Are we the cause of our own problems with public services?

 (This was written before ‘Dancing Bloody Nurses’)

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For the fifth time in just over a month my partner, Viv, and I spent nearly an hour last Tuesday trying to arrange to chat with a GP. We had to subject ourselves to the dial, redial shenanigans at 8am, along with hundreds of others, and the local phone exchange was jammed - a daily event hereabouts. We persevered and got through after half an hour, before having to queue and wait, listen to recorded messages and be put on hold for another ten minutes or so. The reason for this was that Viv had had some hospital tests on Saturday, and, Tuesday being the first working day following that, we needed to chat to the GP to arrange next steps. 

In any sensible healthcare system our family doctor would have called us anyway to discuss the results of hospital tests; in ‘our NHS’, you have to go through the 8am process of ritual humiliation first, then wait at home to be called. Soviet Russia was not the final bastion of obdurate administrative bureaucracy! We were lucky, our GP called us shortly after 9am. 

This got me thinking: Christian Wolmar has, in recent months, written about the ‘Nobody Gives a Damn’ railway in RAIL magazine. I’m tempted to think that the whole of our public services are afflicted with the same illness; however, I do worry that there is the possibility of a more serious problem - namely, that public services such as the NHS, public transport, education are seen not at all as a means to help the public, but as a means to keep them in line. With Net Zero being top of every politician’s list now, and Central Bank Digital Currencies and the chance of another ‘pandemic’ being talked about, things might only be going to get worse.

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Take my far-from-unique experience with the GP, for instance: every time Viv and I want to talk to a doctor we have to go through the 8am dial-redial business, and set aside a whole day to stay at home to be called back. You may think that we could ask to be called back on a mobile phone, and so go about our business of the day; this isn’t possible. Firstly, we need to have various papers and notes to hand, so that we can discuss the matter properly with the doctor; secondly, we would not be able to hold a conversation with a doctor in a busy place like, for instance, a supermarket; and, thirdly, mobile phones do not work well in our area - calls to me on my mobile often go directly to voicemail when I am at home because there is no signal. 

I can’t spend as much time as I would like complaining, writing, or campaigning, about the failings of the NHS simply because of those very failings; caring for Viv comes first. I’m far from the only ‘ordinary person’ in this situation; many people with health issues have carers whose time is taken up with the NHS bureaucracy. Those in power go private, of course, and tell the rest of us that we should be grateful for our ‘envy of the world’ NHS; they, of course, are being protected from hearing the truth about it partly because it is so dire.

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The engagement with the GP isn’t the only problem I had with the NHS that morning. Viv has to have a blood test: once these were done at our local GP surgery and the samples sent off for analysis. Now we have to go to our local hospital, which used to have a walk-in blood test facility, but, not wanting to spend ages and have a wasted journey, after collecting the necessary form from the GP I went online to check this is still in operation. 

It isn’t; the process had changed, as of that day. Yes, as of that morning you now had to go online to book an appointment. There was nothing about that on the paperwork I collected from the GP. (No, I have no idea how elderly people who don’t ‘do’ the internet are supposed to manage). 

Viv is a regular at that hospital, it would not have been too much to expect that she would have received a letter, or even a text message, telling her of this change and the need to set up an online account, but no, such good manners seem to be out of scope for modern day NHS managers. 

There could even have been some instruction with the form I picked up at the GP practice; in other businesses, communication with your customer base is a key part of any change. Seemingly not in the NHS.

I suspect the hospital has been deluged with people expecting a walk-in service only to be told they were expected to book an appointment, and heaven knows how some of the eighty-year-plus age group of patients will manage an online booking system and text messages ‘keeping them informed’. It's another example of the public sector doing something because it is easier for itself, with little consideration of the inconvenience to the public - who, they perhaps forget, pay their wages and appoint, through the ballot box, those who (against strong internal opposition sometimes) ultimately determine the funding and priorities of their business. 

It may be that the elite have noticed that keeping ‘ordinary people’ occupied - like going to hospital to have a blood test only to be told you have to come back - might be a good way of  stopping them having enough time to complain about the service, and will keep their minds off what the elite might be up to with, perhaps, CBDCs and the like. 

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Another example of poor public service is the quality of, and perhaps adherence to, local planning processes. I mentioned earlier the mobile phone signal where we live; we’ve been here ten years and there has been no upgrade to the mobile networks. The existing masts run at full capacity for much of the time; in the past ten years there have been about 3000 houses built locally, maybe the population has increased by six thousand or more - all young(ish) and likely to have, and use, mobile phones. All the developments were approved by officers and elected councillors without consideration as to whether the new residents would be able to use a mobile phone; further, no consideration is given to this problem when designing new processes like banks texting you a code when you do online shopping or getting you to use something like the NHS app.

Oh, of course, no consideration was given either to the availability of GP surgeries when all of those houses were approved either. There was a ‘promise’ of a new surgery, but it never materialised. 

It seems the case that nobody in central or local government gives a damn about planning new developments, and whether they actually work; the council people say that they are ‘following the process’, but could it be that providing developments with poor facilities for ‘ordinary people’ to live in is actually a deliberate exercise: a sort of ‘reward’ them for voting for Brexit, perhaps, or an attempt to keep ‘ordinary people’ away and out of sight of their supposed betters? 

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Public transport is another great example of woeful public service. In years gone by our trains prided themselves on speed, punctuality, comfort and service. There were printed timetables that they judged themselves by. Now, many of our rail companies provide only basic trains, with hard seats, little privacy and variable heating in winter, with no on board refreshments. Neither do the trains stop anywhere long enough for travellers to get off and buy something at a station (as they did in Victorian times). Toilets were once a requirement at every station; now, many do not have them, and those that are on board the trains that have them are frequently smelly and afford little privacy.

Worse, there are no printed timetables. Timetables are known only to a computer, and printed copies - even posters at stations - are not provided because ‘operators might want to change the timetable at short notice’. This gives them an opportunity to increase profits, for, if a train service (as defined on the online timetable)  is late or cancelled they must pay compensation; if, on the day before, they know that the train may not run they can just change the online timetable. Travellers are expected to check their computers daily to see if the timetable has changed - and, if they happen to be at a station where there is no mobile phone coverage, well that’s their problem! 

If the idea is to discourage ‘ordinary people’ from travelling by rail then this is a very good way to go about it. And, of course, travel by road is going to get more difficult for ‘ordinary people’ as internal combustion engined vehicles are discouraged; who does that suit?  

(You think that rail is ‘privatised’; but please think again; any reader of RAIL magazine will tell you how all rail franchises run under micromanagement from the DfT, far more so than in the days of British Rail.)  

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The education system as experienced by ordinary families is likewise shambles. Ignoring the service provided during the Covid pandemic - when schools were shut and children’s development blighted for seemingly no benefit whatsoever -  there are plenty of other problems with state education in the UK.

There is a special needs school almost at the end of our street. We must be unusual in that fact, for SEND resources are desperately thin on the ground in the UK. There are undoubtedly a number of reasons for this - probably the planning experts failing to predict demand may be one - but there do seem to be clear suspicions that, faced with incentives to get children to ‘succeed’ - passing exams well, and getting plenty of pupils to ‘Uni’ - mainstream schools give up on the less bright or the socially challenging kids. The school, or their parents, demand that ‘something is done’ and the child is labelled as having ‘special needs’. 

However, there is a woefully inadequate supply of places in SEND schools, and these unfortunate children are often taken - by taxi, at the local taxpayer’s expense - to a school miles from where they live. We live in Bedfordshire; outside the SEND school I was referring to we have seen taxis from Newmarket (37 miles away) and Braintree (48 miles). Some of these kids must be spending over two hours a day in taxis, just to go to school. Wouldn’t it be better to get mainstream schools to work effectively with all children - including the less able? (Isn’t that what the Equality Act was supposed to ensure…?)

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All of the examples I have mentioned have something in common: they are services provided that are experienced differently depending upon your class. The elite experience of transport - chauffeur-driven limousine, private jet, or luxury train - is very different from that of the ordinary person. Education and health are obtained privately by the elite. And it is to the sort of services used by the elite that we should look for examples as to how things should be done in services provided to all. Further, those in charge of services delivered to all should, and should expect to, experience the same service that their customers receive; if they refuse to do this questions should be asked. 

I have long felt that MPs, Members of the House of Lords, Civil Servants, the Royal Family, and NHS managers should all be barred from using private healthcare. Indeed, they should follow the example of staff and management at The Savoy; they should be required to spend time using the services for which they are responsible. Perhaps those most responsible for health should spend time every year in an NHS hospital, not as a visiting ‘VIP’, but anonymously, ‘under observation’, eating the same food, trying to get sleep on a noisy ward at night, experiencing how ‘ordinary people’ enjoy ‘our NHS. DfT civil servants and other luminaries should be taken to a remote rail station in Wales by taxi, told that details of the next train are online, only to find there is no phone signal, no toilets or refreshments at the station, and the train, when it comes, is packed, and they face four hours standing next to sweaty hikers to get home. MPs and Lords, royals, and relevant civil servants, should be barred from sending their children to private schools: Prince George will learn much more about all of his future subject’s lives attending the local comprehensive than he ever will at Eton (especially if the former includes a handful of ‘special needs’ kids). 

If the elite are forced to use the same services as the rest of us they will surely consider that some improvement is required; if they don’t, we should be asking them why. 

Council planners should be required to live in the estates they approve, where you can’t buy things on the internet because you have no phone signal to pick up the text containing the code you need to confirm your payment, you struggle to see a doctor because the surgery that was promised as part of the planning application was never set up, and people have to walk in the roads - which are falling to bits - because the pavements are blocked by parked cars (despite the planning application requiring on street parking to be prohibited), or, in some cases, the pavements aren’t even surfaced, just muddy verges. 

Those highly paid ‘experts’ and celebrities, including members of the royal family, who advocate the banning of gas boilers for Net Zero should be only too happy to live in a damp Victorian two-bed terrace in Huddersfield, heated only by an air source heat pump, for a whole year; further, they should be encouraged to consider the effects such housing might have on their perhaps elderly parents. They should also be required to use only electric vehicles, or electrically powered transport, when travelling - their blatant clocking up of air miles while lecturing the world on ‘going green’ shows us all how little respect they have for the rest of us.

However, nothing seems likely to change until we have political leaders willing to accept that there is a problem with services provided to ordinary people, and we have a younger generation that is willing to learn from and listen to the experience of older folks, and is prepared to be less deferential to their supposed ‘betters’ than we were when young. Too often, youngsters don’t see the many delivery failures of public services (they don’t use them as much, and can’t relate to past times when things were done better); while these younger people do not see failing public services to be a problem little will be done, for it is a feature of our failed democracy that all of our leaders - elected, appointed and hereditary - seek to appeal to younger voters; the views of anyone with experience in life - who might show less respect to their supposed ‘betters’ - are written off as unimportant conspiracy theories.

 

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Indeed, it’s interesting that such ingrained deferential attitudes exist in the UK; in other modern western countries, individuals of all backgrounds feel more entitled to question their leaders. But deferential attitudes stem from a class structure, which we have in spades but more successful economies have shaken off in the last century or two: might it be the case that reform of our whole political system, including the role of the monarch and/or head of state, might be required to get change, even to simple things like train timetables that suit the traveller? The economies and public services in many other countries do seem to be rather better than ours; might that be because, almost alone in the western world, we still have a monarch (not a head of state), who we entrust to ‘defend our laws’ (the lyrics of the national anthem)? Why do we blindly do this? Why do we assume that the elites work in the interest of the ‘ordinary person’ - when it is too often evident that they don’t?

Those with a little knowledge of history might recall the gallant lads who volunteered in 1914 and were sent off to walk out of their trenches into machine gun fire. Their leaders told them they would be safe, but that they ended up, in many cases, being massacred, sent shivers through the upper classes: fear of revolution was the driving force behind many poor political decisions in the years following WWI.

Of the key players in WWI, it is only in the UK that the political system that allowed such slaughter to happen is still in place, and, surprisingly, there is general acceptance of this. Is this perhaps the root cause for our rubbish public services?

Are we the cause of our own problems?