Observations on public administration

It is a law of public administration that the more administrators there are, the more administration there is to be done. It is a further law that the more administrators there are, the less administration gets done: hence the need for increasing numbers of administrators.

I work in a new medical facility, built at a cost of several millions: no expense spared, except on vital necessities, on which the cheeseparing is so great that it is all paring and no cheese. For the past two weeks, there has been a paper crisis in the outpatient department. There is none of the standard paper upon which doctors can write their clinical notes. Only one master copy exists, and if the doctor requires some paper, a member of staff has to photocopy it.

The problem is that it is no one's responsibility to ensure that there is always enough paper for the doctors to write on. Such a problem is beneath the notice of the senior managers, who have forgotten to delegate responsibility to anyone else, because they are always at strategic planning meetings.

It's the same problem with thermometers. For years, it has been a labour of Hercules to have a patient's temperature taken. Send not to seek for whom the fever burns: a thermometer won't be found, even after an extensive search.

In vain does a doctor argue that if elementary tools of his profession are not easily available, the whole purpose of the clinic is vitiated, and safety as well as efficiency is compromised. The situation does not strike anyone as absurd, let alone disgraceful. What is the shortage of a few tiny items set against the magnificent achievement of a brand-new facility, so much more pleasant to work in than the old one it has replaced? Lord, what fools these doctors be (and ungrateful into the bargain).

When one grows cross about shortages, one gets a reputation for being difficult or pernickety. If one raises one's voice, one is accused of bullying. In the absence of anyone who has responsibility for these things, it is inevitable that one will sound off to the wrong person, because everyone is the wrong person. That is yet another law of public administration.

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