Letters: crime really does pay

Walking through treacle

Sir: Rory Sutherland suggests that poor productivity can be correlated with the explosion of roles designed to support those ‘who do actual, useful work’ but, in practice, only act as anchors buried in the deepest mud, impeding progress (The Wiki Man, 6 January).

Winston Churchill, frustrated at the length of the administrative tail of his armies in the North African campaign compared with the modest proportion of those actually fighting, defined them as ‘useless mouths’. The NHS offers an excellent example of this principle: the number of frontline clinical staff over several decades has increased but has been overwhelmed by those in
non-essential posts.

Sutherland pinpoints the bloated HR industry, but the NHS could add a mountain of counting, auditing, reporting, appraisal and PR activities, not to mention those who justify their existence by arranging meetings which achieve little.

I vividly recall, during my term of office as chairman of our consultant medical staff, attending one weekly meeting of the executive board when we were invited to construct a new mission statement. I offered ‘Walking through treacle’, which did not meet with universal approval. It was the last straw when medical consultants and their colleagues in training were reduced to part-time data-inputting clerks with radical pruning of face-to-face, patient contact time. A campaign for Real Medicine is long overdue.

Dr Adrian Crisp

Weston Colville, Cambs

Tehran’s cards

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Eliot Wilson

Why did the British defence chief visit China?

Sir: Iran’s dilemma in the current Middle East crisis is argued persuasively by Anshel Pfeffer (‘Broken axis’, 6 January). However, it is still obstructing international scrutiny of its nuclear programme and remains crucial to Putin as a supplier of weapons for his war in Ukraine. These are a couple of high cards in Tehran’s hand.

Struan Macdonald

Hayes, Kent

Finding billions

Sir: In your interview with shadow chief Treasury secretary Darren Jones (6 January), he says that he wants to set up an office for ‘Value for Money’, to claw back the billions that are spent on ‘inefficiencies’.