Mary Dejevsky: Is this model hospital still there for all?

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To cast even the most gentle aspersion on a national treasure is to risk big trouble. Just ask Joanna Lumley, or rather the minister forced to apologise for condemning her silence on destitute Gurkhas. So it is with some trepidation that I raise the subject of Great Ormond Street hospital, the temple to paediatric medicine famed around the world.

This is tricky territory. You could say that the hospital is even more of a national treasure than Ms Lumley, and – unlike Ms Lumley – the children of Great Ormond Street are mostly too young or too ill to answer back. Gosh, as it styles itself, also has a hugely professional PR machine, which will ask, in the name of those same children: how dare you? Well, I'm going to dare.

Earlier this week I witnessed a peculiar, and certainly chance, juxtaposition. The BBC news reported, somewhat diffidently I felt, that Great Ormond Street had been accused of mounting a "spin" operation to play down its involvement in the case of Baby P, the toddler killed while on the at-risk register of Haringey Social Services. Lynne Featherstone, the Haringey MP, claimed the hospital's chief executive had "misled" the public about problems at the child protection clinic run by Gosh in Tottenham. As I recall, there was also an interview with a rather tetchy spokesperson, who ignored the specific accusations and insisted that all relevant information had been supplied.

It was pure coincidence, of course, that you could then switch to BBC2 and watch part of a moving and sensitively shot documentary about that same Great Ormond Street hospital. Here were surgeons at the pinnacle of their profession, yet still agonising daily over life and death decisions. They had to explain the odds to anguished parents, then wield their scalpels on tiny human beings – and be answerable for failure as well as success.

And if, after that, you still wanted corroboration for the extraordinary work that goes on at Gosh, you had only to think back a few days to the 14-hour operation to separate Siamese twins from Ireland, and the beaming faces of their parents. In Great Ormond Street, the UK has a world-class hospital that the country and its medical profession can be proud of.

Yet is there a sense in which the very distinction that makes Gosh a beacon for paediatrics around the world, and hospital of last resort for despairing parents, has produced a hospital whose global reputation puts its services to an extent beyond the reach of the city and region it is still supposed to serve? Might this hospital – with its racy Gosh trademark and its ingenious, but unremitting, fund-raising – perhaps draw funds and publicity from other excellent, but less self-promoting, establishments? I have heard whispers to this effect, but the tellers feel mean-spirited even mentioning it sotto voce.

Which brings us back to the claim that the hospital tried to minimise its responsibility in the Baby P case, so as not to sully its reputation (and, by extension, jeopardise its grants and fund-raising). It would stretch no imaginations, of course, to hazard that the hospital was happy to extol its successes high and low, but rather less happy to share its failings. Yet might not something else be at work here?

I assume that Gosh is required to spread its umbrella – as far afield as St Ann's hospital in Tottenham – in part to show that its valuable expertise and resources benefit the more immediate community, not just an elite – as defined by medical need or ability to pay. But do they? Go to Great Ormond Street and you will find the most enormous building projects in progress. Gosh looks more and more like an empire than a hospital. Is it an empire that joyously shouts to the world about its separated foreign twins, but has less time to check the credentials of those examining abused children just up the road?

The day the Russian bear risked a hug

You can easily imagine the panic that news of the Polish President's plane crash spread in the Kremlin. Only two days before, the prime ministers of the two countries had jointly commemorated the 70th anniversary of the Katyn massacre in an act that brought hopes of a belated rapprochement. Now, the Polish President and his entourage, which included the chiefs of all the armed services, had perished in the very same Katyn forest where the flower of the Polish military had been slaughtered in 1940. The curse, it seemed, would live forever.

Add Russia's fatal propensity for saying the wrong thing at the wrong time, and here was a recipe for the immediate outbreak of Cold War II. In fact, to almost universal amazement, the reverse happened – thanks to several things. The first was an unaccustomed show of emotion from Russians, both from ordinary people, and, more surprisingly, from their usually buttoned-up leaders. Vladimir Putin gave his Polish counterpart, Donald Tusk, a spontaneous hug. The second was the combination of respect and efficiency with which Russia handled the recovery and repatriations. Poland's foreign minister was moved to describe Russia's response as "exemplary". Now Russia has, perhaps inadvertently, stumbled upon a way of improving its abysmal image, let's hope there will be more of the same.

We'll heckle our hearts out – if you let us

Something's missing in this election campaign, or so the chattering classes think – and it's heckling. But the point is that you can't have proper heckling without a proper public meeting, and it's this, not heckling, that is dying.

In most countries, you can usually find out in advance when and where a politician is appearing. Party websites have calendars of rallies; when you arrive in a new city, you find updated flysheets. Merkel kommt! you would see all over Germany.

Have you looked for details of election rallies on the internet? I have, and they're not there. Have you seen posters saying Brown – or Cameron, or Clegg, or even your local candidate – will be here at such and such a time? Nor me.

And is this not pretty scandalous? Where are the foreign observers to object that all those visits and meetings you see on television are not open at all; they are packed with trusties or held at such short notice that it's pure chance anyone is there at all. Give us an open meeting, and we'll heckle our hearts out.

Then again, have you noticed? The moment the election was called, the politicians were off around the country in a flash. Schools, hospitals, supermarkets – they're in their element. Which prompts a thought. As they clearly enjoy it so much, why don't we just leave them there, in eternal campaign mode? It would be cheaper than maintaining them in Westminster, and it would keep them out of our hair.

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