“Believe nothing, no matter where you read it, or who said it, no matter if I have said it, unless it agrees with your own reason and your own common sense.” – Buddha
Nearly everyone I speak too recently has a horror story to share about their experiences with the NHS. And nearly everyone has a fairy tale to tell as well.
For several decades now I have been contracted by various parts of the NHS at different times to provide management development and leadership training, to run assessment and development centres, to develop standards for the board of NHS trusts, to turn HR teams into organisational development teams and so on. And for just about all of that time the training has been done against a permanent backdrop of policy and structural changes that makes real learning almost impossible.
So it was with some interest that I read about some work that the National Health Service Social Media Group had been doing to explore the potential of social media to transform healthcare. Recently this group have been talking about how the use of video cameras by patients could provide feedback to drive service development.
I love the idea of social media being used to report on both the good practice and the bad. To shine a spotlight on all that we love and hate about how healthcare is delivered.
But, until we we build a culture where such data can be collected, analysed, reviewed and acted upon by experienced clinicians and managers with the time and resources to provide excellent management and leadership we run the risk of finding ourselves with ever more tearful and frustrated health professionals.
And I suspect that it would be the failures and lapses that would get the attention and the resources. A culture of name and shame is unlikely to work in the long run. And what would it do to the relationship between patient and staff? Do we really want patients to be policing their own healthcare experience? They can recognise and film obvious lapses of protocol and procedures, but the more subtle stuff? And, do we really want service providers to change what they do just because someone is pointing a camera at them?
At its best great healthcare is delivered as a partnership between clinicians and patients. I find it hard to see how this partnership can really thrive when when one party is busy filming the other.
It may have a role in driving out bad practice – but I am not convinced that it can ever drive excellence.
As Deming has shown us the road to excellence is reached by driving out fear, not be increasing it.
[We] have ‘forgotten’ that the economy and all its works is a subset and dependent upon the wider ecosystem. . . Modern citizens have not only lost contact with the land, and their sense of embeddedness in the land, but at the same time they have lost those elemental social forms of more or less intimate and relatively transparent social relations. Thus a basic aim of bioregionalism is to get people back in touch with the land, and constitutive of that process is the recreation of community in a strong sense.
Barry, J. (1999), Environment and Social Theory (London: Routledge)
How does poverty play out in the economic powerhouse of Yorkshire, the retail and tourist success story, the regenerated and rebuilt city, that is Leeds?
Well, here are some figures, collated by the Leeds Initiative and published on their website.
- In Leeds there are 29,695 children aged under 16 who are living in poverty – 22.9% of all children in this age range
- There are 33,295 dependent children aged under 20 who are living in poverty (22.1% of the children / young people in this age range)
33000 children, 1 in 5 of our children, living in poverty.
Poverty is not distributed evenly across the City, and these averages hide pockets of child poverty that are as high as anywhere in the UK.
On October 14th we are holding an Innovation Lab where the people of Leeds are invited to come and think about how poverty works in the city and what we can do to disrupt it, personally and collectively. We would love for you to join us….http://povertyinleeds.eventbrite.com/
We are a crisis management society, a society that congratulates itself for solving problems that, in its ineptitude, it has created –
“Over the last two decades, our educational philosophy at every level has been more and more dominated by an instrumentalist model; less and less concerned with a building of virtue, character and citizenship – ‘civic excellence’ as we might say. And a good educational system in a healthy society is one that builds character, that builds virtue.
“Character involves … a deepened sense of empathy with others, a deepened sense of our involvement together in a social project in which we all have to participate.”
So says the Archbishop of Canterbury, Rowan Williams.
I agree, we are a crisis management society. Essentially laissez-faire in our approach. We prefer to leave well alone until there is a clear deviation from the norm. A banking crisis, a riot, a rotten press, an even more rotten copper or three or a disappointing world cup Then like an angry manager we seek out someone or something to blame and unleash our fury in an attempt to get things ‘back to normal’.
Except, back to normal is back to being a crisis management society…
The Archbishop’s analysis, that blames the education system for a failure to instill a particular form of morality and character, strikes me as an attempt to further promote compliance and acceptance. To reset the threshold at which a crisis might be sparked just that little bit higher. It strikes me as yet another attempt by a laissez faire manager to postpone the next crisis. It also implies that the moral crisis in our society lies exclusively with those that take to the streets in order to threaten our communities rather than those that take to the boardrooms and the cabinet tables.
My analysis is a little different. People need to feel a degree of respect, dignity and power in their lives. They will do whatever it takes. They will organise if that helps, gangs, co-ops, social enterprises, lottery syndicates.
We need to stop being so laissez faire and make some major changes to ensure that access to respect, dignity and power is made much more accessible to many more people. We have to help people to find the keys to their preferred kingdoms. I suspect that our broken society will then pretty soon find ways to mend itself.
Because it is not so much broken as abused.