INSANITY AND THE GRAVY TRAIN


In the late 1830’s the Tsarevich, Alexander was due to visit the province of Vyatka. ‘Five days before the Tsarevich was due to visit Orlov, the Mayor had written to Tyufyayev [The Governor of the province]…that so and so, a wealthy merchant and prominent person in the town, was boasting that he would tell the Tsarevich everything, [respecting corruption]. Tyufyayev disposed of the man very cleverly; he told the mayor to have doubts of his sanity…and send him to Vyatka to be examined by the doctors…The mayor did as he was bid; the merchant was placed in the hospital at Vyatka.’[1]

‘The head of the health watchdog, Dame Jo Williams, cast doubt about the mental stability of a high-profile whistleblower who she wanted the Health Secretary to remove from the board, The Independent can reveal.

Kay Sheldon, a non-executive director of the Care Quality Commission (CQC), was subject to ‘priority monitoring' and declared a ‘risk’ to the regulator after she had raised concerns that public safety was being compromised by poor leadership and performance.’[2]
Dame Jo Williams

I worked in the NHS as a manager for a couple of years and as a Dual Diagnosis specialist for a couple more. I have been employed by local government within the probation service and worked for a number of voluntary sector organisations. In all these roles I worked as part of what is called the social care sector. Wherever I worked I heard, for it was never far away, the rattle and rock and roll of the gravy train.

Whilst working in the NHS the great El Dorado was Foundation Trust status, this offered serious incentives for senior management and much was to be sacrificed to attain this goal; canteens were closed, services reduced and juggled around; all in the name of becoming leaner and fitter,in the name of service improvement. Financial autonomy meant greater financial responsibility and commensurate financial rewards for senior managers; bigger cars, more expensive foreign holidays, fatter pension and redundancy pay-offs.



The 1990’s saw the emergence, in the addiction treatment field, of a new Quango, The National Treatment Agency, [NTA]. The scramble to get well paid jobs provided by this emerging organisation and thus join the burgeoning Quangocracy was a phenomenon to behold. In practice all the usual suspects, in the small world of substance misuse, were successful[3] and settled quickly into the new jargon and new priorities set by new Labour, rather in the way you can slip comfortably into a new pair of pyjamas. Selling this new formula to a weary treatment world paid for many a vacation in exotic locations, indeed paid off a few mortgages. (Many, having mastered the new language – in reality describing the same old problems in a different way- went on to go freelance and become ‘consultants,’ offering freedom and big bucks). How much treatment benefited is, to put it generously, questionable.

When I see the word ‘charity’ this now impresses me about as much as the word reverend, and fills me with a similar amount of suspicion.[4] This is not to say that many voluntary sector[5] organisations do not do a great job, sometimes working with the most challenging clients, or helping people or tackling issues neglected by the state. I have worked for some excellent charities[6] and can bear testimony to the professionalism and commitment to service users.

Irene Khan Amnesty International [See Footnote]
However the rapid expansion of the voluntary sector and increasing financial rewards for senior executives has produced a gravy train culture spanning charities, housing associations and, at the top of the pyramid, the extraordinarily lucrative Quangocracy, to which so many in the voluntary sector aspire.[7] One possible by-product is that the majority of organisations are now run on rigid hierarchical lines; some are little more than mini autocracies with senior managers a law unto themselves.

Now as it happens I can think of at least half a dozen people who would have suppressed information had it been threatening to the organisations for which I worked. They might even have done it in the macho, ‘read my lips,’ style alleged in the CQC case; though the more soft spoken power of The West Wing was then more in vogue. 
It is interesting that the majority of people I am thinking about are women. This may be simply a consequence of the fact that women are much better represented at senior management level in social care, particularly in the voluntary sector; though it does rather call into question the line that the world would be a softer gentler place if run by women.[8]

The English language lacks a solid definition of sanity; it offers up, ‘the state of being sane, of sound mind.’ The definition of insanity is little better. In the brave new world of the booming ‘Third Sector’ and Quangocracy a definition could possibly be:-

To rock the boat, to reveal truths about an organisation even when do so will harm the welfare, well being and interests of that organisation as a whole; to expose malfeasance to the outside world without expectation of financial gain.’

From the viewpoint of those enjoying the considerable rewards of the Quangocracy such behaviour is nothing other than insane.



[1] Alexander Herzen, My Past and Thoughts, University of California Press 1982, p212.
[3] Sitting on interview panels they interviewed one another, old comrades from the voluntary sector clambered on board this new manifestation of the gravy train.
[4] All manner of crimes and misdemeanours, and charlatanism are committed by persons operating under the cover of the word ‘Reverend.’ As to charities, charitable status covers private schools like Eton and a range of dubious lobbying groups. Not to mention the range of ‘charities’ which are in reality tax avoidance scams.
[5] Re-branded the third sector by New Labour;  I once met an acolyte of Hazel Blears at Luton airport who informed me, with all due solemnity that his job was “building capacity in the third sector.”
[6] However for the lay person the word charity is somewhat misleading. Many voluntary organisations, i.e. ‘charities,’ working in the local community now receive 100% of their funding from the state. In the past independence was traded for secure funding; now of course many enjoy neither.
[7] The case of Amnesty International represents a particular insight into this culture of reward; following her resignation as Chief executive Irene Khan received a payment of £533.103, a sum four times in excess of her final salary, in itself an impressive £132,490. Kate Gilmore, her deputy, who resigned at the same time, recieved an ex-gratia payment of £320,000.
For a list of the most lucrative posts in the charity sector see:-
A separate issue is the possibility of gongs, the CBE, OBE’s, Sir’s and Dames. These baubles, available now at senior level in social care seem to hold some attraction.
[8] The most flagrant example of bullying and intimidation I ever experienced was from a woman. However it is of course true that we still live in a highly patriarchal society, it is men who set the tone.


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