Archive for the ‘managerialism’ Category

Suddenly, an awful wet crunching and groaning and sick heavy breathing. It’s…huge…festooned in the rags of a once-respectable suit, waving a bladeserver torn from a rack like a child’s toy…dripping with stale blood. No! The NHS IT Zombie has escaped, and it’s fortified itself by eating BT’s brains. Now it’s coming for us. DAATA! it groans. WAAAANT YOUR DAATA! Run!

Seriously; BT has recently had to spook the stock market by warning of a huge hit to profits from its Global Services big-IT division. But reading this FT story carefully, it seems that a lot of that or maybe even the whole thing is down to the NHS National Programme for IT, and specifically the London Region patient management contract. (The other bits are the ones that haven’t gone to ratshit yet.)

The regional patient-management segments were always the most challenging bits of the NHS NPfIT; partly this was natural, because their function – a workflow, documentation, and management information system for the entirety of a major hospital’s operations – was by far the most complex in the project. The NHS National Network is a big VPN; the Spine needs to authenticate users, validate input, write to the DB, synchronise, and retrieve; but the patient management system needs to deal with all the possible pathways patients take through the hospital.

Partly, however, it is unnatural and caused by the politics of the project. The regions don’t actually correspond to any organisational entity in the NHS – they exist only for the IT project. They therefore have to replace existing systems that vary widely inside each region and cope with organisations in different chains of command. And each region was originally meant to be implemented by a different company; now, most of them have either given up or gone bust, and BT is doing much more work than previously planned, and this of course means that it has to deal with radically varying solutions already installed.

Worst of all, though, the regions mainly exist because the Government wanted to have the job done by the Big Consultancies – Accenture, EDS, and friends – that it was used to dealing with. Assuming that they wouldn’t be interested in small contracts, the Government invented a completely new organisational level in order to sweeten the deal. They further insisted on the contracts being covered by intense secrecy, which cut off any possibility of talking to the users. And the Big Consultants proceeded to move the actual development to the US and India to save money, thus avoiding any institutional knowledge that might somehow have seeped in.

Now, it looks like BT is planning to offer a “more tailored service” to the hospitals – which sounds a lot like “doing the requirements exercise we should have done back in 2001”. Of course, it’s going to cost money and nobody knows how much yet, but I suppose it’s progress, especially as the sacking of Fujitsu from the project means that it looks more and more like a BT job (London, the ex-Fujitsu South, the national projects, and perhaps more besides).

But it’s still not too late to take radical action. Part of the original plan involved using a common data exchange standard for the whole NHS; if this exists, there’s no need for much of the rest, especially not the regions and possibly not the Spine. We could define some goals and a set of data formats, then break out the cash to the individual hospitals, trusts etc to use themselves. In fact, when various US, Australian and Finnish hospital sysadmins tried that, they came up with the best healthcare IT system yet. The problem with the NHS NPfIT is quite simply that it didn’t listen to the bureaucrats.

Which is why this is sense. I have no idea what such a sensible set of ideas is doing in George Osborne’s in-tray, and I suspect the Tories may think it’s a way of preventing IT development in the public sector. But I think a cross-government requirement for common data standards, as much open source as possible, and perhaps even building everything with a sensible API for further development would do nothing but good. And perhaps the project cap might help – after all, the way to deal with zombies is to destroy the brain.


George Osborne is not getting any better. His latest shaft of brilliance is to threaten everyone with a sterling crisis – Chris Dillow has details and more. The problem here is that for a start, he is deliberately beating the water to drive sharks away from his vulnerable ideological underbelly. The Conservatives’ “economic plan” currently foresees a range of stupid and incoherent things – they are for tax cuts, specifically in employer National Insurance contributions, but the cuts are to be funded by spending cuts elsewhere, and savings in that eternal demagogue’s standby, “waste”.

So this isn’t a response to the economic crisis in any way; a basic Keynesian accounting – and before you all speak up, this particular one is basic to essentially everyone’s view of economics – shows us that aggregate demand equals (C+I+G+X)-(S+T) where C is consumption, I is investment, G is government spending, X is net exports, S is savings and T is taxation. If you reduce T, you obviously increase aggregate demand. But if you’re paying for this by reducing G, the net effect depends on the percentage of an increase in income that isn’t spent – the marginal propensity to save. The value in terms of aggregate demand of a tax cut is given by dT/(1/marginal propensity to save), known as the balanced budget multiplier. This can in fact be quite significant, for example if the tax change is highly progressive, so that the rich (who have a high marginal propensity to save) pay more and the poor (who don’t – they don’t have the spare cash) pay less.

Actually, even if the cut was to be paid for by borrowing, it still wouldn’t help very much. The Tories intend to only cut NI for those businesses who haven’t laid anyone off – which will be how many in a year’s time? Surely, if they are consistent conservatives, they should be encouraging companies to sack people so as to bring about a fall in prices and the realignment of demand with long term aggregate supply? After all, if they still reject Keynes, as Osborne seems to, this is what they presumably want.

Sometimes, the inchoate voice of the Internet-at-large tells you more than any amount of data: like this.

What a lot of people who should have known better forgot at the election was – HE’S A TORY.

Further, it is not any Conservative’s place to complain that the pound is in jeopardy. The UK has been running a structural current-account deficit for many years, and the vast growth of the financial services sector is a consequence and apparently a deliberate one. When an economy has a current account deficit, this means it imports more than it exports. In order to pay for this, it needs to run a corresponding surplus on the capital account – it needs to import capital. Down at the micro level, this means that banks are lending money to people who want to buy imports, that the savings of exporters are not enough to fund this, and therefore that the banks must borrow on the wholesale market (or issue shares to overseas investors, etc).

A further important factor is the role of the housing economy; if house prices grow faster than GDP, which in the UK they always do during the boom phases, this means that the new mortgage lending cannot be funded from the repayments on the old, and that housing must import capital from the rest of the economy. And, as the rest of the economy has to import capital for its own needs, therefore the mortgage banks must use the world market for money.

As a further twist, the banks got very good at importing capital and then re-exporting it, taking a turn on the deal and therefore significantly contributing to the current account. Everyone who praised the growth of the City since 1986 implicitly supports this state of affairs. But all this is predicated on the import of capital, which implies a current account deficit and therefore a significant currency risk. (No wonder City Tories have no confidence in Osborne.) The Conservative Party, especially, has no right to complain about it whatsoever, having essentially invented this entire structural model, as Ross McKibbin explains in a now-seminal article.

But even this isn’t the worst. Consider Osborne’s actual remarks.

Mr Osborne suggests that Mr Brown “doesn’t care” how much he borrows. “His view is he probably won’t win the next election. The Tories can clear this mess up after I’ve gone. That is deeply irresponsible. It’s a scorched-earth policy, which I think the history books will write up as a total disaster and which the public will see through between now and the election.”

Osborne is being positively Straussian here, in attributing the worst of his own motives to others. And he’s got form for this. After all, in the event of a major sterling crisis, he would stand to gain impressively, although for the reasons I’ve given above it would do the country a power of bad. It would look catastrophic, and the J-curve effect means that the short-term effect of devaluation is deflationary – the recession would initially be worse. Further, the sectors most affected by this would be finance (obviously) and the import-heavy consumer economy.

The electoral, regional and class distribution of the impact would also be helpful for the Conservatives – the costs would fall disproportionately in South-Eastern marginals and on swing voter groups, whereas the benefits would arrive later, handily after a hypothetical Chancellor Osborne took office, and would be concentrated in the export economy, that is to say in the West Midlands, the North, and the new town techie belt. Or,just where the Tories worry that they need to build strength in the long term.

And if you want to know the sort of thing they actually think is good for us, under the exoteric surface, check out this beauty from Alan Duncan. Constrained by the existing law, Dunc can’t promise to get rid of your workplace rights, so instead he’s hoping to scare people off exerting them, by making anyone who loses an industrial tribunal case pay the employer’s costs. Now, that might well be appropriate in the majority of the civil law, but it’s wildly inappropriate for employment law because of the structural inequality of power involved. Arguably, the ancient legal principle of “equality of arms” can only be maintained in this field if you can’t be scared into silence by the risk of paying Sir Bufton Tufton QC’s bill.

Mind you, there are reasons to be cheerful. Osborne has just staked his career on a forex trade, only weeks after making an enemy of Nathan Rothschild. And even super-europhobe Tory funder Stanley Kalms is making noises about needing “more heavyweight, more grey hair on the front bench”; if that isn’t a reference to Kenneth Clarke I don’t know what is. Who else could it be? Heavyweight rules out Redwood, Franciscus Mediocritus and a bunch of others. Grey hair? Can’t be William Hague then..

An unremarked-on aspect of the 1.5% interest rate cut last week. Namely, are we already living in a near-real time planned economy, as Stafford Beer foresaw? It sounds like I must be joking. But how else are we to interpret Sir Terry Leahy’s trip to see the Bank of England and the Treasury? Tesco boasts that one in every eight pounds spent in the UK passes through its tills; this bit is always in the papers. They rarely mention their huge management-information system, except to the trade.

If you wanted close to real-time information about the consumer economy, I can’t think of anything that would work better. After all, even at KwikSave you’d get a daily cycle of cashflow information. And Tesco runs a hell of a lot of deliveries; their visualisation dashboard must provide a fearsome amount of data on what flows where. Chuck in the Clubcard voluntary-surveillance stuff. The tills are, unlike Kwikkies, presumably networked.

Back at the start of the…well, at the start of the latest frantic wave of the world financial crisis, I messaged Dsquared to say that I had the impression his workplace was suddenly full of Bakelite consoles springing out of forgotten compartments. In fact, of course, the people going into manual reversion for the first time in 30 years were the good folk at HM Treasury. According to David Scott and Alexei Leonov’s memoir, there was during the launch of the Apollo spacecraft a T-handle in front of the pilot. If you turned it one-quarter of the way, the launcher’s computer and those of the capsule were locked out and the rocket’s control systems slaved to those of the capsule, so you could then fly the whole thing by hand.

Well, with the financial intermediaries choked up reprocessing all the stuff they shipped off the balance sheet – or rather, into the twilight zone – someone has to control these things. Ordnung muß sein. Now we’re well into T-handle country. What are we going to do with it?

We’ve blogged before about the NHS’s computer project. So I’m not at all happy about this remarkably silly post at Timmeh’s. He takes issue with a post of Richard Murphy’s about bank nationalisation:

Yup, the people who brought you the NHS Spine are to be put in charge of developing all banking software in Britain.

Well, this is a strawman to begin with. Is Murphy the Chancellor now? But let that pass. Really? A group of mostly American healthcare computing specialists? Several of which no longer exist? Or does he mean the big IT consulting firms involved – like IBM, BT Global Services, and Accenture? Because I’m pretty sure they do a hell of a lot of financial work as it stands; in fact, everyone was worrying last week about IBM’s third quarter results precisely because banks are big customers. (They turned out to be OK, in that mysterious IBM way.*)

But perhaps he thinks the NHS NPfIT was developed by teh government bureaucrats? Or at least, he’s willing to pretend it was to suit ideology? The whole problem with NPfIT, as we’ve said before, is that the system was developed completely in isolation from NHS bureaucrats or indeed anyone else who would have to use it. The NHS trust IT departments were kept well out of it. The upshot was that the developers knew literally nothing of the NHS’s requirements, its business processes, or the data the system was meant to handle.

No wonder it was a disaster. In fact, when a group of US hospital bureaucrats had a go at designing a medical IT system, they came up with a beauty – there’s even a satisfied customer in the comments. Why? Because they knew what it was meant to do and how. Compare this comment:

I met a guy who works for this company. I cannot repeat what he said, since he has a family to feed. But suffice to say he was deeply worried about the implications for safety of life. That was a few months ago.

The whole thing is rotten to the core, and desperately needs to be scrapped. Now.

The good news is that the thing still doesn’t work well enough to turn it on even as a pilot project, so we’re safe for a while yet. But what did happen the last time the Government took on a really challenging in-house IT project? You ask Daniel Davies.

(* probably something to do with asking the fucking users – that or the staple Nazi market, or wearing a lot of pale blue shirts.)

So I took my stupid damn idea off to the stupid ideas club. When we got there, guess who? Spyblog was waiting at the rendezvous with some Dutchmen and an Argentine documentarist and half the No2ID members not currently in hospital. And after we made our way through Jock McZanu’s EU Maddie monsoon (GOOD HERE ISN’T IT???) to the pub, who shows up but Rat; carrying a total of 30GB of mass storage on his person in an array of USB drives, a fob GPS, and God knows what in his piercings.

Anyway, we talked over the thing, and many other things besides; what should happen if secret police become members? wouldn’t it be easier to do an open-source clone of a BMC helpdesk ticketing app? (why? why? I thought my brain would concrete) how would you sterilise an airport fingerprint reader in less than 10 seconds? So I promised to revise the proposals, and well, here they are.

Or would be, but nobody likes a 2,000 word blog post. So instead it’s here on Google Documents, which probably means something badological. Read. Mark. Learn. Inwardly digest. Comment. Here at first, but if you want to take part just tell me and I’ll give you write privileges. If anyone cares very much I’ll get it set up on Sourceforge and set about preparing a list of functions and tables. I still think Django is the way to go, in which case the mapping of the org model into Python classes into db tables should be as straightforward as these things ever are.

This story; from China is predictably horrible:

Chinese authorities have sentenced two women in their 70s to a year’s “re-education through labour” following their application to hold a protest demonstration during the Beijing games, a relative said yesterday.

Officials said this week they had not approved a single permit for a demonstration, despite designating three parks as protest zones.

The International Olympic Committee’s communications director said she would look at the women’s case, but stressed the games were “not a panacea for all ills”.

Wu Dianyuan, 79, and her neighbour Wang Xiuying, 77, sought to protest about their forced eviction from their homes in 2001. They went to the Beijing Public Security Bureau (PSB) four times this month to request permission to demonstrate in the zones – created for the Olympics to counter criticism about restrictions on political expression in China…

But that isn’t my point. My point is that it’s all oddly familiar. For a start, they have been placed under an “order” which restricts their movements, subjects them to the scrutiny of a neighbourhood committee, and isn’t subject to a court hearing or to an appellant jurisdiction of any kind. Why not? Because, of course, it’s not actually punishment. Only breaking; the order would be a crime, and would result in your being sent to a labour camp.

Yes; they’ve reinvented the ASBO. Meanwhile, 77 applications to demonstrate have been made and absolutely none granted. 74, apparently, were “resolved through consultations”, another two turned down because the form wasn’t properly filled in, and another rejected on the grounds it involved a child. (Won’t somebody think of the children?) And I was fascinated by this quote from Sir Mucho Pomposo Wang Wei of the Organising Committee:

Wang Wei, vice-president of the Beijing organising committee, told reporters they should be “satisfied” with the protest zones. “The idea of demonstration is that you are hoping to resolve issues, not to demonstrate for the sake of demonstrating. We are pleased that issues have been resolved through dialogue and communication – this is how we do it in Chinese culture,” he told a press conference.

He added: “We want everyone to express their opinion. Everyone has the right to speak; this is not the same as demonstrating.

It’s so familiar; the insistence that anyone who disagrees is doing so out of spite, that only acquiescence is “serious” or “helpful”. I’m surprised he didn’t offer them a Big Conversation, but in fact, with the right mistranslation he might have done. Similarly, the re-education through labour order for disturbing the public is just a translator’s caprice away from an anti-social behaviour order.

Perhaps there’s a wider truth here; this sort of events/urban regeneration politics seems to follow the same grammar all over the world. It’s conceived of as a project; which implies there are only participants, or else obstructions. Despite the money and the bulldozers, it respects class boundaries; veering around the villas of the rich. It needs special security arrangements which always turn out to involve some sort of summary justice based on vague and unchallengeable notions of appropriateness, propriety, or order; similarly, these are always temporary but are never revoked. The state authorities and private interests involved are indistinguishable. (Interestingly, the legislative foundation tends to be very hard to get rid of; the Act on the Great Exhibition of 1851 is still in force and still a major headache for anyone planning to build on or near the original site.)

More deeply, it seems to include a sort of quasi-medical view of society, or more specifically of the city. It, and we, need to be made better. Not only the method of this treatment, but the definition of better, is reversed for the doctors; but we are responsible if it doesn’t work, because we didn’t comply sufficiently. The nudgers’ cognitive biases are not examined; it’s our fault if we don’t press the right coloured shape in response. Equally, no-one suggests subjecting the Home Office to compulsory psychotherapy in order to get rid of its hysterical anxiety, but it seems to want to make everyone happy.

I’m about to propose something to make Daniel Davies cry. Specifically, it’s a solution to a problem we currently deal with by a cash transfer through the tax and benefit system. But I think I’ve made a good case that trying to deal with high energy prices by paying the poor to burn more energy is not sensible, except perhaps as temporary relief of the symptoms. Instead, I suggested, why don’t we pay them to insulate, or to install £1,895 air-source heat pumps, and get rid of the problem; after all, we subsidise the rich to do these things to their property. And I suggested that, if we’re too stingy or the government is short of cash, we could use the money now paid out as winter fuel payments.

Terrifyingly, there’s a chance someone might pick up on the idea – because it turns out they’ve got one like it in exciting America. Surely it’s got to be good. The Californian municipality in question is offering loans to carry out energy-saving improvements, to be paid back through property tax. I’m not quite sure how it works, although here are more details; but it seems to be restricted to homeowners, and I’m far from sure if the repayments are additional to the property tax you’d already pay or not.

My brilliant scheme has the distinction that, rather than the user repaying it, it’s repaid from the benefits they would otherwise claim. In a sense, it capitalises the stream of WFP cheques over ten years. Government gets to save on the benefit payments over and above the amortisation period of the heat pumps or insulation; the recipient gets to save hugely on heating; and society saves three to four units of energy from gas for every unit of electricity the heat pump uses. (The technology is wonderful.) And it hits the cheapest way of saving bulk CO2.

Here are some numbers. The two main groups of WFP recipients get £200 and £300 respectively; this is currently planned to go up quite sharply. (Another reason for my brilliant scheme is that tying bits of the government budget to prices that might rise without apparent bounds is stupid.) To be conservative, and also because I could have tried harder, here are some data from 2006. £1.98bn was spent. Elsewhere, it looks like 11,407,000 individuals received money, but the relevant number is a number of buildings not people. It seems 8 million households received WFP, which is a fair enough proxy. That gives us an annual payout per premises of £247.50; with a full-heating ASHP at £1,895, that’s a bit over seven and a half years to pay it off.

We’ve already got a list of recipients, and we write to them every autumn. Obviously there are people who don’t want to be bothered, and probably they are right, so we’ll give them the choice of fuel payments or [whatever silly name our friendly local special advisor comes up with]. Given the usual take-up rate for optional benefits, I’d reckon the pressure every year should be manageable enough; but if we felt militant enough we could make it voluntary-but-automatic.

One question I’d raise against myself is why this pensioner obsession. Don’t a lot of them own their homes? What about children? Well, for some reason they are the only group in our society we find it necessary to give special help with their energy requirements. Minister, I am a mere technocrat. I don’t bother my head with these things…but you might want to look at the numbers for some of the in-work benefit schemes.

I have been away, cutting down to only very restricted Internet/computing usage, and living in a district that would make Abu Muq piss his baggy pants. (Walthamstow, he says. You’ve never been to Bradford, have you?) Which is amusing, because (as in every poor/immigrant ‘hood in Europe) every second business is a mobile phone/computer shop. You can pick up a wrap, an Algerian hooker, and an 8GB Nokia N95 in the same queue. But I succeeded in not opening my laptop for a whole seven days, which is a record for me at any time since 2004 at least. This gives rise to a challenge; how quickly can I resynchronise myself with my auxiliary brain? So far I’ve spent all of today slurping up a week’s worth of blogs, to say nothing of the e-mail; the comments, the spam, the news services, and a number of high-activity mailing lists.

And isn’t it fucking horrible? I just decided to skip Sadly, No! and a few others; one forgets just how much ideological trench warfare blogging we get through in a week. Anyway, to business. (Speaking of which, there’s the work re-sync coming up tomorrow. Thank God I zeroed my inbox before going on holiday. And, yes, I have been reading them; you want to know whether you’re going to have to run off the plane and form a defensive perimeter around your job…) I am delighted to see that a hitherto unknown revolutionary political-theatre collective, something similar to the Space Hijackers, successfully staged a demonstration that satirised literally every feature of the Blair/Brown years in one chaotic afternoon of low-level violence, massive traffic disruption, heavy-handed policing, and blanket media coverage.

I refer, of course, to the people who staged the mock Olympic torch relay through London. It was a great idea in itself, but the genius was in the details; who would have thought of including nameless foreign security police beating up thought-criminals while pretending to be Olympic Committee bigwigs? And then, they set about Sebastian Coe, a real Olympic bigwig and one of the most annoying men in the kingdom? And then, who would have imagined a sort of Jim’ll Fix It slot in which the ambassador of a vicious dictatorship got to pretend to be a world champion runner with the aid of thousands of cops?

Working Tessa Jowell in there was inspired (“Your Excellency, Auntie Tessa fixed it for you!”), but having the speeches drowned out by a monster sound truck advertising the products of some other country that didn’t toast its industrial base by playing dire pseudo-stripper cheesepop at maximum volume right there in Downing Street? Genius. It just says it all – the authoritarianism, the obsession with “events”, the utterly whorish foreign policy, the corporate arse-licking, the total absence of anything like taste or class, and the fucking people. Seb Coe. Tessa Jowell. Yes!

Hand that man an Arts Council fellowship. Seriously, it’s like a committee of Chris Morris, Mark Thomas, Linda Smith (yes, I know) and Tim Ireland designed the whole thing. They’ll never try the real one now, will they?

Remember when the Airbus A380 was delayed and it was an example of the total bankruptcy of socialist Europe’s way of life? Look what’s happening with Boeing’s 787 Dreamliner (and BA’s fleet)…

Boeing blamed the delivery delay on continuing problems with flight control software, being produced by Honeywell International, and integrating other systems on the plane, which it did not detail.

It said it now expects the first test flight of the 787 to take place “around the end of the first quarter” next year, suggesting it could be as late as March or even April 2008.

That is a drastic extension to its original plan to start airborne tests in August 2007. In early September, Boeing scheduled the first test flight for mid-November to mid-December as it wrestled with software problems and a shortage of bolts.

Bolts? Boeing has run out of bolts? That’s positively Soviet. Call GOSPLAN and get a brigade of shock workers on the bolts right now! There’s probably one huge bolt on a low loader in the yard at Boeing Field… Snark aside…actually, fuck putting the snark aside. Let’s get the snark out of the shed and give it a damn good snarking. There’s something about the Reuters report that makes me think the software actually uses bolts; it’s made in Seattle, after all.

I suppose they called it the Dreamliner because unlike the A380 it’s, well, still a dream.

Remember this post on how the NHS National Programme for IT was doomed? Chatter is circulating that the whole thing might be scrapped, or at least subjected to a major review. Against this background, the big chief, Richard Granger, is leaving and has said some surprising things.

E-Health Insider reports; and it’s somewhat disturbing. Apparently, Cerner’s software is of shamefully awful quality:

“Sometimes we put in stuff that I’m just ashamed of. Some of the stuff that Cerner has put in recently is appalling.”

In June, of course, Granger had said that the Cerner package might be used system-wide after iSoft spread itself over the landscape in small pieces.

n December 2005 Nuffield Orthopaedic Centre became the first NHS site to go live with Cerner Millennium under the NHS IT programme. It has since suffered a string of problems ranging from missing appointment records, to inability to report on wait times. The Millennium system – now installed at six NHS locations in the South – remains unable to directly integrate with Choose and Book or meet 18-week reporting requirements.

In April, 79 members of staff from Milton Keynes NHS Trust signed a letter outlining their frustrations at the Millennium system, stating: “In our opinion the system should not be installed in any further hospitals….Speaking at the BMA’s annual representative meeting on 29 June Wrede said: “We should have a public inquiry. The people who made the original Cerner contract should be brought to book and as Cerner Millennium R0 [release zero] is not fit for purpose…” The motion calling for a public enquiry was passed.

The first Cerner installation by BT, the NPfIT contractor in London, is scheduled to go live at Barnet and Chase Farm NHS Trust within the next week. The trust is understood to be due to recieve the same release zero version of the Millennium software that has so far been used in the South.

Clearly it’s appalling, but not appalling enough to do anything about it. And why is it appalling?

He said a key reason for the failings of systems provided was that Cerner and prime contractor Fujitsu had not listened to end users. “It really isn’t usable because they have building a system with Fujitsu without listening to what end users want..”

Now there’s a surprise. But this problem has been well-known for the last 12 months! I blogged about it 9 months ago! Instead of anything useful, though, we get stuff like this triumph of managerialist crapspeak:

Granger also cast further light on Accenture’s departure from the NPfIT programme at the end of 2006, describing their relationship with sub-contractor iSoft as a failed marriage, in which they had failed to realise their co-dependency.

You what? More worrying, though, than this sort of vacuous cruft is the man’s continuing addiction to bully rhetoric and bully tactics:

“Who contributed evidence to the public accounts committees? For just about every figure quoted as an expert in this programme, I’ve got HR files on them. They generate a piece of opinion that often substantiates their world view.”

I don’t think the NHS is losing a great deal with his departure.