Recent Articles

Bits and Pieces

Image Credits

Main | July 2007 »

June 2007

Thursday, 28 June 2007

The Last Confession by Roger Crane starring David Suchet

Ambition is pitiless. Any merit that it cannot use it finds despicable. ~ Eleanor Roosevelt (1884-1962)

I doubt that The Last Confession by Roger Crane and starring David Suchet will be particularly well received when it reaches the Haymarket Theatre on July 4th. This is a pity because the play is well acted, well constructed, and well directed, and has an impressive set. It also has an excellent cast of thousands (actually 21 men and 1 woman, but you see what I mean). Above all, it retells a story that deserves to be remembered.

When Albino Luciano was elected Pope John Paul I in 1978 it would have been more appropriate if he had adopted the name Innocent XIV. For naïve he was and innocent he died. The play recounts the battle waged – and the victory won – by the reactionary Curia (Vatican Civil Service) against the reforms proposed by John XXIII in the second Vatican Council in 1962. The Cardinals in the Curia held back those reforms during the 15 year pontificate of the indecisive Paul VI after John XXIII's death. When Paul died, the Church's liberal faction – especially cardinals from Africa and Latin America – engineered the election of John Paul I, "The Smiling Pope."

John Paul I believed that, as the head of the church, it was his responsibility to decide on the Church's future direction, he wanted reform. But this was a naïve belief and he seriously underestimated the power and determination of his political opponents. When he told the world that he would carry out the promises of Vatican 2 and would brook no opposition, his enemies dug in their heels.

In his 33 days as Pope, he decided to rid the Curia of its arch reactionaries, including Cardinal Villot, (Bernard Lloyd) the Head of State, the most powerful man in the Vatican. He was also on the point of sending home to Chicago the corrupt Bishop Marcinkus (Stuart Milligan), head of the scandal-ridden Vatican Bank, who controlled the Church's purse-strings. Marcinkus, a native of Cicero Illinois (the home town of Al Capone) was involved with the Banco Ambrosiano, the P2 Masonic Lodge, and the Roberto Calvi affair. (In case you have forgotten, Calvi was known as God's Banker and was found hanging under Blackfriars Bridge in London.) John Paul had crossed swords with Marcinkus before when the bishop facilitated the sale of the Catholic bank in Venice to Ambrosiano at a knock down price.

In order to frustrate his reforms Cardinal Villot had set about burying the new Pope under an avalanche of paperwork. During the night of the 33rd day of his pontificate, John Paul I died mysteriously in bed, still working through the papers. The previous day, he had told his three main opponents that they were about to be dismissed; he planned to sack Marcinkus the following day.

No autopsy was performed after the death of a man who had no history of illness and had complained of no symptoms of ill-health. A poorly conducted Vatican inquiry revealed a number of inconsistencies and discrepancies in witness accounts of the hours leading up to his death and the discovery of his body. And outright lies were told by officials. Since then, there have been a number of well-documented conspiracy theories suggesting that John Paul I was murdered, including an extensively-researched book by David Yallop (In God's Name), an author who specialises in investigating unsolved crimes.

The Last Confession is Roger Crane's first play. He is a lawyer based in New York and he tells his story well. He focuses on the fictional last confession of Cardinal Benelli, a powerful and ambitious Vatican Politician with a liberal outlook.

Masterfully portrayed by David Suchet, Benelli is instrumental in ensuring the election of Luciano in the hope that he will institute reforms. But his vanity is offended when the new Pope, brilliantly captured by Richard OCallaghan, does not immediately invite him to become Head of State. So he leaves his newly-elected protégé unprotected and surrounded by the wolves in the Curia.

Benelli confesses the guilt of this sin of omission, as well as a second sin, this time of commission. When he is tempted by the opportunity to be elected Pope himself, he abandons the inquiry into the John Paul I's death.

The confession is made to a priest who doubles as John Paul I's replacement Cardinal Wojtela, creating a link between this extraordinary story and the next pontificate.

However, despite the clever way in which all this is brought together, and the excellent use of narrative to bring out issues of conscience, the play lacks a soul. There was a 20 minute discussion between the actors, the director and the audience after the performance that I saw in Bath. I was bemused to hear that some of those involved in the production had had their faith strengthened by it. After watching a man of integrity and decency crushed by naked ambition and lust for power, I find it difficult to understand how anyone could maintain respect for the Catholic Church – whether Pope John Paul I was murdered or not.

Thursday, 21 June 2007

Why do nurses hate Patricia Hewitt?

"We pity in others only those evils which we have ourselves experienced." ~ J-J Rousseau (1712-1778)

We all want a better NHS and the present government has spent a huge amount of money to effect improvement. In order to ensure that the money was not wasted, and to measure how much the spending is improving matters, measurable targets were introduced. These were intended to show, for example, that waiting times are falling. At the same time, strict budgetary controls were put in place to ensure adherence to the spending plans.

The unintended consequences of these policies have been frightening. Among the worst is the phenomenon of "gaming", which reveals much about the mindset of the people charged with our welfare.

Seriously ill patients left to suffer

To meet the target that accident and emergency cases should be seen within four hours, hospital managements have instituted policies that mean that newly arrived critical patients may be left to wait while less urgent cases who could safely be left but arrived earlier are dealt with first. In this way the less urgent patients do not exceed the four hour deadline. This reduces the number of potential black marks on the hospital's performance target. But seriously ill patients may be left to suffer risking the eventual outcome of their treatment and, sometimes their lives.

It has also been reported that patients not seen within four hours can be left almost indefinitely. They can only be counted as falling outside the target once, so there is no longer an incentive to see them at all.

Also, to delay the start of the four hour deadline patients can be left waiting outside in ambulances. The clock in the reporting system only starts to tick once the patient has entered the hospital. This means that the ambulances are not freed to return to service as quickly. But, of course this is not the hospital's problem.

To its credit, the government is trying to audit the situation better and is stamping out instances of gaming when they come to its attention.

Management ignores impact on patients

But the real question is: how can a group of people in a position of power and control believe that it is right to focus on achieving targets, while ignoring the impact on patients. At best, fearful and vulnerable people are left without support or help. At worst, health and lives are put at risk.

Another horror which has come to light is the instruction given to cleaning staff in one hospital to turn over sheets instead of washing them – to save money. And this at a time when hospital-acquired infections are killing patients. Again you must ask the question: what is going on in the heads of those that make these decisions.

An insight into how this might happen was provided by a series of three programmes on TV where a management expert, Gerry Robinson (who had proved his ability to turn around failing companies) was asked to cut waiting times in an NHS hospital without spending extra money. A major obstacle that he encountered was the reluctance of the chief executive to come out of his office to see what was going on in his hospital. He hated leaving his comfort zone – which was analysing figures – and saw no benefit in meeting the people he was managing.

My argument here is a little complicated but please bear with me. The chief executive saw his job as studying financial and statistical reports and using them to find ways to allocate his resources better. He had been successful in balancing the hospital's budget, for example. He did not see it as part of his job to watch the hospital at work, gauge morale, understand logistical problems, pay attention to detail and judge the effectiveness of the team he was leading. He did not see how his skills and position, and his visible lack of concern, and complete lack of encouragement could affect his staff and help them with their problems. If that was his attitude to his staff, for whose jobs he was responsible, imagine how remote he was from the patients.

Quick and dirty ways to make the figures look better

With that sort of leadership, it is easy for a culture to thrive where managers just look at numbers and seek quick and dirty ways to make the figures look better. And once in existence a culture reinforces itself. (Presumably that is how the CE got his job.) Anyone with sensitivity, anyone with imagination, will not want to work long in an environment where callous decisions are routinely made. They will drift away. (And whistle-blowers are pilloried). Meanwhile, the administrators left behind will recruit staff who see things in the same way that they do: that the whole thing is a game where the sole objective is to get the numbers right.

Going into hospital is frightening. Sickness makes you vulnerable, and however minor your problem, you are surrounded by the suffering, pain and fear of others. Your own mortality is never far from the front of your mind. If this is exacerbated by a callous institutional framework more interested in its own problems and preoccupations, the experience becomes much worse.

Irreconcilable clash of cultures

So it is not surprising that Patricia Hewitt (The Health Secretary) faced such a hostile reaction when she addressed the Royal College of Nurses. Many doctors and most nurses are drawn to the profession by a vocation to care. I have been relatively lucky with my health so I have not had to meet too many nurses, but all those that I have met, have shown genuine care and empathy and have helped me through frightening times. It is lucky that these medical staff act as a buffer between patients and an uncaring administrative structure.

But in an uncaring environment these humanitarian instincts are undervalued. Doctors and nurses feel unappreciated. There is an irreconcilable clash of cultures. No amount of money spent by the government will improve matters if the bureaucracies through which they effect their policies tolerate – and indeed generate such callous behaviour.

Image credits
http://www.suelebeau.com/images/principal.gif

http://upload.wikimedia.org/wikipedia/commons/thumb/6/6c/Physician_in_hospital_sickroom_printed_1682.jpg/300px-Physician_in_hospital_sickroom_printed_1682.jpg

Coming Soon

My Photo

Look up

Blog powered by TypePad

Counter