[Robin McAlpine Blog] The anatomy of failure

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The anatomy of failure

There’s quite a bit going on just now with the Scottish Government backing right away from what was core policy in both the budget and in its never-more-than-skin-deep commitment to the wellbeing economy. But now that my power is back on I just want to take one last shot at making sure you don’t believe any of the excuses and buck-passing you’re about to hear about the failed National Care Service proposals.

To get the basics of why those I’ve been involved with are so angry, go and read this. It tells you a lot about why this went wrong and makes what I think is a clear and cogent case for why there must be a real, independent inquiry.

But since that may not happen, let me pre-emptively deal with some of the special pleading which will come from various people as the fall-out from this disaster is sifted through. You can summarise it simply like this; from the very first moment this was floated, it was doomed – and virtually every action taken by everyone involved from that point on made it ever more certain.

As with so many messes, it begins with Sturgeon. Sturgeon has no understanding of care issues, no background, no professional experience – but she does like an emotive subject for a backdrop to one of her ’emotional’ moments. In 2016 she made an announcement about kids in care which seemed purely designed to provide a cloying photo opportunity.

At the 2016 SNP conference she announced that under her watch every child in care was going to be ‘loved’. This had a strong relationship to PR since it resulted in a bunch of young people who had experienced care being made to wave hearts at her in front of the cameras.

What it bore no relationship to was the practice of care. ‘Love’ is meaningless and its definition should be left to the poets and songwriters. There is a world of serious academic work on what produces good care outcomes (attachment, reliability, consistency) and none of them are ‘love’.

This background is important; throughout her tenure Sturgeon toyed with care issues to burnish a particular image she wanted to present. What she didn’t do was stop to learn anything about care. By the time of the pandemic she was on the back foot. The first six weeks of Scottish Government Covid response was an absolute debacle (sending Covid-positive people to care homes etc.).

So this results in her daily TV show and that demands content. That’s how to think about the NCS announcement; content for a daily format TV show. There was no depth to the thinking and no understanding of what people who were promoting the idea of a National Care Service were actually asking for.

To save this it would have required proper advice from care professionals. Instead Sturgeon wrote up a minimalist brief and gave it to a former civil servant who was responsible for the system that is clearly failing. So this starts as a soundbite and quickly becomes a managerialist perspective on how you manage care services. This is still not about understanding care or the sector.

Up to this point we have a politician asking a bureaucrat to design a care service which is then progressed by another politician via private sector consultants

The response to the review the former civil servant carried out (he is Derek Feely and it’s generally known as the Feely Review) was hardly ecstatic. To say that it was really pretty minimal and bureaucratic with nothing much transformative would certainly not be unfair. Then again, to say this was a care service for managers, by managers wouldn’t be unfair either.

Then we get into the world of (deep sign) Target Operating Models. There is a good chance this terminology is not something you year much; well that just shows you you’re not spending enough time around the Scottish Government. This is the jargon term for explaining how a new system is supposed to work, and it is always outsourced to one of the big four consultancies.

Up to this point we have a politician asking a bureaucrat to design a care service which is then progressed by another politician (Jeanne Freeman) via private sector consultants (KPMG in this case). To be fair, Freeman retires before the contract is issued and so when another civil servant warns that the contract should not go to KPMG because of its track record of dishonesty it is Humza Yousaf who overrules the official.

So we get months of consultancy churn where economics graduates sit in a boardroom trying to work out how a care service should work. At this point the closest anyone with any knowledge of care has got to this process is submitting evidence to Feely. So when the legislation appears it contains no information about care.

I can’t really be clear enough about this; it is a ‘framework bill’ so it’s only about restructuring, not care. And so when now-health-secretary Yousaf unveils the Bill in mid-2022 it is not well received. Within a few months it is clear that this is being met with outright opposition by anyone who knows about care or actually delivers it. Increasing numbers of core organisations announce they will boycott it.

A consensus emerges that the legislation must be paused because it isn’t fit for purpose. This is despite some minor concessions being negotiated with Cosla over the scale of the centralisation. So by early 2023 it is paused. Except by ‘pause’ I really mean ‘tank on with like nothing happened’.

The pause is no such thing (and note that Yousaf is SNP leader by now and its Michael Matheson who is leading). What happens is an insane plethora of working groups and experience panels and meetings and submeetings and loads of other fiddles. Basically many dozens of time-wasting exercises are concocted.

And then the legislation is reintroduced unchanged. I honestly can’t be bothered tracking all the lies and rollback of promises at this stage. Basically they say they’ll adapt the Bill at Stage One. Then they say they won’t but will amend it at Stage Two. Then they say they won’t, they’ll offer amendments at Stage Three. Then they say they won’t amend it at all but will ‘tweak’ it through secondary legislation and guidance.

So they bring it back as was, everyone boycotts it again, so a year later there is yet another pause. They take one last chance at resurrecting it (Matheson is gone now, crushed under a stray iPad so now it’s Neil Gray not calling the shots). They fail. They abandon the whole thing at a cost of £27 million.

This policy was dead on arrival and has been maintained in coma state for four years for no justifiable reason at a cost of £27 million of your money

Four health secretaries in four years, seven figures spent on consultants, literally countless working groups, continual mendacity and dishonesty in dealing with everyone and eventual failure. That’s it. Is there anyone who can hold their head up? Well, the Finance and Audit Committee of the Parliament did a good job of exposing the worse-than-substandard financial planning.

And the many, many people in the care sector who had to waste large chunks of four years of their lives to prevent this mess actually becoming law deserve everyone’s thanks. Plus whichever civil servant pointed out that no contract should have been going to KPMG. But that’s it.

What I’m trying to get across here is that from start to finish there wasn’t a three-minute period when any of this was fit for purpose. Anyone whose fingerprints are on this failed, end of story. Swinney, Yousaf, Matheson, Robison, Freeman, Gray – all failed. KPMG failed (eight Powerpoint slides for £540,000 for god’s sake). And the civil service? People should be disciplined.

Since I know all of this, why am I so adamantly calling for an inquiry? (Not a public inquiry – we’re asking for the Finance and Audit Committee to commission Audit Scotland to go through this with a scalpel and name names). It is that I know what happened but I truly have no idea why it happened. This isn’t the pet project of any politician because they came and went like mayflies.

Freeman, Yousaf, Matheson and Gray all screwed up, but I never got the impression any of them was much more than the fall guy. Swinney was warned about this (I know first hand) but he was arrogant and pig-headed about it and refused to accept a defeat no matter the cost in pressing on. But it isn’t his baby either.

The continuity of determination to ignore everyone who knew what they were talking about may have been down to the government’s policy advisers (I seldom get tired of explaining how bad the Spads are, generally speaking). But they don’t usually demonstrate the will power to be that bad for that long.

My guess is that this was a pet privatisation policy of elite civil servants. There is a class of them that think the primary problem with public services is the people delivering them. Look at how Paul Johnstone (who came after Feely in the same role ‘running’ the NHS) has left the civil service and now seems mainly to promote NHS privatisation on behalf of big corporations.

So that’s my guess. I think this is a story of elite civil service privatising zeal meeting weak government and pliant consultancies to produce a mess that the politicians own. But I could be wrong and I want to know because this keeps happening over and over. Remember, if you’ve been reading me for a while I’ve been telling you from the beginning that exactly what did happen was going to happen.

What I can promise you is this; this policy was dead on arrival and has been maintained in coma state for four years for no justifiable reason at a cost of £27 million of your money. If someone’s head doesn’t roll for this, I question whether there is any integrity left in the upper reaches of government in Scotland.

Source: The anatomy of failure