09 February, 2013

Sadly, NHS not so different from (some) other workplaces

I, like many others, was shocked by the reminder in the news this week of the dreadful failings at the Mid Staffordshire NHS Trust between 2005 and 2009 which led to terrible neglect of patients and many unnecessary deaths.

This kind of dereliction of duty in the hospital sector is particularly shocking since it really is (or can quickly become) a matter of life and death, and also because when someone is ill in hospital we expect that people around them, and most particularly nursing staff, will be caring and compassionate.

Yet this kind of breakdown in work ethic and respect for persons is not restricted to the healthcare environment. It can occur anywhere and is something that I've experienced in my past, working in an office environment for a large organisation.

Sarah Montague on Radio 4’s Today programme interviewed a number of individuals who work, or used to work, in the NHS in order to try and find out why a situation such as that in Mid Staffordshire might occur. The people she interviewed talked overwhelmingly about employees who didn’t care and senior management who failed to listen; a culture in which complaints were ignored and in which whistle blowing by staff was met by bullying, coercion and the threat of dismissal; a culture in which underperformance was not challenged and in which underperformers were moved sideways rather than disciplined. The net result: an environment in which the best performers leave and the worst performers stay, and in which people behave exactly how they please without check. A veritable recipe for disaster.

All of this I recognise from my past. The environment that I experienced was one where the senior managers (who had had been in place for years) were interested only in keeping complaints to a minimum and making sure that their own positions were safe. They ignored internal complaints about underperformance and unacceptable workplace behaviour. This meant that people simply suited themselves—turning up late for work, failing to do their jobs properly, and being (sometimes shockingly) rude to their managers and those with whom they worked. When the head of department retired, a new head was hired who recognised all of these problems and set out to change them. She really rocked the boat and (surprise, surprise) was fired (or ‘asked to leave’) in less than a year.

I found it incredible that this kind of situation could exist and be allowed to continue, and I left the organisation as quickly as I could. My experience was of course far less shocking than the situation at Mid Staffordshire. For starters, people didn’t die as a result. But nonetheless, the situation that I experienced was harmful to those it touched and unacceptable. I also find it interesting, from a purely intellectual point of view, how people—some people—will behave in the absence of a strong, engaged and moral leadership, no matter what the sector.

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