcare, Healy has retweeted a couple of things. One was from a patient claiming to have ‘lived experience’ – the use of that phrase alone suggests that he falls into the category of a ‘professional service user’ (my neighbours don’t talk about ‘lived experience’ when they discuss their the local health services). Another retweet was from someone whom I have corresponded with, Finola Moss. Finola is a blogger who is doing some brilliant work exposing just how much money the Top Doctors who are involved with private psychiatric provision are now making. One company very much in Finola’s sight is Cygnet Healthcare and it was info relating to the billions that Cygnet is now raking in that Healy retweeted. The Medical Director of Cygnet is Robert Kehoe. Kehoe was the ‘expert witness’ who lied in a report about me, Brown, my PhD supervisor and even my lawyer after we had all made representation regarding the criminal activities and negligence of the Hergest Unit. David Healy was one of those named on the documents submitted to Kehoe in evidence. I later discovered that Kehoe’s business partner had a personal connection to Healy’s colleague at the Hergest, Dr Tony Roberts.

Author: Sally Baker

I am a writer and a sociologist, originally from Somerset, but I've been based in Wales for most of my life. I had my first encounter with a mental health professional in 1984 at the age of 21. My GP described this man to my then partner - who also became a sociologist - as someone who had experienced 'considerable success'. My meeting with this psychiatrist was a disaster and we attempted to complain about his insensitivity and highly inappropriate behaviour. That was the first time we were threatened and pressurised to withdraw a complaint against a mental health professional. This man is long dead - he was a retired psychiatrist from the North Wales Hospital Denbigh, T. Gwynne Williams, who was working shifts in the student health centre at University College of North Wales (now Bangor University). We discovered years later that this 'successful man' was notorious - he had been an enthusiastic lobotomist...

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