My first reaction was to imagine a meeting at a hospital
with the management saying to the assembled doctors and nurses:
“Unless you are kind
to the patients, then you could go to prison!”
This, by the way, is to members of a caring profession. What an insult.
It is all a matter of culture. There is no way that the NHS, that leviathan,
can be changed overall but I am convinced that it is feasible to change the
system (without changing the rules) in individual units such as a health centre
or a hospital.
If the leadership at any level is fixated with box ticking
(and what idiot thought that one up) then it will be a top down organisation
run on the basis of keep your nose clean and keep to the rules.
The problem is the ingrained blame culture in the NHS and to
an extent it is far too prevalent in business in general. As long as people know or even feel that any
mistake will be severely punished then they will keep their heads down and make
sure that all the boxes are ticked and they have covered their corporate
backside by copying everyone in on emails.
By the way, this is not a rant about the public sector; it
is a plea for a more enlightened approach to running a business or an
organisation. What is even more galling is that it a classic case of attacking the symptom of a problem and not the underlying cause. That is another insult to the professionalism of the NHS.
The fact is that unless the needs of the consumer of the
service (in this case, the patients) are paramount and are the driver behind
every decision, then the suits will prevail and nothing will change.
I am convinced that a good leader in a hospital (and I am
sure that there are many of them) will make sure that there is a management
team in place that has the patient absolutely at the forefront of everything
that goes on. This, of course, implies
that everyone at management level has the same ethos.
I would suggest that whether public or private, the course
is clear. If that ethos is absent in
anyone at management level then they need to move on or out. There can be no compromise; we hire people
for their experience and expertise and we fire them for their attitude.
If you can’t change
the people, change the people.
Experience and expertise should be a given and should take
no more than fifteen or twenty minutes in an interview. Far more important is the attitude and
behaviour of the people.
The NHS, of which we can be justly proud, is a caring profession and the leader should give
everyone whether professional or administrative the opportunity to demonstrate that
in their view the patients’ needs are the most important factor in the success
of the unit.
People need to be paid the compliment of assuming that they
do care, that they are compassionate, that they do understand the needs of people
in an environment outside the normal.
The problem is that the politicians think that by threatening
the people in the NHS they will achieve better care. What nonsense!
Engage the people in the NHS, let them demonstrate their inherent compassion, that the
patients needs come first, that they truly care for the vocation they have
entered and things will change.
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