This is going to be an untidy and meandering blog. I know this before I
start. I’ve tried drawing and I’ve tried mind mapping, but my thoughts are
still not neat. I have so much whirling around in my head from what I’ve read
in the national news over the last few days, that I just have to go with it.
What started me off was ‘A Bridge Over You’, the NHS
Lewisham and Greenwich NHS Choir’s sublime merging of two beautiful and deeply meaningful
songs. I downloaded and streamed this, as I feel so very strongly about the
importance of this song on so many levels, as discussed on Twitter with
@PaulDuxbury. This hospital has more recently been in the news due to financial
issues (it went into administration in 2012) and the campaign to keep A&E
open, which was won in the High Court and the Court of Appeal, in 2013. Yet, a
choir including staff from ALL kinds of roles (not just doctors and nurses –
who are the only ones some parts of the media seem to value) has put together
something so harmonious and deep, that the hairs still stand up on my arms and
I feel quite emotional whenever I listen to it. This kind of connection is born
of passion, dedication, respect for the part everyone plays in the whole team, and
bags of goodwill. Boy, wouldn’t some of those modern ‘staff engagement’ programmes
with bells and whistles like to generate even a fraction of that? More of that
later…
Anyway, one of the reasons this song made such an impact is
that, as people who know me will appreciate, the NHS has been one of my life’s
great passions. As a child, I loved going to the parties for the children of
staff at Christmas put on by the Obstetrics and Gynaecology Hospital my mum
worked at, as a Medical Secretary. I can even remember the name of the obscure
Crossroads actor who attended one year to give out the presents… There were also
summer fetes etc. Then I got voluntary then paid student summer jobs in medical
records and clinical coding (in the days before IT – well not strictly speaking
– the Medical Records Manager did have to go to see to the computer
occasionally – a massive mainframe taking up much of the hospital’s roof space…)
In 1989, I got a great career boost, that really set me up. Stafford District
General Hospital (fondly called the DGH) set up a local, rotational management
training scheme, thanks mainly to the far sighted Unit Personnel Manager, who
had come from retail. Yes, this is the same hospital as the major, very
distressing and serious Mid Staffs Hospital scandal. It was a very different
place then. In one of my roles, I was called a GMSO (General Management
Services Officer – got to love the NHS’s addiction to acronyms) which I suppose
would now be called an Executive Assistant or Staff Officer post to the Deputy
UGM (Unit General Manager). Every morning at 9.00a.m. sharp he met with his
senior nurse leaders, his PA and I to make sure he knew exactly what was going
on and could address any urgent business or issues there and then. The senior nurses
had already done the rounds of all of the wards for their clinical speciality
that morning. I remain convinced to this day that like a spider (a nice one) in
the middle of an intricate web, he was completely up to speed, could, and did
use his professional, and not inconsiderably strong personal influence, to maintain
a high standard of care for patients at that time. (That’s one of my messy tangents now done….)
Starting with a Diploma in Health Services Management gained
in that role, the NHS, over the course of a further 22 years, gave me some
wonderful opportunities and experiences, which included a Master’s Degree, and
roles that enabled me to become a Chartered Fellow of the CIPD. The major
changes in NHS commissioning that started as soon as the Coalition Government
got into power in 2010, indirectly led to me leaving the NHS to take up a post
as an HR Director in a Probation Trust in 2011. And so, I thought, I spent the
first half of my career in the NHS and now I will spend the second half in
probation services or the wider criminal justice sector...
Wrong! As part of the
government’s political commitment (OK…… unshakable ideological stance) to
reduce the state as much as possible, the partial privatisation of probation
was already on its way. One of the many wonderful things that happened to me
during this time, however, was working for @CEOLewis, who made me start to use
Twitter. From that seed, I started to write some blogs and also gained a fantastic
personal learning network, which helps my professional thinking more than I can
say. (That’s another mini tangent ticked
off.) What I meant to illustrate by this was how very influential the NHS
has been on my life, although my roles have always been in corporate support –
never the “back office” see Basic needs, security needs and the back office and She's at it again.
This kind of segues messily into the other themes that have
really been bothering me in recent national news. One is the devastating floods
in the North of England. I am horrified, but not surprised to note that the
government were told in very robust terms only a couple of months ago, by its
own committee of experts, of the much heightened risks of flooding and of the need
to do something, and that they have slashed spending on flood protection
despite the lessons learnt in 2007 and the investment that followed.
(The government, or rather specifically the Secretary of State for Justice at the
time, did not listen either to overwhelming academic, specialist and practical
evidence of what works to reduce crime, and of the criticality of joined up
working across the whole criminal justice sector, local authorities, housing
agencies, the NHS, specialist charities, etc.)
Another theme is tax dodging (legally) by major
corporations, whose defence is that it is legal and that to change the rules
might make them relocate to a more tax friendly country. Oh, and it’s OK, because
their staff pay income tax and NI. Staff who earn enough to be over the NI
threshold that is (there’s a problem being stored up for years to come) and
whose jobs and pay are quite secure… But we hear that more people are in work
than before the credit crunch – yet economics isn’t working as expected – the Chancellor’s
tax revenues are lower than forecast. Does it take a genius to work out what
low pay and badly used zero or minimum hours contracts lead to for the economy?
As a mother to a 21-year-old and an 18-year-old, the prospects for young people
worry me a lot. And another thing, even their education is commodified. I read
a blog, (or was it in a Guardian article) the other day by a university
lecturer who is harangued by students who don’t agree with the grade she gives
to their work, or who think course work extensions should be given for the
flimsiest of reasons, because they ‘have paid £9000 a year for this, you know,
and the customer is always right…’ (Another
ranty tangent!)
Then there is the article in the Independent article shared by
@DrGrumble that the Chancellor is on course to privatise more public assets
that any Chancellor since 1979. It will come as no surprise for you to read
about my intense dislike of Thatcher’s ideology – I see many crises now as the
direct consequence of initiatives that she put into train such as the housing
crisis (selling council houses to long term occupants at major discounts – but with
no reinvestment), railway and utility privatisation – which only seems to have
pushed prices up… I could go on another rant. Back to that article, the sums of
money involved in current privatisation are simply eye watering. And I bet most
people aren’t really aware or don’t care enough – but they will when a tipping
point is reached with the privatisation of parts of the NHS and, suddenly, what
they took for granted has gone… As we said, when playing cards over Christmas,
you can only play your trump or picture cards once.
For the record, I am not against change and I love
innovation. Although when I, and others, expressed views against change for
ideological reasons only (recent probation service privatisation) I think we
were seen by some as change haters, or at the very least as irritating
distractors / detractors? We had already done a lot of work to rationalise the
estate and streamline support functions (two favourite ways of saving money
without affecting the front line or cutting jobs) and we were winning awards that
any self-respecting private sector company would shout about from the rooftops (e.g.
2011, British Quality Foundation Gold Medal for Excellence – all of the
probation service), and gaining accreditations (e.g. EFQM level 4 on first
attempt, ISO 14001, and OHSAS 18001 – locally awarded, but no longer live when
the organisation was abolished and reformed*)
Some of our inefficiencies were down to national contracts
we were contractually required to use as a commissioned public service. It
gives me no pleasure to see news items now appearing indicating that some of
the new probation contracts are at risk of failing, or of potential large scale
job cuts. I still have former colleagues working in the service, who I know are
full of integrity and care passionately about public safety, reducing the
number of victims of crime and believe that people (service users) are capable of
desistance from crime. So for them, potential victims of crime, and for service
users who want to change, I do hope this does not become the train crash that
it might. (Please forgive this tangent in
particular – it’s still quite close to home.)
(*The other thing I
could wax lyrical on is the number of babies that have been thrown out with
bathwater and the waste of public money and effort that represents.)
Another way of saving money, I haven’t mentioned in this blog,
that is becoming a missive, is outsourcing and shared services. I’m not a huge
fan where this is done to excess. As I blogged in my first proper blog, The Man in the Sorting Office, some outsourcing of certain functions where processes could
be mapped, and easily standardised then replicated, was possibly a good thing,
but even in an exam question I answered in about 1990, I wondered what was in
it for private sector providers, who have to make a profit in order to continue
to function. One answer that sprung to mind then was that in public services
where typically 70% or more of the budget is spent on wages, reducing staff pay,
terms and conditions is the main way to reduce costs and make a profit. I am also
musing on how efficient large shared service centres really are. From many
anecdotal conversations with friends who work in the private sector (for companies
you will have heard of) see The tail wagging the dog? and
the public sector, my view is that these can actually reduce efficiency and
push back lots of administrative work to operational professionals or managers
(whose time probably costs more than that of the adviser in the former local
support service.) A false economy in many cases, and in more cases, so remote
that they can lack in any practical understanding of the business they support.
I suspect that many of the staff who work in these large service centres are
not fully fulfilled or challenged professionally, and that they know that the
limited service they offer (after lots of process mapping, standardisation and removal
of the use of discretion and local decision making) can often really piss off
the customer.
I really need to find a conclusion, before I go on yet more
ranty tangents about the biased media, vested interests to make the rich richer,
extending the FOI etc. etc. so I will return to the NHS. During my time there, and certainly
in the earlier years I experienced or knew of the following:
·
Ward entrances decorated like Quality Street
scenes at Christmas, all vying to win ‘best decorated ward’ when my boss at the
time did the rounds on Christmas Eve afternoon
·
Summer fetes and fun runs every year
·
Hospital cricket, football and even croquet
teams
·
Quiz nights between teams from neighbouring
hospitals
·
Plays and comedy sketches written by and
performed by junior doctors
·
Numerous organised social events including a
charity ball (featuring an honoured guest of a well-known Coronation Street
Actress)
I could add more, but I think these are all examples of wonderful
staff organised events and traditions – a bit like the social and community life
that former mining communities experienced, but on a looser scale, obviously. I
sensed that everyone was working for the NHS for the same reasons, no matter
what role they held (and there were many more then, before outsourcing, such as
carpentry, engineering, catering). As I said earlier, there was BAGS of goodwill; BUCKET LOADS in fact, and no need for hand wringing about the lack of staff engagement.
Staff were engaged with their vocational profession, with their team, with
their hospital or community service, with a tangible desire to make a difference.
See What happened to vocation? So, to see
evidence of this shared sense of purpose and vocation from the NHS Choir has,
as I hope you can see, if you have been kind enough to bear with me so far, had
a profound effect on me. I hope it has made people think, and not just those in
the NHS and wider public service (past and present), who will get its meaning,
and no doubt have a unique and personal response to it as I have. Wouldn’t it
be great to see this incentivise a renewed appetite for collaborations such as
choirs, sports teams and all sorts of other group efforts – no matter what
further adverse polices or events come along to challenge us?
I have to end with a link to A Bridge Over You on YouTube.
Thank you for reading to the end. I warned you at the start
that it was messy. I wish you a very fulfilling and energising 2016, full of
learning, working together and positive opportunities.