"The decay and collapse of society starts with its 'Industries of Compassion'. When those institutions that nurture and care for the weak and vulnerable fail and continue to fail, it is the event horizon. Romatoca is the canary in the mine. It is failing. Corruption is rife, brutalization is the norm and it's ability to kill and eats its own is frightening."
- Philip Mole, 2012
Romatoca, a hospital drenched in corruption, nurturing sociopath's, destroying lives. A hospital where patients are financial commodities in state sponsored fraud and staff are destroyed if they speak out.
Welcome the Queensland Health (sic).
Chapter 1
He had to re-apply for the job that he’d been doing successfully for over two years.
Queensland Health (sic) upgrades jobs for many reasons.
The job may attract more complex work or be given greater responsibility. However, in Spartacus’s case, as best as I could judge, the upgrade came about because of a nasty and self-serving decision made by Varroa Myte, the Director of Administration (DOA). It appeared to me that the DOA valued the position more highly as a job for a mate, than as a management role contributing to the success of the hospital.
As a result of the selection process for the upgrade, Spartacus lost his job as CAWT.
The person who got the job had the same surname as the DOA. Spartacus thought it was unjust, and objected. I saw him twist and turn and try to advocate for himself. It was painful to watch. He tried to explain to the DOA that he was critical of a process that robbed a man of his job. In reply it was pointed out to him that the successful candidate, Sherri Myte, a dull young thing with particularly vacuous eyes, in my opinion, had worked as a filing clerk in the office of the Chief Executive Officer (CEO) and therefore, it stood to reason, she must have higher skill levels than he. Also, her English was fluent; it was felt this would allow her to make a greater contribution to the goals of Queensland Health (sic). It was further explained, in a low and menacing voice filtered through a toxic plastic smile, that he should be very cautious with his criticism of Queensland Health (sic) processes, because “some people” had taken a keen interest in his performance.
He understood what he was being told. He understood the need to get a better understanding of their language.
I will call the hospital where we work Romatoca. Ro-ma-to-ca is made up of the first two letters of Rockhampton, Mackay, Townsville and Cairns, the main hospitals along the east coast of Queensland.
By doing this, you can’t tell which hospital I’m talking about. I need to disguise its real name to protect the innocent people still working there.
Although he did not have an actual job, as such, Spartacus always had a lot of work to do. This was because very few of the senior managers, and I have to confess they are my peers, know what they are doing. They are clueless about running a hospital. They don’t know their arse from their elbow. They have developed their careers by being clerks who do a lot of filing, bent over in the bottom drawer, legs slightly apart, or by having the right surname and good English, or by using kowtow rituals that are almost art forms. Never have so many incompetent hopefuls carried so much freshly brewed fair-trade coffee to so many indolent managers as they do at Romatoca.
Sure, I might be a little jealous on this point. Everyone knew my contract was nearly completed and I’d be moving out soon. The toadies had done their cost-benefit analysis and dumped me from the coffee-run list. No good sucking up to an arse with a use-by date stamped on it. All this might sound a little crazy to someone who has not worked for Queensland Health (sic), but trust me: it’s true. Queensland Health (sic) enjoys a wealth of surplus staff – people who have no real job to speak of, but because they have been appointed permanently they cannot be sacked easily; well, not immediately, anyway. For most, like Spartacus, it is through no fault of their own that they find themselves jobless. They are just as much casualties as the poor bastards languishing in the Emergency Department waiting rooms.
I can assure you that staff, desensitized by the legions of Queensland Health (sic) spin doctors, would not see anything out of the ordinary in what I am telling you. Some might pause and think about it for a minute, but then they would give that little smile and say, “Oh. Yes, of course.” Spartacus was always busy “supporting” managers, writing their business cases, preparing their budgets, preparing submissions for funding grants and attending meetings as their proxies. It was not uncommon to see him standing deferentially next to seated managers, reading out loud to them from a financial report, as if they were having the words from the comic strips explained by a patient father. He was always very busy – rather strange for someone who didn’t have a job.
The story of Spartacus and Romatoca is not remarkable in Queensland Health (sic). It is an organisation in turmoil, an organisation which turns and twists on itself, snapping and biting its own body parts like a rabid dog, or which staggers around like a diseased cow, falling and crashing into things.
Finally, in an act of demented frustration, Spartacus turned to the last refuge of the damned.
He went to the union, the Federated Union of Clerks-Queensland (FUC-Q).
He went to FUC-Q because he had been told their role was to protect his rights in the workplace. The name of the genius who gave him that advice was never revealed. I suspect that guilt rather than humility was the reason for the secrecy. True to form and with the greatest of empathy, the union delegate at Romatoca told him to ring a call centre number. And of course, with the optimism of the truly innocent, Spartacus rang the number and was told that unfortunately there was nothing FUC-Q could do. FUC-Q seemed to know a lot about his case even before he rang. The call centre operator, reading from her card of instructions, printed in large bold text, speaking in clear English with only the merest hint of a Mumbai accent, told him to keep notes. If anything happened to him that was unjust, he should ring them straight away.
For clarification, Spartacus asked for an example of what unjust would be. The call centre operator said in empathetic and fluent English, “You know – unjust,” and promptly hung up.
Chapter 2
Nature hates a vacuum.
So if you have a management team who have no idea about their business, then sadly the laws of nature take over. And like a neglected garden, the business chokes with the rank weeds of chaos, indecision and failure. And then, regardless of the true nature of the business, the management of failure becomes the business by default. There is plenty of proof of this: the home mortgage business in America; the tax system in Greece; the banking business in Iceland; the property market in Tokyo. The list is endless.
It’s a universal law that the day-to-day management of chaos and failure requires endless meetings to ensure that all the fools are in the same boat, on the same page, singing from the same hymn book and collectively agreeing on the way forward. The daily life of a Queensland Health (sic) manager revolves around endless, pointless meetings; it is the only way forward.
The managers, all highly educated technocrats, cheerful and blithe in their ignorance, have no idea of how to run a hospital. But they are very eager and very good at exercising power, attending meetings, developing drafts of strategic plans and beginning sentences with, “I have to say –” just to confirm that they are speaking.
The finance meeting had been called to enable managers at Romatoca to attend a teleconference with senior managers from Corporate Office. The meeting only had one agenda item – the budget over-run at Romatoca and how to reduce it. Although these are technically two items, they are always considered one item within Queensland Health (sic). Problem and solution are rarely seen by the technocrats as separate elements of the equation.
Everyone was sitting shoulder to shoulder, leaning forward onto the table trying to get a clear view of proceedings. It would be trite to make comparisons with snouts and troughs, but I have to say it looked for all the world like a row of Berkshires lined up along the edge of the table. Spartacus sat at the far end, squeezed uncomfortably between the pointy corner of the table and the wall.
Varroa Myte spoke at the domed speaker-cum-microphone in the middle of the table.
“I understand your concerns, Commissar General, but we have taken steps to reduce the over-spend in the Administrative Work Teams. You are aware that Sherri Myte has recently assumed the role of CAWT and has given the budget her closest attention.” Varroa’s tone attempted authority and achieved mediocrity.
“Good on her! She seems to have had a rather rapid rise in the department. What was her speciality again? Oh, that’s right! Filing. Well done.” He was a hard man to pick, the Commissar General. Praise could be damnation, or equally it could be praise.
It was clear that Varroa was attempting to lay the blame of the budget situation at Spartacus’s feet – an arrogant act, as a quick look at the books would clearly show they were in order when he was sacked – that is, if the “looker” knew what a “book” was and where to “look” once the “book” had been identified.
The Commissar General continued, “But the situation remains that many areas of Romatoca are significantly over-spent. As the DOA, it is your responsibility to ensure that workers understand that they must not spend more than the budgeted amounts for their areas. It is your responsibility to ensure that government policy is followed without question. Area Commissars are looking to the DOAs to tightly police such matters.”
“Commissar General, there are circumstances beyond the control of Romatoca which stop us from achieving the goals set by Queensland Health (sic).” She whined like a bitch. Varroa was a truly vicious and nasty piece of work. She was by turns a bully or a coward, depending on the needs of the moment – a true workplace sociopath. He ignored her.
“That brings me nicely to the main reason for today’s meeting. Queensland Health (sic) has decided that a radical approach is required to get Romatoca into line with its budget. We have decided to roll out Monetary Acquired Deficit Determiner for Expenditure Review (MADDfER) at Romatoca.”
“What does that mean?” Varroa sounded perplexed and wrong-footed
.
“It means, Varroa, that as of next financial quarter, Romatoca will be allocated a budget. What you do with it will be determined by loading all your financial projections into MADDfER, and it will tell you how much money you have, where you can spend it, who has delegation to spend it and what services you need to cut to meet your targets. Now there is no such thing as a ‘fiscal target’ or a ‘budget target’. There is only compliance, total compliance.” He sounded like a patronising father dealing with a slightly dull child.
Around the conference table people moved uneasily in their seats and exchanged looks of concern. A few of them gagged with gulping motions and took extremely deep breaths to avoid vomiting on the spot. I knew the finer details of their budgets and understood their concerns. I knew they were all going to have big problems meeting the targets, because most of them had no idea how to manage their departments, because most of them didn’t know, on a day-to-day basis, what their departments actually did.
Years of rampant managerialism had taken a toll; most of these people only had the wildest and vaguest concept of what a budget was. As I looked around the table, the only one I thought had any idea of what to do was Spartacus. Managerialism, the practice of employing people with a clone of a Harvard MBA, then appointing them to senior management positions regardless of their knowledge or skills, is a modern management trend in public health. Eventually, all corporate knowledge and humanism disappear, leaving the organisation with a senior management team of distilled incompetence, overseen by smiling technocrats sipping fair-trade coffee. It was going to be a hell of a ride.
“Commissar General, I can only say on behalf of everybody here at Romatoca, that we welcome this wonderful innovation, and embrace the obvious responsibility that comes with the reward for our excellent performance. May I ask how many other hospitals have been rewarded like Romatoca?”
“A communication from the Minister’s office will be promulgated at the conclusion of the roll-out period.”
“Commissar General, can I ask you to take questions from the managers with us here today?”
“Go ahead.” His tone was short.
Varroa pointed to Sherri Myte.
“Commissar General, Sherri Myte, CAWT, speaking here at Romatoca.”
“Yes, Sherri. Your question?” His voice faded away from the microphone.
“If a department is not allocated enough funds to do stuff, how should we deal with that?” She blinked rapidly, as if a particularly bright light had been shone unexpectedly into her eyes.
“Do stuff? Do stuff? Oh, you mean your work. You would take direction from your MADDfER Committee.”
“But we don’t have such a committee, Commissar General.” Blink, blink.
“You will have by the close of business today.” His voice sounded uninterested, as if he were checking his emails as he spoke to our meeting.
“Of course we will, Commissar General,” Varroa chipped in.
“Commissar General, this is Halina Goldenshower. I am new to Romatoca, having recently been appointed to the role of Facilitator, Operational & Organisational Logistics (FOOL). I have to say, I have only been the FOOL for a matter of days and am not really familiar with the funding situation, but I feel comfortable in offering some suggestions on how best to carry this issue forward. I would like to nominate a number of positions in the FOOL’s area, which I believe can be eliminated without any impact on service delivery.”
The noise made by a room full of stunned managers all sucking in air at the same time creates an eerie whistling sound. It also depletes the room of oxygen; a number of the women began to tilt in their seats. The moment passed just in time to prevent a Workplace Health and Safety incident when the pressure dropped and temperature spiked and the air-conditioners kicked in, pumping the room full of fresh, recycled, deodorised, oxygen-rich chilled air.
“That’s an interesting offer, Halina. Tell me, if you don’t mind sharing, where did you work before you became the FOOL at Romatoca?”
I watched Halina in amazement. She had such confidence; her offer was such a grand sweeping gesture, a totally insane and utterly counter-productive gesture, but so heroic. It was breathtaking in its ineptitude; it was bewildering as to what her cunning plan might be in making the offer. Her accent declared her English heritage and underlined her leap into the heroic cliché of the ignorant full frontal assault. Lord Cardigan could have used her at the Charge of the Light Brigade.
Spartacus couldn’t believe it. He looked as if somebody had just snap-frozen his face for a Rocky Horror Show poster. He didn’t move for a full five minutes. He was truly shocked by this woman’s offer to the Commissar General.
“I was a kindergarten teacher at Nar Nar Goon North, down in Victoria, and before that I was a funeral insurance telemarketer, in England.” Halina beamed to the room.
“Really, a kindy teacher! What a noble profession that is, working with all the little kiddies. How interesting that your career should develop into being a FOOL at Queensland Health (sic).”
Varroa injected. “Commissar General, I have to say, we are very lucky to have secured Halina for our management team. She has a degree, an MBA.” Varroa nodded.
Halina continued to look about the room, beaming at her peer group, her flabby jowls adding five kilograms to her head and ten years to her appearance. Her peer group beamed back like so many little sunflowers turning to follow the glow.
“Oh, my! An MBA, you say! How wonderful! We look forward to your contribution, Halina.”
I had difficulty deciding if the Commissar General was being sincere or if he was being sarcastic. I would have chosen sarcastic, but you never know; he was the Commissar General, and such people are never to be over-estimated. I looked across at Sherri Myte to see if she had engaged in any of the ebb and flow of the meeting. Unfortunately, her attention had drifted. She was attempting to get the top off her ballpoint pen, a task which challenged her, because in the depths of concentration she had allowed her tiny pink tongue to peek out at the corner of her mouth and a lock of hair to fall over her face. She was inscrutable.
“Finally, Varroa, I need to inform you that Queensland Health (sic) will be assigning an implementation team of MADDfER experts to Romatoca to direct Phase One of the software’s roll-out. The program links with purchasing, budgeting and payroll. The Team Leader will be Aden Micelf, a truly gifted man of national stature. He is a man with particular strengths in payroll management.”
There was no mistaking the reaction to this piece of information: somebody was going to get sand kicked in their face by the big kids. In the moments after the Commissar General had rung off, the room remained silent. It was a dull unnatural silence, considering the room was in the middle of a chaotic and boisterous five-hundred-bed hospital. Varroa broke the spell.
“All right, everyone, it looks like we have been given a wonderful level of support by Queensland Health (sic) – a new management tool, an expert implementation team and the autonomy to truly self-manage our budget. This will certainly allow us to demonstrate excellence in what we do here at Romatoca. I guess the first order of business is to establish a MADDfER Committee.”
I had the feeling that Varroa had not finished her monologue, but that did not stop Halina’s enthusiasm for her own opinion, or hide her ignorance of the social contract.
“I have to say, Varroa, I’d like to be on that committee.” Her voice was chirpy and keen.
Spartacus had once told me about a hunting technique in his country.
“You know, Buddy, as a child, I would go on hunting trips with my uncles. We would hunt foxes in the winter. The fur was very valuable and supplemented our families’ meagre incomes. The technique my uncles used was to take a live rabbit with them out into the forest, and then to set themselves in a hide with views in every direction. Once they were set with their rifles ready, one of the uncles would pull the rabbit out of its carry bag and begin to strangle it. The rabbit would emit a piecing squeal. The noise of the rabbit’s distress would attract any fox for miles around. They would come running so hard and fast towards the squealing rabbit that it would be impossible for my uncles to get a clear shot. So, my uncles waited, and when the running fox was well within range they would yell, ‘Hey!’. For a split-second the fox would stop running and look up, and then my uncle would squeeze the trigger. Bang!”
Sitting in that conference room, in my head I heard a “bang” similar to one from Spartacus’s childhood, and I saw Halina sprawl backwards off her chair and lie in a pool of spreading blood. I glanced across at Spartacus; I’m sure we were having the same thought.
“Thank you, Halina. A very generous offer. Anybody else have any ideas?” She paused for a nanosecond, before continuing, “Perhaps, Halina, I could ask you to form a committee, and then advise me of the names.”
Bang! Deep in the forest a gun went off.
Halina smiled even more widely, as she looked around the conference room, nodding and beaming to each of the group.
Just at that point Sherri managed to get the top off her ballpoint pen. Unfortunately, it came off with such a rush of force that her arm flew sharply to her left and her rather lean and sharpish elbow impaled George Force in the temple. He slumped, unconscious, into a formless heap across the conference table.
The meeting disintegrated into a shambolic closure, as George was wheeled out on a gurney, the Model S100 gurney. It was so narrow it only just supported the width of his spinal column, and not much else. This meant that his arms, and most of his ribs and back, hung unsupported like slaughter-house meat from an overhead boning rail.
I wondered if I was the only one to remember George’s spirited support of purchasing the S100 instead of the larger S500.
To be continued...............