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Camden New Journal - HEALTH by SIMON WROE
Published: 19 March 2009
 
Foundation Trust communications chief Dave Lee
Foundation Trust communications chief Dave Lee
‘Machiavellian tactics’ on NHS vote

Trust communications chief comes under fire for leaked email on extra beds board meeting

MEMO to all mental health staff: please could you refrain from name-checking controversial figures of antiquity.
The communications chief for the Camden and Islington Foundation Trust, Dave Lee, has inadvertedly caused unrest by drawing parallels between potential strategies for the board and the famous political philosopher Machiavelli in a private memo leaked to the New Journal.
Service users said they were upset to learn that Mr Lee suggested, in an internal email, a possible Machiavellian “scenario” for handling a governor who wanted beds at St Luke’s Hospital for mentally ill patients to be made available.
The number of beds at the psychiatric unit – based in Muswell Hill but used by Camden and Islington – have been reduced over the past year against the wishes of some service users.
The trust’s new chairman, Richard Arthur, has apologised for any distress caused by the email.
He said he had asked “at the risk of being branded humourless... for briefings to be plain and unvarnished, preferably without references to Italian philosophers” in the future.
In a document to fellow trust members last month seen by the New Journal, Mr Lee debates whether to tell a governor, David Hayes, about constitutional fine print that would allow him to put the decision to reduce bed numbers at the hospital to a vote.
He wrote: “It is a tactical question as to whether, at the meeting, we pro-actively offer him this option – the main down side is that it will encourage 1 or 2 other governors to try this at most meetings... Reputationally, we have to consider how ‘denying a vote’ on the issue looks in the local papers, so Machiavelli would probably angle for this scenario.”
Shrinking wards at hospitals such as St Luke’s in Haringey – a result of the trust’s controversial Cost Improvement Programme – have led to increased tensions on the board.
A Camden Mental Health Consortium spokesman said: “Anyone who has attended a meeting of the governors has witnessed the continuing battle which rages between the directors and the Service User Governors.”
Niccolo Machiavelli was a Renaissance diplomat and political commentator who argued that power must be held through brute force and cunning. In his seminal book, The Prince, he writes: “It is far safer to be feared than loved.”
Mr Arthur, who was one of the email’s recipients, said the memo had not been not intended for publication and was “embellished with jokey comments which probably won’t make it to the comedians Hall of Fame”.
He added: “I am sorry if [the comments] have offended anyone... The substantive advice was entirely accurate.
“Both the chair and the governors acted entirely properly. Behind this, there is clearly a slightly fractious relationship between two or three service user governors and management.”
Mr Arthur said: “This is unfortunate, as I would like to see all 37 governors and directors working together for the good of the trust. I understand that the occasional spat or leaked email makes for a good press story. The real news is that we have a really first-class institution on our doorstep.”
A spokesman for Monitor, the regulatory body for NHS foundation trusts, said: “Monitor expects the board of directors and the board of governors at all NHS foundation trusts to work together to achieve the best outcome for their patients, service users, and members.”

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