Alex – a Man under Pressure

Illustration by Bill Morris

When the Hospital Inspector’s Office calls, you take the call. That was the pearl of wisdom given to Alex all those years ago by his old mentor. “keep them sweet” he used to say. Those were wise words as these officials can wield much power with their reports and “final scores.” Your position in their “quality” league tables matters, despite all the protestations that it doesn’t, and Alex, ever mindful of this, dropped everything to respond to the Inspector’s call. “They’re coming next week,” he yelled through the door to his secretary, “get the inspection machinery rolling.”

As if it had received a call to arms, the administrative infrastructure of St. Angela’s University Teaching Hospital got into gear, fast. All the necessary papers, reports and examples of “best” practice – “good” is not enough – were mustered in the hospital’s very grand boardroom. Alex knew he had to put on a professional show as there were rumours that his hospital would be subject to a merger. Well, that’s what they called a hostile takeover in those days so that it would look like everyone was working in “partnership.” Like all Chief Executives caught up in this situation, he was very anxious.

“Oh no, disaster” he cried on hearing that the Inspector’s Office had indicated that Reggies, the children’s hospital on St. Angela’s campus, was to be included. “That place is stuffed with problems – all those prima donnas,” he said in despair.

“Too late, they’re coming” said Sue, his ever-present and trusted fixer, officially entitled the Director of Organisational Development and Human Resources. Including the children’s service in the inspection added complications as it was much harder to control the environment – the children, the parents, the toys, the noise, and, worst of all, some of the medics. And as for rules, they didn’t understand them and therefore they didn’t obey them – it was “adult stuff.”

Alex was concerned about the regular “nappy scandal” drum beat from the local press. It stuck to him like the glue paste that was smeared over everything he touched at Reggies. The editors wouldn’t let it go, no matter how many times Alex had explained that the computer glitch was now fixed. Clearly, a rookie reporter had got the brief to pursue the story and keep it in the public eye. It was the talk of the local supermarket checkouts, bus queues and waiting rooms – it had legs, as the editors used to say.

The rookie reporter generated interest from the big boys at the national press. They started phoning him for new pieces – a glimmer of recognition which was sufficient to keep him on Reggies “nappy scandal” case. With the pressures feeling like a vice around his head, Alex tried to run his hospital, and get it ready for the forthcoming inspection. Then the phone rang. It was the police. They had arrested one of the Reggies doctors. Continue reading →

What’s He Done Now?

Alex, our exhausted Chief Executive, was trying to keep everything quiet and rolling along at St. Angela’s and its children’s hospital, Reggie’s, so that the forthcoming inspection would go smoothly. There was a rumour that a hostile takeover dressed up as a merger was in the wings. His nerves were shredded by the local press’s constant attention to with the “Nappy Scandal” – the ongoing story of new computer muck ups, no orders, too many orders, and management with “no grip”. And then there was the ever-present car parking problem – too many cars and not enough spaces. It was particularly bad at Reggie’s.

Reggie’s had its fair share of Prima Donnas. The one I recall with a wry smile was Dr. Rudi Van Der Loo. He was a pathologist – not a speciality noted for having Prima Donnas, but Reggie’s conducted bone marrow transplants and pathology was central to the programme’s success. Rudi, known as Rudey to most, exhibited a form of Prima Donna Syndrome known as the “playboy”. Such individuals were loveable rogues, naughty in the extreme, but charming, utterly charming, and they exhausted the patience of bureaucrats. Continue reading →

Infectious Prima Donna Syndrome

Alex, our weary Chief Executive, had a lot on his plate including a basinful from Reggie’s Children’s Hospital.

Illustration by Bill Morris

The junior doctors were constantly complaining about their poor training, supervision, and rotas …; the managers were always anxious that the rules and procedures were not being followed; and the ever-present car parking monster was biting at his heels again.

More seriously, the nurses were grumbling as the nappy problem was getting under their skin. Alex was constantly parrying the press who smelt blood on The Nappy Story. Meanwhile, he had a new building to construct in honour of Reggie’s benefactor.

Sue, his ever-present supportive director, was in her element “doing OD,” calming everything and everyone. She smoothed the frictions between Reggie’s five committees as they planned for the new building. They were optimistic that the ceremony to turn some earth to show the building was on the way would happen soon. Indeed, to help things along, Dr St. Clair, Prima Donna number one from last time, had already ordered a golden shovel. And Sue was left to sort out the payment for it, like the posh bunting invoice for the recent fête. Continue reading →

Reggie’s Creatives Play Havoc

“I must have silk.” The words still rang in my ears after all these years. It was my first real encounter of precious “creatives” meeting bureaucrats at the Western Theatre all those years ago where I first learnt about Prima Donnas in the great Costume Department Dispute. It was still fresh and vivid in my mind as I sat in the planning meeting at Reggie’s to discuss how the row in the fundraising committee was going to be handled. There was some urgency as the upset was starting to overshadow the forthcoming fête.

Illustration by Bill Morris

“How do you cope with a problem like Dr. St. Clair?” Sue, the disputes procedure chair, groaned as she opened the meeting. “He recognises no authority but his own; he is dismissive of all except those who are useful to him; and now he proposes to bust the budget for the fete.” Sue, as the Chief Executive’s deputy, was tasked with getting Dr. St. Clair under control, and settling the row before it spoiled the fundraiser’s fête. The problem was compounded for her as Dr. St. Clair was in charge of the Medical Advisory Committee as he was a recognised senior paediatrician; and he was a charismatic charmer, when it suited.

There were five committees working on how to spend the endowment for Reggie’s new building—

— and the all-important (in the eyes of the Chief Executive and the bureaucrats) Financial Control and Project Management Committee. There were sensible people on this group but they didn’t understand (or tolerate) creative types. Continue reading →

St. Angela’s Children’s Hospital — Reggie’s

Like all big University Teaching Hospitals, St. Angela’s has a busy children’s hospital on its campus. These places are usually separated from the main building in special ways — the age of its patients; the culture, look and feel of the place; and how its systems work. At St. Angela’s, to its rear, away from the river, you will find a fenced off area where the vibrant colours and the sound of children playing in the courtyard greet you. You often forget to look down as you rush to the main entrance and stumble over the toys and small furniture that litter the place.

Illustration by Bill Morris

As with most hospitals, St. Angela’s had a competition to name this special place as Reggie’s after the big white rabbit of that name, jumping out of a fine top hat.

There was much excitement when Alex, our weary Chief Executive, had been called to a meeting with a film star. St. Angela’s was to be awarded a fabulous endowment for a new building for Reggie’s from the man of the movies whose own child had been saved by the wonderful doctors and nurses there. As with all these things, the money was not quite enough for the hospital’s ambitious plans so a fund-raising committee was set up. They also launched a design competition involving world-class architects and environmental specialists as St. Angela’s wanted to lead the way in all things “green”. Alex needed a steering committee involving senior staff, children, and of course the local posh ladies who formed “the Friends”. Continue reading →

A Secret Club?

There I was, having a quiet cup of tea working on my questions for the meeting with Mr. Fryer when I received the message from Verona Pharmaceuticals (VP’s) investigators that the share price was moving again. The message also said that more information had been gleaned from the hidden camera in the Clinical Trials Unit’s desk computer. The investigation was starting to make progress. It was clear that the poor girl Jules was either very clever, or a pawn. And as for Ronnie, who knows?

St. Angela’s University Teaching Hospital (Illustration by Bill Morris)

Alex, St. Angela’s weary chief executive, convened a case conference to assess the investigation’s direction. It was a large meeting involving VP’s fraud team, the financial authority’s investigative team, and St. Angela’s inquiry team, led by Sue to whom I worked. Our conclusion was that the share price movement was not random and that whoever was behind it was very knowledgeable about how confidential clinical trials information – good or bad – can affect share prices. He or she was probably connected to the traders involved, and smart enough to manipulate the share price through the traders for personal gain. Listening to the discussions, Alex felt the dread of the hospital’s inspectors finding out about the investigation. He needed to keep all this under wraps. Continue reading →

Fiddlin’ Share Prices

There is crime, and there is white-collar crime where, they say, there are no victims. Not true; there are victims. Share prices move up and down all the time according to the market’s view of the stock. If you watch the trends carefully, you might jump in and place a bet. You might make money; you might lose money; just depends if you got lucky and spotted the trend.

The market rules are all about fairness and openness, where all information is known to all at the same time. But this is not always the case. Some know more than others. Some know when important information about a stock’s value is going to be publicly available. Some know when to buy or sell.

Illustration by Bill Morris

This is “insider trading” – access to privileged “what” and “when” information. It gets more devious when a real smart person knows how to move the market, manipulate the share price. Privileged information, good or bad, can be leaked onto a trading floor by a casual comment, a tip, picked up maybe over coffee, in the wine bar, over a beer. In the febrile atmosphere of trading, rumours are picked up and acted on quickly to buy or sell. If you are “in” or “out” first, you make money. Continue reading →