The reports of the enquiries into Jimmy Savile’s abuses at NHS hospitals present harrowing evidence. Extensive recommendations are made about how institutions ought to prevent a recurrence of such abuse, by managing access to their premises, and by more thorough personnel checks, not just for high-profile celebrities, but also for the large numbers of volunteers and fundraisers associated with hospitals. Press coverage has emphasised the effects on Savile’s victims, but rather less has been said about where ultimate responsibilities lie – in other words, where should this particular buck stop?
The overview of the reports provided by the lead investigator, Kate Lampard, summarises the key lessons learned from the inquiry. These focus principally on the management of access to hospital premises and the oversight of hospital volunteers. The report declines to pronounce on the much broader and “weighty issue of when and on what terms it is ever justified for those at the heart of government to waive the machinery and procedures of good governance or invite outsiders including celebrities to engage in public service management.”
This leaves significant questions unanswered, particularly when taken together with the partial public record of Savile’s encounters with Mrs Thatcher in the course of his fundraising. The overview report makes no reference to these meetings, although the report on Stoke Mandeville summarises the chronology of correspondence between Savile and Mrs Thatcher’s private office (held in file PREM 19 / 878 at the National Archives). Press coverage has already referred to the anxieties expressed by officials who asked the Prime Minister what she had promised Savile and whether she was going to appear on Jim’ll Fix It.
The wider context is that the Stoke Mandeville appeal was seen by the then Health Minister, Gerald Vaughan, as the kind of initiative which the government wanted to encourage as part of a broader policy of stimulating charitable support for health care. Civil servants made it clear to the inquiry that Ministers expected them to remove obstacles from Savile’s path. This included turning a blind eye to his neglect of due process in procurement of NHS capital investments, even when his own preferred course of action was to prove more costly. Note also that Savile’s activities began in advance of the 1980 Health Services Act, which rolled back a thirty-year prohibition on direct fundraising by NHS authorities. With hindsight, was that Act a post hoc attempt to rationalise the activities Savile had started?
Unremarked by the report on Stoke Mandeville is the fact that there are various redactions in the relevant file (PREM 19 / 878). Redactions took place on 11 October 2012 – almost as soon as the revelations about Savile’s behaviour became public knowledge. Two documents are redacted in their entirety (records of a phone message and a letter, both from Savile to Thatcher). Several partial redactions are also evident from material sent to Thatcher by officials and by Gerald Vaughan, Minister of Health.
There is surely a public interest in disclosure of this material. What subjects might it cover? In the case of the material from Savile, did this relate to impatience with NHS procedures, demands for greater freedom in developing the appeal, or threats to withdraw his support? The partial redactions of official notes are also puzzling – a sentence, or at most a short paragraph, here and there. What might these be? A willingness to turn a blind eye to Savile’s impatience with bureaucratic procedures (e.g. in relation to procurement) might be worthy of note. Or do the redactions conceal anything darker, which indicates awareness of Savile’s abuses? The reason for such redactions is usually to avoid embarrassment to individuals who are still alive. That does not apply to Thatcher, Savile or Vaughan. Is there not a case for full disclosure, given the scale of the criminal activities which have now been exposed and their impacts on so many individuals?
The whole episode raises the need for caution and regulation when public policy comes face to face with philanthropy. The context in this case was characterised by severe resource shortage and a government willing to offer greater scope to voluntary initiative. Against this background a national celebrity willing to lead a massive fundraising drive represented a gift horse whose mouth, unfortunately, was not inspected at all. As ever, Aneurin Bevan’s words are very much to the point:
“Warm gushes of self-indulgent emotion are an unreliable source of driving power in the health organisation. The benefactor tends also to become a petty tyrant, not only willing his cash, but sending his instructions along with it”
Of course, I’m quoting from In Place of Fear. I don’t think Bevan could have anticipated, however, that the NHS’s major philanthropist, licensed at the highest level, would have not only sent instructions, but also struck fear into the heart of patients.