I love this episode. Partly because it has one of the best puns ever, "the Minister doesn't know his ACAS from his NALGO". Partly because of the memos of NHS bureaucracy that Hacker reads out. But mainly because it isn't afraid to poke fun at the "sacred" NHS. These days politicians and most of the media treat the NHS like it is some kind of utopian dream come true, the envy of the world. How refreshing to have someone come along and remind us it's the country's biggest bureaucracy.
The plot revolves around a new hospital which employs 500 administrators but no medical staff, and hence treats no patients. When he hears about this, Hacker wants to shut it down and use the money to reopen closed wards of hospitals. Even the union rep thinks it is a lost cause. But not Sir Humphrey. "Isn't that a bit defeatist?" he says. Sir Humphrey's attitude is "those 500 people are seriously over-worked". After all, "the essential work of the hospital still has to go on," as Mrs Rogers (Chief Administrator) says.
As usual with Yes Minister, it's all about the writing. It all starts with an amusing story of how the DAA has been juggling the official statistics (I know from first hand how exactly true this is). The dialogue is quite superb. I love the permanent secretary's understated line, "we've found at the DHSS that it takes time to get things going... Having patients around would be no help at all." The hospital situation may be a comic exaggeration - at least, one hopes so - but it is brilliantly exploited. Of course, trying to lay off administrative staff in order to treat more patients inevitably provokes immediate industrial action. In the end the situation can only be resolved - in typical Yes Minister style - by a quid pro quo, which somehow trades off an unfavourable enquiry report into the DAA by using empty hospital beds to house Cuban refugees.
How about the acting? Nigel Hawthorne continues to portray Sir Humphrey perfectly as the pure cynic (especially when he gives his explanation of exactly why the NHS is funded by the government). Paul Eddington has to try out new facial contortions to convey his disbelief at the operations of St Edward's. And during the conversations between Hacker and Sir Humphrey, watch Derek Fowlds: he is obviously enjoying watching the punch up from the sidelines (which is perfectly in character).