Management Consultants Raking in £3,000 a Day from the NHS

One of the great commenters on this blog remarked a little while ago that they had seen or heard something to the effect that although Blair did give increased funding to the health service, much of this disappeared into the pockets of management consultants and administrators rather than actually reaching where it was needed – the medical professional on the front line, for example. The pro-democracy organisation Open Democracy has published a piece reporting that the NHS spends £3,000 per day on private management firms. The piece by Adam Bychawski begins

‘NHS England is paying management consultants day rates of up to £3,000, despite the government claiming it cannot afford to give nurses and junior doctors a real-terms pay rise.

Some executives from top consulting firms including Deloitte and PA Consulting are being paid the equivalent of an annual salary of more than £600,000 by NHS England for their services – more than double what its own CEO is reportedly paid.

Deloitte, which charged the most for its consultants last year at up to £3,000 a day, was ironically hired to help NHS England improve how it keeps track of its spending on private companies.

The findings come after a deal was struck between health unions and the government for a 5% pay rise for more than a million NHS workers. Ministers had dismissed demands for an above-inflation rise on the grounds that it would be unaffordable.

Unite and the Royal College of Nursing rejected the offer, with the former saying that it fell well short of the current rate of inflation. Both are planning to continue with strike action, while the British Medical Association (BMA), which represents junior doctors, is continuing negotiations. The BMA is looking for a 35% pay rise to make up for 15 years of below-inflation pay increases.

Unite’s national lead officer Onay Kasab called the figures “a damning indictment of a government that seems intent on destroying the NHS and has learnt nothing from the pandemic, when it allowed the health service to be plundered by private sector profiteers”. He added: “The money would be much better spent providing a proper pay rise for NHS staff to end the recruitment and retention crisis that is crippling health services.”

The day rates were disclosed to openDemocracy through a Freedom of Information request only after the Information Commissioner’s Office warned NHS England that it could be taken to court if it continued delaying its response.

The figures also show consultants from PA Consulting were paid up to £2,500 a day to provide NHS England with support for its Covid vaccination programme between December 2022 and March 2023.

More than a dozen consultants from Ernst and Young were paid up to £2,343 a day last year to give NHS England recommendations for a system that would make it possible to share patient health records electronically between trusts.

The health service also forked out up to £2,350 a day on consultants from KPMG to support improvements to its digital services.

NHS England told openDemocracy that the rates are negotiated centrally by the government.

“It is absolutely appalling to see huge sums of money syphoned off into consultancy firms in this manner,” Julia Patterson, chief executive of NHS campaign group EveryDoctor, told openDemocracy. “At the very least, there should be published reports annually demonstrating the added value provided by contracting strategic advice.

“Local healthcare experts – such as the NHS clinicians, who are woefully underpaid – would be much better placed to offer advice about the planning and processes within their respective areas.”

The sums raise questions about whether the government has learnt from its disastrous NHS Test and Trace scheme, which was criticised for relying too heavily on private sector consultants. Deloitte staff were paid up to £6,000 a day to work on the programme despite an inquiry later finding that it failed to slow the pandemic.’

For further information see: https://www.opendemocracy.net/en/nhs-england-consultants-deloitte-kpmg-pa-consulting-ernst-young/

Get the privatisers and profiteers out of the NHS, and the Tories out of government.

New Culture Forum Interview with GB News Director on the Truth about the Pakistani Grooming Gangs

This is going to be controversial, but I think this video is important as it exposes the biases and distortions in the official reportage of the Pakistani grooming gangs and the fear of being accused of racism that allowed them to get away with their crimes for decades. I’m very much aware that the New Culture Forum is part of the free market fanatics, the IEA and that GB News is a Conservative media outlet pushing the culture war issues because the Tories don’t really have anything else to use to boost their image. But this is a very, very real issue, and the ingrained refusal to investigate and prosecute these men because of their religion and ethnicity has led to the horrific abuse of 1,500 + extremely vulnerable girls in Rotherham alone. And it also demonstrates how this scandal has its deeper roots in the refusal to tolerate anything that contradicted the multicultural dogma that states that ethnic minorities and immigrants somehow automatically adopt British culture and values when they immigrate to this country. These men didn’t, and the interviewees state that this was partly due to the nature of chain migration itself and the backward culture of the region from which most of the groomers came – the Mirpur region of Pakistan.

The video is part of a new series, ‘Deprogrammed’, being launched by the NCF, Presumably the title means that its against the supposed falsehoods with which we’ve been programmed like robots by the lamestream media. The video features Harrison Pitt, a writer for the European Conservative, interviewing Evan Rigg, a Canadian freelance journalist, and Charlie Peter, a presenter on GB News who produced a documentary on the Pakistani grooming gangs. It begins with Sajid Javid’s 2018 investigation of the gangs. Despite expectations, this turned into a whitewash as the Tories were sensitive about race in the wake of the Windrush scandal. It therefore concluded that the majority of abusers and gang members were White men. The report was originally withheld from publication and it took an internet petition with 180,000 signatures to get it released. In fact, the report on which Javid’s report was based contradicted its findings. It stated that the collection of statistics for ethnicity had been so poor, it was impossible to say which race the majority of offenders was composed of. What evidence there is stated that White men constituted 30 per cent of offenders, and Asians 28 per cent. This was despite Whites constituting 85 per cent of the British population and Asians 8 per cent. By these statistics, Asians are massively overrepresented as groomers and abusers.

Peter’s stated that one effect of his documentary was that it had helped changed the law. The news about the gangs in Rotherham had first been broken a decade ago by Andrew Norfolk, after which more reports from other towns flowed in. However, these reports were mealy-mouthed and heavily censored. More documentation on the ethnic composition of the gangs is needed, along with the imprisonment of their members. Many of those convicted served only light sentences and returned to the same areas in which their victims were living afterwards because of a reluctance to send offenders to Britain’s overstretched and crowded prisons. He supported the launch of Cruella’s National Crime Agency taskforce because local authorities and police forces and had been too mired in political corruption. The problem was that these organisations prioritised community cohesion and multiculturalism over the safety of women and girls. The girls were further regarded by politicians and the media as belonging to the underclass, wild girls whose unsafe lifestyle brought their abuse on themselves. There was the further problem in that it had gone on for decades, but the people who initially talked about it were far right. In fact, they were often ordinary, decent people who were branded far right because they talked about this taboo topic. When patriotic, decent, socially conservative members of the left spoke about it, they were bullied and harassed. Anne Crier was ignored when she spoke out in 2003. Jack Straw was pilloried for complaining about it, and Sarah Champion was similarly removed from Labour’s front bench for the same reason. Peters therefore considered Braverman very brave for taking on the rape gangs. He was struck by her comments that the truth wasn’t racist as something that needed to be said to defend a government policy.

The abused girls were targeted because they were White. This was a result of mass migration, which had produced a very insular and clannish community. The immigrants involved came from the very backward Mirpur and Kashmir regions of Pakistan. It was chain migration operating through first cousin marriage. This prevented these communities from establishing links with the wider community and entrenched the traditional gender power structures that gave men immense power and control over women. It also meant that these abusers were extremely difficult to catch because family members did not want to inform on each other. This occurred at the same time the social solidarity of the wider community was declining due to the economic devastation of local industries and a process of social atomisation. Sexual behaviour became more licentious during the ’90s and Noughties, when it became acceptable to go out of an evening for casual sex. But this was also contrasted with the moral conservatism and judgmental attitudes of the tabloid papers.

The emergence of the Pakistani rape gangs flew in the face of the classical liberal doctrine that held that relentless waves of unwanted migrants would not lead to the destruction of social bonds, and especially the left-wing mantra that ‘diversity is strength’. Peters here contrasts the state of three of the countries with the highest rates of diversity – Liberia, Congo and Papua New Guinea, with very homogenous societies like Denmark, Japan and South Korea. Nevertheless, the assumption is that the more Britain becomes diverse, it can still function like Denmark and the other two nations. It’s assumed new immigrants will assimilate, but assimilation only goes so far. The Canadian journalist remarked that although he comes from a very similar nation, he will never be British. How will people from very different cultures like Liberia do so? Will it be their children or grandchildren who become British? Some migration is needed for countries to remain dynamic. The problem in Rotherham was that it was too much, too quickly and unwanted. And as the new immigrants could join the electorate after a few years, this resulted in the creation of a new electorate without the consent of the old one.

He then discusses the noxious activities and careers of some of those involved in the gangs and the suppression of action against them. One of these ratbags was Maruf Hussein, Rotherham’s Community Cohesion Officer, who refused to accept the reports that 1,500 + girls were being molested. The gangs were also assisted by White female converts to Islam, such as Shifra Ali. Ali set up a bogus taxi hotline which was supposed to supply taxis to take the girls to school. She died in 2009, unfortunately, before she could face justice. After Hussein resigned, he rebranded himself as an anti-racism activist. It has also been alleged that Hussein also launched a failed accusation of racism against a Labour colleague on the council for expressing concerns about the grooming gangs. He was then found working for NHS England as a diversity and inclusion officer. on £49,000 p.a. It is a disgrace that the doctrine of diversity hasn’t been harmed and even been strengthened by it, because it showed how such monstrous crimes could be ignored through censorship and lies. Once again the 2020 report is mentioned for its conclusion that the majority of abusers were White men. It showed that the ‘blob’, the right-wing name for the obstructive civil service and the diversity industry could spin the gangs as a White problem. This is despite the fact that there were 19 trials in which the gangs were composed only of Pakistani men. And while the police may not collect statistics on ethnicity, the names are included in the trial records. Further studies have also shown that Pakistani men dominate this issue. But the blob, Sayeeda Warsi, the Guardian and parts of the government will accuse you of racism if you talk about this.

The conversation then goes back to 2015 and comparison with the way the continental countries such as Germany were able to combat the Syrian rapists in Cologne and other cities. The interviewees make the point that Syria isn’t the same as Mirpur and Kashmir. England also has a particular nervousness when it comes to migration and accusations of racism. Peters then goes back to 1870 and Gladstone’s violent denunciation of the Turks’ atrocities in eastern Europe. His comments, if made now, would result in his being thrown out of every political party except, perhaps, Reform and the SDP. And there is the problem of the ethnic composition of constituencies affecting what their politicians are prepared to say about particular issues. Would Gladstone have made his comments, if his constituency had included a large Turkish population? He mentions the comments Tracey Brabin, the mayor of West Yorkshire, made three weeks ago on the Daily Politics. Brabin dismissed Cruella’s comments about the grooming gangs as ‘dog whistles. This is two years after a teacher in Batley was forced into hiding for showing cartoons of Mohammed in class as part of a lesson on free speech. It’s also just a few weeks after the controversy when an autistic boy scuffed a Quran, and his mother was dragged before the local mosque to beg its congregants’ forgiveness in what is described as a ‘Maoist struggle session’. Present at this kangaroo court was a police inspector urging restraint. Peters saw parallels here with the grooming gangs, especially as Maruf Hussain had also spoken to the police. If Brabin cannot tell the truth about these problems, what else will she cover up?

The video ends with a discussion of what ordinary people can do. They state that there are good resources out there about what people can do if they feel their children are being abused. The NSPCC is one, although they have reservations about them because of the charity’s statement that different communities should not be singled out. They are particularly impressed with Maggie Oliver and her campaign and organisation against the gangs.

Peters is questioned about the response by the working class to the documentary. Did they regard him as a hero? Peters replied by stating that he was only a documentary film-maker and not a hero. The real heroes were the survivors of the abuse, who put their lives at risk to talk to him. He was immensely grateful to them. It was easier talking to them and editing their accounts than talking to politicians as there was no waffle. As for Braverman’s proposed actions, the proof would be in the pudding. He would be very impressed if the offenders were imprisoned and deported. The survivors were cautiously optimistic, and Peters said he would be there to hold the government to account if it failed them.

38 Degrees Urges People to Send Sunak A Message Against NHS Waiting Times on Social Media

A few days ago I signed a 38 Degrees petition, as this says, sending a message to Sunak about the number of people on NHS waiting lists. They sent me this follow up message asking me to get on various other social media platforms, which I’m not on. However, I’m putting this up for anyone who is on them to send their personal message to our farcical Prime Minister.

‘David, you’re one of more than 33,000 of us who said you’re up for holding Rishi Sunak to account for delivering on his pledge to bring down NHS waiting times. [1] Thank you!

The latest figures – released this morning – revealed that 7.2 million patients are stuck on waiting lists in England alone. [2] It’s a notable INCREASE since the Prime Minister made his pledge a few weeks ago. [3] What’s worse, experts are warning that waiting times are unlikely to fall in 2023. [4]

It’s a step in the wrong direction and now it’s up to us to raise the alarm!

Together, we can make sure he knows we’re watching and demanding urgent action. Getting this message all over social media is a crucial step in piling on the pressure needed to force him into action.

So, David, will you share a message with your friends and family to demand the Prime Minister delivers on his pledge to bring down waiting times?
Use the buttons below to spread the word:

SHARE ON WHATSAPP

SHARE ON TWITTER

SHARE ON FACEBOOK

SHARE ON INSTAGRAM

Thanks for everything you do,

Mike, Jonathan and the 38 Degrees team

NOTES:
[1] 38 Degrees: I’ll hold Rishi Sunak to account on his NHS promises
[2] NHS England: Consultant-led Referral to Treatment Waiting Times Data 2022-23
[3] BBC News: Rishi Sunak’s five promises analysed
See note 1
[4] The Guardian: NHS waiting lists in England unlikely to fall in 2023, research suggests‘

Bristol South’s Motion Condemning Keira Bell Decision

My local constituency Labour party, Bristol South, passed another motion at the monthly meeting last Thursday, to which I am very strongly opposed. This motion was brought by the LGBTQ+ officer and another, long-standing local party officer and activist condemning the judge’s decision on a case brought by a detransitioning transperson, Keira Bell. As I understand it, Bell had been a minor when she decided that she was in the wrong body. This was supported by the medical professionals who treated her, and she was given gender reassignment treatment, transitioning from a girl to a young man. However, she now believes that this was wrong, and that as a child she was unable to make a proper decision on this immensely serious, life-changing process, and therefore sued. The judge has concurred, ruling in her favour.

This has upset the trans rights lobby and very many LGBTQ+ activists. One of the complaints of a number of gays is that the mainstream, established gay rights organisations such as Stonewall have been captured, as they see it, by the trans lobby, and a proper concern for securing the equality and dignity of ordinary gay and bisexual men and women has been ditched in favour of an inflexible, doctrinaire demand for gay rights. It is an immensely controversial issue. Gender critical feminists, who believe in the reality and primacy of biological sex over gender and the idea that someone can be a member of the opposite sex simply by identifying with it mentally, have been abused as ‘Terfs’ (Trans-Exclusionary Radical Feminists) and worse. They have received threats of death, rape and sexual mutilation by enraged transgender activists. J.K. Rowling, the author of the ‘Harry Potter’ novels, has been accused of hating transpeople and wanting to kill them simply because she posted a tweet stating that ‘transwomen are not women’. Nothing she said was remotely hateful. Far from it. She actually urged transpeople to have the best life they could, dress how they want and sleep with whoever would have them. She just didn’t regard them as real women. That’s it. But because of this she has been mercilessly pilloried and vilified.

The transition of children is of particular concern. The American lawyer and writer Abigail Shrier has argued in her book that the sudden rise in young girls feeling unhappy with their sex and wishing to transition into boys does not come from an authentic confusion or dissatisfaction with their sexual identity. Many of the young people affected have previously shown no unhappiness with it, or any desire to transition. Rather this sudden desire to change sex is a psychological illness created partly by the promotion of gender and trans ideology on the internet acting on deep-seated but common anxieties about sex and their bodies that many girls go through when entering puberty. She compares it to other, pernicious and destructive psychological diseases such as anorexia and bulimia. There have also been concerns that many of the young people, who were persuaded by organisations like the Tavistock institute, that they are transgender are in fact merely autistic, and that the psychological symptoms of that condition have been misinterpreted. Gender critical gays and lesbians have also claimed that many of the children, who are put forward for gender treatment, are in fact not transgender but simply gays, who don’t conform to gender-typical norms. Again, Linehan and his friends and conversationalists in the gay community have expressed concerns that many of the parents of children treated by the Tavistock institute and elsewhere, were homophobic. They were unable to come to terms with the possibility that their child might be gay, finding it easier to believe instead that they were in the wrong body. If this is true, then these gender critical gays are absolutely correct to condemn the transitioning of such children as a form of anti-gay conversion therapy, as nasty as the other forms which enlightened governments around the world are seeking to proscribe.

At the moment children confused about their gender identity are given puberty blockers to stave off the onset of physical adulthood. This is intended to give them time to consider properly whether they really want to go through with transition. The drugs are supposed to be safe and fully reversible.

The drugs’ opponents are convinced they are not. In interview on Newsnight, the writer, comedian and broadcaster Graham Linehan stated that the drug used, Lupron, was developed to treat men with terminal prostate cancer. Its effects on teenage girls is unknown.

See: Father Ted creator Graham Linehan on trans rights – BBC Newsnight – YouTube

He and others, who share his concerns, argue that the drugs are not reversible and may have serious physical side effects, such as lower bone density leading to a greater vulnerability to osteoporosis. It is also claimed that 80 to 90 per cent of children, who identify as members of the opposite sex, actually grow out of it once they become adults. They mature into either straight or gay members of their sex. On the other hand, according to one study, the overwhelming majority of children put on puberty blockers go on to cross-sex hormones and then gender reassignment surgery. If this is also true, then the use of puberty blockers as treatment is leading to the transition of children, who don’t need it. Especially as cross section hormones seem to have very serious effects.

I tried to raise these issues with the LGBTQ+ officer in the time allowed for us to ask questions regarding the motion she had proposed. I am not a medical person, and admit that in this matter I am merely an ordinary member of the British public who is influenced by what he sees and reads on the Net. The LGTBQ+ officer’s motion was impressive. She clearly laid out her case and it was supported by footnotes. It was also clear that she was acting from a position of genuine concern with the potential harm done by the judicial decision.

She replied that the drugs are fully reversible, that the loss of bone density was not a danger and that children were not being wrongly transitioned. One of the objections to transgender therapy is that it demands that the patient’s trans identity should also be reinforced and supported. Hence medical professionals may be wrongly convincing confused people that they are transgender. The young woman responded instead that this was not the case, but it had been found that patients responded better if their trans identity was supported. But if the patients decided transitioning was not for them, that would be supported too. She was also worried that the judge’s decision would undermine Gillick, which provides for children to receive contraceptive or abortion advice and assistance without the knowledge or consent of their parents. She dismissed the objections to the use of puberty blockers as misinformation. It was bad science, like climate change denial, especially as much of it came from the religious right.

I strongly disagree. I believe instead that the bad science is that embraced by those supporting the use of puberty blocker and trans ideology. For example, according to the website, Transgender Trend, Radio 4’s Woman’s Hour on June 30th 2020, reported that NHS England was no longer saying that puberty blockers were fully reversible. The NHS’ website states that GIDS, an organisation closely associated with the Tavistock Institute, advises that puberty blockers are fully reversible if stopped. But it also says that their long-term psychological effects are not known. It also states that the possible side effects of puberty blockers are hot flushes, fatigue and mood changes. The website also removes the previous claim that without such treatment, trans children are vulnerable to self-harm and suicide. I believe this was a claim made by the LGBTQ+ officer, but my memory may well be playing tricks. Instead the NHS simply states that they may suffer from depression, anxiety and distress.

The World.wng.org website also cites a report by the Tavistock and Portman NHS Foundation Trust of December 2nd, 2020, that all but one of a group of children put on puberty blockers then went on to cross sex hormones. This also noted changes in children’s bone density and that their normal growth flatlined. There was also no improvement in their psychological wellbeing. The website also cited Michael Laidlaw, and endocrinologist of Rocklin, California, that there was also a loss of bone density which put such children at risk of stunted height and osteoporosis.

See: Are puberty blockers reversible? The NHS no longer says so (transgendertrend.com)

Study: Effects of puberty-blockers can last a lifetime – Sexuality – WORLD (wng.org)

It may well be that these sites are aligned with the right. The WORLD site seems to be. But their articles are properly referenced with links to their sources, which includes NHS England and the Beeb’s Woman’s Hour. I therefore believe that objections to this information because of the overall political bias of the sites are false, and trust the information they provide. Which supports what Linehan and others have been saying, as well as the American endocrinology Dr. William Malone in his interview with YouTuber Benjamin Boyce.

As for the objection that the Keira Bell judgement undermines Gillick, I do not believe that the two are entirely comparable. Transgender treatment leads to profound, permanent physical changes that affect a person for the rest of their life. It also has to be said that the children coming for such treatment are too young that in law they are barred from seeing certain types of film, buying alcohol and tobacco and so on. The fact the law deems them incapable of purchasing those items in the views of the gender critical movement supports the idea that children are not capable of deciding whether or not they wish to change gender.

I say here that I certainly do not hate transpeople. I have every sympathy with those who are confused about their gender. I do not wish them, nor anyone else, to be harmed or victimised in any way. But I think the current transgender ideology, and particularly as it is applied to children, is doing immense unintended harm.

I therefore believe that while Bristol South’s motion was proposed and passed in entirely good faith and from the very best motives, it is utterly and profoundly wrong and mistaken. I therefore fully support the Keira Bell judgement.

NHS Privatisation: Cuts to My Local Health Centre

Visiting our local health centre the other day, my parents, along with the other local people enrolled there, were handed a letter, explaining that due to funding cuts the health centre was having to cut back on services. It also advised its patients that if they wanted to raise their concerns about the restriction in their service they could contact:-

1. NHS England at FAO Linda Prosser, Director of Assurance and Delivery, NHS England South West (BNSSG), 4th floor Plaza, Marlborough Street, Bristol BS1 3NX
2. your local MP at the House of Commons, Westminster, London SW1A 0AA
3. Jeremy Hunt, Secretary of State for Health, via his website http://www.jeremyhunt.org

Unfortunately, this is happening to the NHS and GPs’ services all the country. It is no accident, and it is certainly not the fault of the many dedicated doctors, nurses and other health professionals working in the NHS.

It is the result of over 30 years of privatisation begun with Margaret Thatcher. Thatcher and her former Chancellor, Nigel Lawson, denied that they wanted to privatise the NHS. They merely stated that they wanted to include more private provision in the NHS. This is a lie. Released cabinet minutes showed that Thatcher and Geoffrey Howe wanted to privatise the NHS along with abolishing the rest of the welfare state. They were only prevented from doing so because the rest of the cabinet realised that this would be the death knell for the Tory party. And a fact-finding mission to the US to see how their private healthcare system worked by Patrick Jenkin showed that it was massively inefficient.

Nevertheless, the amount of private healthcare in the NHS was expanded, and state provision duly cut by successive governments. It was Maggie’s government in 1989 that ended the state support for care for the elderly in nursing homes. As a result, the families of those, who need this kind of care, are forced to fund it themselves, often through selling or remortgaging their homes because of the immense expense. It was also Maggie’s government that ended free eye tests, and picked a feud with the doctors that saw the majority of them leave the NHS.

This privatisation has continued under Tony Blair, Gordon Brown and now David Cameron and Jeremy Hunt. Blair and Brown were deeply impressed with American private healthcare firms such as Kaiser Permanente, and wished to reform the NHS on their model. The ultimate intention was to replace the publicly owned and operated NHS with private healthcare funded by the state, but administered by private health insurance companies. As a result, NHS work has been given to private hospitals and clinics, and private healthcare companies have been given NHS hospitals to manage. Alan Milburn, Blair’s health secretary, wanted the NHS to become merely a kitemark – an advertising logo – on a system of private healthcare companies funded by the government.

This has been carried on the current Conservative government. And they have used the same tactics Margaret Thatcher did to force private healthcare on this nation. The dispute with the doctors over contracts a few years ago was part of this. It has left the majority of NHS GPs wishing to leave. Yet elements within the Conservative networks responsible for foisting these demands have seen this as an opportunity for forcing through further privatisation. Penny Dash, of the National Leadership Network, and one of those responsible for the NHS privatisation, has looked forward to the remaining GPs forming private healthcare companies. Furthermore, an report on the Care Commissioning Groups now in charge of arranging healthcare in the NHS by one of the private healthcare companies also suggested that they could form private healthcare companies, and float shares on the stockmarket.

Further privatisation has come with Andrew Lansley’s Health and Social Care bill of 2012. This exempts the state and the Secretary of State for Health from their statutory duty, as the ultimate leaders of the NHS, to provide state health care. It is carefully worded to disguise its true meaning, but that is what has been intended by the bill. Dr David Owen, one of the founders of the SDP, now part of the Lib Dems, has tabled amendments trying to reverse this despicable bill. He and many others have also written books on the privatisation of the NHS. One of the best of these is NHS SOS, by Jacky Davis and Raymond Tallis, published by Oneworld.

This process cannot be allowed to continue, and I strongly urge everyone to resist the creeping privatisation of the NHS, Britain’s greatest public institution.