The term ‘official Scotland’ covers a number of important institutions: central and local government; national organisations responsible for a wide range of services (e.g. health and education); professional bodies which set standards and control entry to particular occupational groups; regulatory agencies intended to monitor performance and investigate complaints.
Those who occupy senior positions in these organisations seek to project a positive view of their function and achievements. Visit any of their websites and you will encounter grandiose ‘mission’ and ‘vision’ statements, expressed in boastful discourse. There is also usually an appeal to a version of Scottish identity that emphasises justice, equality, inclusion and public service. Terms such as ‘accountability’ and ‘transparency’ are regularly invoked. In practice, much of this turns out to be rhetorical flourish.
The point about language is important. The various agencies of official Scotland enjoy considerable powers of ‘narrative privilege’, a concept that refers to the ability of senior figures to tell their own story in a way that reflects well on themselves. Policy documents, minutes of meetings and reports of enquiries are crafted using sanitised bureaucratic language designed to put a favourable spin on events and forestall further enquiry. Within government, civil servants have had decades of experience in finding forms of words that conceal more than they reveal. Under pressure, however, they may resort to the tried and tested techniques of delay, evasion and cover-up.
The Use of Patronage
Central government is able to exercise patronage in deciding who should be appointed to boards, committees and working groups. Relevant experience and expert knowledge play a part, but appointments are also influenced by perceptions of whether candidates are prepared to observe the unwritten rules of the game. In a brilliant study of the policy community in education published in 1988, Andrew McPherson and Charles Raab showed that ‘deference and trust’ were essential qualities. Those chosen had to be prepared to defer to established hierarchies and to demonstrate that they could be relied upon not to rock the boat. There is no evidence to suggest that the situation has changed markedly in the post-devolution period. Dissident voices continue to be marginalised. For those who are willing to conform to official expectations – and there is never any shortage of aspirants to the charmed inner circle – there is often the prospect of receiving some minor recognition in the honours list in due course.
Mechanisms designed to hold public bodies accountable have had limited success, partly because their protocols and procedures are weighted in favour of institutions rather than members of the public. To lodge complaints with any hope of success requires knowledge, determination and stamina. Freedom of Information (FoI) legislation has had some benefits but institutions have learned ways of resisting requests. The Scottish Information Commissioner has had cause to criticise government ministers for failing to respond to FoI requests within the statutory time period. And many of those who have taken their complaints to the Scottish Public Services Ombudsman have been dissatisfied not only with the outcome, but also with the way their submissions have been handled.
Professional bodies, such as those representing doctors and lawyers, often claim to be motivated by an ethic of public service, which places the interests of patients and clients above their own. The record hardly bears this out. The campaigning group, Action for a Safe and Accountable People’s NHS (ASAPNHS), which has drawn attention to the serious failings of health boards, in some cases leading to avoidable deaths, as well as the failure to conduct properly independent enquiries, has encountered major obstacles when it has raised its concerns not only with NHS Scotland, but also with government ministers and Police Scotland. A study of the written replies ASAPNHS has received provides an interesting insight into the linguistic tactics of back-covering organisations.
The Scottish legal profession hardly inspires great confidence either. The Crown Office has been castigated for entering into plea-bargaining deals which seem to favour criminals and lead victims and witnesses to feel that justice has not been served. Scotland’s system of Fatal Accident Enquiries has been described as slow and inadequate, again often leaving relatives of the deceased feeling that they have been treated shabbily. As for complaints against solicitors, is there anyone, apart from lawyers themselves, who is satisfied with the procedures of the Law Society of Scotland and the outcomes of cases taken to the Scottish Solicitors’ Discipline Tribunal? The self-importance of the judiciary might just be tolerable if it was matched by an impressive track-record of judgements. But its members constitute a closed, self-perpetuating elite which allows them to disregard outside critics.
A Compliant Media
One of the reasons why the Scottish establishment gets away with its various strategies to maintain the fiction of a properly democratic society is that the media have too often failed to hold officialdom to account. Newspapers are under great economic pressure and employ few investigative journalists of the kind who might interrogate press releases and dig beneath the surface. Moreover, one journalist has referred to the ‘clubby nexus between politics and the media’ in Scotland which often prevents potentially embarrassing stories being published. Who knows how many articles have been spiked following a discreet telephone call from a politician or senior official to a newspaper editor? Official Scotland is a relatively small world and many of the key players meet and socialise on a regular basis. Cronyism with a Scottish accent is no more acceptable than the public school/Oxbridge variety.
For too long Scottish people have been presented with a flattering self-evaluation by the powerful, unchallenged by a dispassionate assessment of the evidence. Far from being a beacon of democratic enlightenment, official Scotland exhibits many of the worst features of narrative privilege, bureaucratic defensiveness, professional protectionism and the abuse of patronage. There is no easy answer to this deep-seated cultural problem, but the first step is to acknowledge that it exists. Only then can the task of meaningful reconstruction begin. There will be strong objections from those who flourish under the present dispensation and who have developed various means of protecting their interests. It is highly questionable whether existing political parties are up to the task of reform, since many of their members routinely collude with the networks of influence that maintain the deceptions. Identifying the most promising sites of resistance would be a useful starting point.
Image: International Council of Education Advisers via Scottish Government CC BY SA 2.0
Paul Cochrane says
Still sitting on the fence Walter! :-}
Always worth a read and always challenging. I love this guy’s writing.
Fay Young says
Straight to the point! And familiar to anyone who has any dealings with Official Scotland. For me, it’s the dead hand of government appointments…
”Those chosen had to be prepared to defer to established hierarchies and to demonstrate that they could be relied upon not to rock the boat.”
And the mission statement. So deadly pompous. Perhaps Official Scotland needs to develop a sense of humour – last month I met a lovely young creative company, their mission declared on Facebook: “to scare the crap out of Scotland” they deserve success!
Rab Wilson says
This email sent earlier to Robbie Pearson, CEO Health Improvement Scotland;
FAO Mr Robbie Pearson, CEO Health Improvement Scotland
Thank you for your response (attached).
I didn’t know whether to laugh or cry when I read this Robbie. You fail to answer virtually any of my questions (below) then go off on some weird Scot Gov gobbledygook tangent about how wonderful everything will be tomorrow.
It is abundantly clear now (from your letter) that the Scottish Government, with regard to making NHS Serious Adverse Event Reports (SAER’s) available to the public for any scrutiny whatsoever will now effectively completely stop when this new Duty of Candour comes into place. The public will not be allowed to see SAER’s in any meaningful shape or form.
On the 1st of April 2018 the Scottish people will have the greatest April Fool’s Day trick that’s ever been played on them with the implementation of this nonsense. I salute its creators clever, if twisted, sense of humour.
Some history Robbie; when the government got a public kicking and egg all over their faces in 2012 when my story was on national TV and newspaper front pages due to the massive and deliberate cover-up by NHS Ayrshire and Arran in failing to manage, share or learn from SAER’s and the deaths caused by this, it seems the Gnomes of St Andrews House got together and said how do we prevent a PR disaster like this from ever happening again. The answer is this new Duty of Candour.
The Duty of Candour – as can be seen from your letter – means in a very Orwellian sense the exact opposite of candour in its true meaning (the quality of being open and honest; frankness). In reality it means that only a tiny percentage of SAER’s will qualify to be seen by the public under the new duty of candour. Where before SAER’s were meant to all be published in patient confidentiality redacted format on all board websites the opposite will now be true. It is already happening; some boards have no SAER’s on their websites for public scrutiny.
The attached Health and Sport Committee report (published Tuesday, 27th Feb, 2018) contains some revealing information. Let’s sift through the dross and get to the diamonds!
Following the catastrophic PR disaster and political fallout from my case Health Improvement Scotland (HIS), in other words you Robbie, produced the new national framework for managing SAER’s. This was revisited by HIS in 2015 and an updated framework produced. This national framework was meant to ensure that SAER reports would all be learned from and that the public could openly scrutinise this. This has of course not happened and hundreds of patients have continued to die needless and preventable deaths with no accountability from boards. ASAPNHS have appealed for investigations by Police Scotland into these deaths (that number now in their hundreds – if not thousands) and Police Scotland are busy trying their best to do nothing about it. Hopefully the media in Scotland will one day wake up and realise that this is the ‘Scottish Hillsborough’ and that it has been going on, hidden in public view, for years!
Meanwhile, in the attached H&S Committee report (see pages 36 – 40) Shona Robison appears to throw John Burns (CEO NHS A&A) and yourself under a bus in her response to Brian Whittles question on adverse events.
If the board are obliged to undertake a trend analysis then what the hell were both they and HIS doing in 2012-13 when no SAERS were recorded? I would remind you that the 2012 HIS review remarked on the low number of SAERS which at that time was averaging 19 per year. Yet no questions were asked when NHS A&A produced zero reports for a whole year!? Can you explain this Robbie?
The attached Excel Doc shows the number of SAER’s produced by health boards over recent years. NHS A&A figures stick out like a sore thumb Robbie, yet no-one appears to have queried this? Health boards round the world must be beating a path to John Burns’s door to discover the secret of NHS A&A’s miraculous solving of the SAER problem! Perhaps beatification for John Burns may follow!?
NHS A&A it appears have found a new and novel way to counter the bad publicity and problem of SAER’s – they stopped producing them! You even state in your letter (attached) that you encouraged them to do this?
Over approximately a 3 year period we have @ 2,500 SAER’s in Scotland, and these are only the patient safety related incidents that were escalated to SAER’s. There will no doubt be tens of thousands of Datix reports that were not escalated to full SAER’s (no doubt swept under the carpet with other nasty and potentially embarrassing dross!).
When this insane ‘Duty of Candour’ kicks in then, as you say in your letter Robbie, ‘it will be a legal requirement for NHS Boards to publicly report on adverse events where duty of candour has been applied’! And here we have the real Catch 22; Only those SAER’s where duty of candour applies!! I predict that only a tiny percentage – a handful per year? – will see duty of candour applied, or be allowed to qualify, for public perusal. You read it here first!
Where now we have (or at least should have – though we do not!) @ 2,500 SAER’s publicly accessible over three years I predict in the future perhaps 10 a year being made available to the Scottish public. This at a time when the Conservative Health Secretary Jeremy Hunt has recently made the announcement that all adverse events in England will be made publicly available.
In Scotland meanwhile the Gnomes of St Andrews House seem determined that SAER’s will never be seen by the Scottish public again.
In that H&S Committee report Shona Robison refers to the ‘inconsistencies’ of NHS A&A health board. What in reality is being done about those ‘inconsistencies’? It would appear that the lessons have still not been learned there – as John Burns assured me personally they would 5 long years ago – plus ca change!
This Duty of Candour is in my opinion and experience of the behaviour of health boards and health ‘scrutineers’ (as we are in the illegal position of having no official public health regulator in Scotland!) nothing but an archly cynical exercise in deliberately attempting to continue the cover-up of bad things when they happen in our health service. You may fool some of the people with this – but I for one am not being fooled Robbie.
This Duty of Candour should be scrapped before it contributes to more needless and preventable deaths in our health care system.
ASAPNHS will continue to battle for public accountability and for justice and, as there must now be, criminal prosecutions of directors for negligence in our NHS.
David Gow says
Can you give some more details of your case so as to help the reader?
Rab Wilson says
My NHS whistleblowing story can be seen/heard here;
Since that time I have campaigned tirelessly with other NHS whiatleblowers and health campaigners for justice in our NHS relating to; individual bullying cases; breaches of Health & Safety law by NHS Directors/Boards that have resulted in hundreds (if not thousands) of avoidable/preventable deaths in our NHS; a national cover-up of Serious Adverse Event reports that means that lessons are not learned from SAER’s – and patients continue to die from similar events and situations that happen time and again; and much more! Who is culpable in this so far? Scottish Government, very senior civil servants, Police Scotland, COPFS, PIRC, Lord Advocates (past & present), Justice Secretaries ( past & present), Unions, Proefessional Regulatory bodies…. We have thousands of emails and letters that prove our case that all of these parties have colluded in sweeping what we term ‘The Scottish Hillsborough’ under the carpet by refusing to carry out criminal investigations into those we hold responsible (very senior people) for these many, many deaths. I’ll try and post more…
David Gow says
why not write a piece instead?
Rab Wilson says
Time, and too many commitments! We’ll see… Perhaps our group can provide something!
Dr Peter J Gordon says
Nobody has written better about the corridors of power than Walter Humes (not even C. P. Snow).
I could not get anywhere close to providing such an important, insightful and necessary attack.
I hope that it is okay, but I have reproduced Walter’s words in full (with full acknowledgment and link to this page) but have added a few bits o’ my oan, including twa o’ my films:
aye Dr Peter J. Gordon
Bridge of Allan
Rab Wilson says
Is it possible to attach PDF documents here?
David Gow says
don’t know frankly but you can send to me
Rab Wilson says
At what email address??
David Gow says
Chris Attkins says
Professor Humes is always worth reading. His insight, candour and wit combine to inspire thought – and hopefully action.
Tommy Lusk says
“And many of those who have taken their complaints to the Scottish Public Services Ombudsman have been dissatisfied not only with the outcome, but also with the way their submissions have been handled.”…I have an experience of this. I’d need to look out the detail, but basically, it was handled badly. This was acknowledged and past to the boss (final arbitrator of the process) who decided that although the complaint was handled badly, it could not be considered again.