Is it me or does Jeremy Hunt have the perpetual look of a man who is on his way somewhere else, but keeps being stopped by annoying people and made to do stuff about health? It may have been the case since day one: “Jeremy, we are giving you health.”
“I’m just going shopping.”
“Health Jeremy, it’s a big challenge.”
“We need tea bags and I’m thinking of buying a cravat.”
“You’ll oversee the very tricky Francis report and there will be cuts. But you’ve got to keep saying there are no cuts… A cravat?”
“I think people who accessorise appear more interesting. Do I have to have health? I don’t really believe in health. I believe in homeopathy and flamboyant neckwear.”
“Health Jeremy. It could be the making of you. Don’t forget the biscuits.”
And Mr Hunt has embraced the job with all the passion of a man who knows he is meant to be somewhere else but can’t quite remember where. It is hard, however, to fault his precursory reflections on the Francis report into the crisis of care at Mid Staffordshire. “Failing NHS bosses will go,” he said, adding: “Just as a manager wouldn’t expect to keep their job if they lost control of their finances, nor should they expect to keep it if they lose control of the care in their organisation either.”
Of course one might measure the power of a statement of intent by imagining the effect of saying the opposite. If Mr Hunt had said, “And let me be clear, if NHS managers lose control of care they will be keeping their jobs and may well get new foot spas as well,” we might have been a bit more surprised than we were by the suggestion that being rubbish at managing might mean you have to stop managing. In short he is saying the correct - if blatantly obvious - thing. Managers who do not facilitate care should not be working for the health service.
But dare we hope that there might be some promise in what followed? Mr Hunt went on to talk about maintaining a happy and motivated workforce, implying (tell me if I’m clutching at straws here) that one of the key issues to generating and maintaining care, kindness and compassion lies in dealing with how carers feel.
Unfortunately, we appear to have constructed a culture that, in the face of failure, looks to blame rather than repair. It would be a concern to me if the lead-up to the publication of the Francis report is marked by hints around how we will further monitor and punish potential failures rather than how we might prevent poor care by ensuring better supervision, a more emotionally literate environment and a culture less prone to what former chair of the Health Commission Sir Ian Kennedy referred to as a tendency towards “guerrilla warfare” by some nurses.
The least fashionable thing in the world of health at the moment is humanism - the capacity to construct the qualities and work with the emotions that characterise the healthcare environment. Such concerns, the facilitation of caring relationships and the ability to offer compassion and softness appear to have no value because they are hard to measure and can’t be bought. But they can be constructed.
We can, if we are willing, respond to the Francis report by addressing how care and how compassion, can be rebuilt where necessary and sustained . We can do that if we are willing to ask the right questions in the right detail; we can do it if we turn our attention away from blame and towards potential and repair. It will be an opportunity of a lifetime. Here’s hoping.
Mark Radcliffe is senior lecturer, and author of Gabriel’s Angel