It was in 1994 when I changed jobs and was briefly based in the offices of what was the Family Health Services Authority in Manchester.
The whys and wherefores of how the NHS was managed back then aren’t entirely relevant to the story except to say that the FHSAs were the bodies responsible for family doctors, dentists, pharmacists (or chemists as I prefer to call them) and opticians.
They were essentially pay and victuals organisations governed by a set of regulations contained within the Red Book. Anything within its covers could be achieved, as long as it was accompanied by the correct paperwork. Anything without did not exist.
Nothing epitomised the ethos of the FHSA more than the use of the fax machine. There was only one and it sat in the general office guarded by a cohort of clerical staff.
Beside the fax there was a book that had been carefully ruled into columns in biro. In this you had to enter the date, your name, the department you were from, who you were sending the fax to, their fax number and the time it took to transmit it.
I duly filled in the details a few times and then one day asked them why. ‘Why what?’ was the puzzled reply.
‘Why do we enter all this information in the book?’ The only explanation was that this is what they had always done since getting the machine installed.
‘But what do you do with the information?’ I went on, thinking that there must be someone, somewhere who analysed the usage.
‘Nothing really. When the book is full up, we put it in a drawer with the others and start a new one.’
So the fax book had been filled in for years to absolutely no purpose whatsoever and it had never occurred to anyone to question the practice. And these were otherwise pleasant, intelligent people in thrall to the dead hand of bureaucracy.
The book disappeared soon afterwards, as did much of the pointless bureaucratic thinking that once dogged the NHS.
The serious point is that the FHSAs, and the Family Practitioner Committees before them, were run by GPs for GPs and were dogmatically bureaucratic. These are the same GPs that the present government want to ‘free’ the NHS. It could all end in tears. Tiers of bureaucracy I mean.