A letter to the archbishop

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Kenneth Roy

• Mario Conti writes to the cabinet secretary
• What happens next?
• Actually, it’s pretty hard to believe

Kenneth Roy

On 31 March, the Roman Catholic archbishop of Glasgow, Mario Conti, wrote to the cabinet secretary for health, Nicola Sturgeon.
     Dear Nicola
     I acknowledge with thanks your letter of 29th March with reference to St Margaret of Scotland Hospice and the decision by NHS Greater Glasgow and Clyde to cease offering funding for the 30 continuing care beds at St Margaret’s.
     I appreciate the distinction of services provided. My concern remains that without this funding the Hospice may be non-viable as a service to the dying. Why is Blawarthill preferred over St Margaret’s for continuing care – on what grounds can the NHS justify its decision?
     Yours sincerely
     Mario Conti

     [‘Blawarthill’ is a reference to a scheme approved by NHS Greater Glasgow and Clyde, handing over care of elderly people nearing the end of their lives to a private operator – for profit – in preference to the existing service being provided charitably by St Margaret of Scotland Hospice, which earns the highest grade for quality from the Scottish Care Commission.]
     This letter to Nicola Sturgeon from one of the most senior figures in the Scottish church was dealt with by a civil servant, Richard Dimelow, of the ‘Quality Division, Healthcare Policy and Strategy Directorate’.
     At 2.18pm on 15 April, Mr Dimelow wrote to a senior officer of NHS Greater Glasgow and Clyde. His email began:
     Hi Anne
     The Cabinet Secretary is currently exchanging correspondence with Archbishop Conti and this is the latest letter and draft response. I would be grateful if you could let me know if you/Robert are OK with the wording below, before forwarding to the Cab Sec.
     The draft letter follows. It invites Archbishop Conti to contact Robert Calderwood, chief executive of NHS Greater Glasgow and Clyde, who would be ‘more than happy to take you through the process which resulted in the health Board reaching this decision’, although Mr Dimelow adds that the relevant papers had been posted on the board’s website. The letter proposes that the hospice ‘gives due consideration to the various options for alternative service provision’ proposed by the health board. There is no suggestion that there has in effect been only one option on the table – to turn St Margaret’s into a glorified nursing home – and that this option has been consistently rejected by the hospice.
     The email from Mr Dimelow ends:
     Many thanks and happy to discuss.
     Richard


Who is the ‘he’ and ‘him’ referred to here? I believe it is none other than the archbishop of Glasgow, Mario Conti.


     Later that day, at 5.06pm, Mr Dimelow received the following email from the senior officer of the health board whose first name is Anne:
     Robert not here til [sic] Tuesday but I think its [sic] fine. The only think [sic] I wonder about is whether we need to strengthen the fact that he [sic] has asked this before and been answered, I suspect you addressed these point sin [sic] your letter to him [sic] in 2007. Also the fact that he [sic] met Tom and Sir John in dec [sic] 07 at which point the rationale for the Board’s decision was explained in detail [no full stop]
     Who is the ‘he’ and ‘him’ referred to here? I believe it is none other than the archbishop of Glasgow, Mario Conti.
     The informality of this exchange, the use of first names, the familiarities of address, the solicitous nature of Mr Dimelow’s email, the solecisms in the reply, the use of ‘he’ and ‘him’ in references to the archbishop – or indeed to anyone else in official correspondence – and the matey atmosphere of collaboration – all this is irritating to say the least.
     But it is also deeply disturbing.
     More than 100,000 people had signed a petition to save the hospice; negotiations between the parties had broken down, almost beyond repair; there had been a debate in the Scottish parliament only a few weeks before, with all-party expressions of support for St Margaret’s; the cabinet secretary had spoken then of a ‘window of opportunity’ in which to resolve the dispute; and, of course, at the bottom of it all, at the human core, there was the question of dying people and how best to care for them.
     In the face of this aggregate of public concern and frustration, widely felt particularly in the west of Scotland, and coming so soon after a public undertaking from Nicola Sturgeon that she would be closely monitoring the progress of discussions, was this exchange of emails the best the two bureaucracies could manage in dealing with a letter from the archbishop of Glasgow? Was it, really?


As the journalist who has taken the closest interest in this continuing saga,
I feel increasingly like an onlooker of an elaborate charade.


     I had imagined (in my surprising naivete) that, following Nicola Sturgeon’s speech in the Scottish parliament, there would be a renewed sense of urgency in seeking a way out of the impasse. Yet, barely five weeks later, we have an Edinburgh civil servant drafting in the minister’s name what is essentially a rehash of the health board’s own position; and, a few hours later, we have a senior officer of the health board suggesting to the Edinburgh civil servant that the archbishop should be reminded ‘he’ had been told it all before.
     In what sense is any of this part of a ‘window of opportunity’, with its suggestion of light and space? It feels like the same old broken window of official complacency and myopia. To read these emails, it is as if 100,000 people had never signed a petition, as if a debate had never taken place in the Scottish parliament, as if there was no all-party support for the hospice, as if the minister had never uttered. Nothing – absolutely nothing – had changed.
     And where is the hospice itself? The answer is nowhere. It was not consulted for its view of the archbishop’s letter. Why?
     It is true that the letter is asking for ministerial clarification of the health board’s policy, a policy as perplexing to an archbishop as it is to the rest of us. But part of it is concerned with the viability of the hospice in the event of a partial withdrawal of its funding, a matter on which the hospice would have been able to give Mr Dimelow helpful information. Did it not occur to Mr Dimelow that the other party in this illusory ‘window of opportunity’ had a legitimate interest in Mario Conti’s letter?
     As the journalist who has taken the closest interest in this continuing saga, I feel increasingly like an onlooker of an elaborate charade. I have news for Mr Dimelow and for Nicola Sturgeon. Six months, almost to the day, after the parliamentary debate in which the cabinet secretary said she would be closely monitoring the progress of discussions between the hospice and the health board, there has been no progress whatsoever. There is no ‘range of options’. The health board remains inflexible. The hospice continues to reject the only option on the table. There is not even a date for the next meeting between the parties.
     Sadly, deplorably, the assurances officially given have proved to be valueless. What is said publicly may not be what is said privately. But the elaborate charade is not without its educational merits. As a result of a freedom of information request, and the results published in SR today, all of us know rather more about the manner in which letters from senior figures in the Scottish establishment are dealt with by the civil service.

This article was reproduced with the kind permission of Kenneth Roy.

Read Kenneth Roy at the Scottish Review.