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'Let’s turn our backs on the blame game and focus on repair'


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



















Readers' comments (14)

  • “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.”

    Jeremy Hunt failed in his last job as Culture Secretary, but instead of being fired he was promoted to Health!

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  • Anonymous | 19-Jan-2013 1:11 pm

    he is in an excellent position to understand failure then. surely experience is a prerequisite for the job.

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  • Never mind jeremy hunt failing??? All of the present bunch of scheming mps have failed the nation over the past few years, with their false promises, 'false expenses ' claims and absence from the house of commons debates. In my opinion, I'd sack them every time the failed the nation, and, stick 'em in prison with all the other felons, until they repay the treasury all their ill-gotten gains.
    They got this country, the Nhs and all public sector workers in this catastrophic state we are in. Not the average hard working (wo)man in the street.

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  • tinkerbell

    Iama Cynic | 20-Jan-2013 1:10 pm

    the rich and the clueless are a dangerous combination to govern the working class who have to go out and earn a living.

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  • Yes But

    Hunt wants to claim that by improving the skills of individual numbers, as opposed to increasing nursing numbers, things like Mid Staffs can be prevented. He only mentions the bits that suit him.

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  • when will the government understand that making cuts is not the answer to improving care. if there are 6 patients who need feeding on the ward and only 3 staff to cater for 30 patients, who do you prioritise?
    why do the nurses get the blame all the time, it is difficult to spread staff so thinly and expect better care, there are insufficient beds to cater for all and insufficient resources , the nurses need support not a tongue lashing

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  • jane stewart | 22-Jan-2013 9:47 pm

    the government made budgetary cuts not staffing ones. the managers are responsible for cutting back staff probably because they are one of the most costly resources where they should be making savings elsewhere instead. I am convinced with careful planning and proper allocation of funds where they are most needed this is possible. I just wish people would stop blaming the government just and using it as a weapon because they are anti-tory on principle. Please think of your patients and leave politics to the politicians. we should all be working together.

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  • How can we turn our backs on the blame game when it seems so inherent in our makeup as human beings? Whatever we do, there is always somebody who is convinced they could have done our job better!

    Look at all the initial blame unfairly pointed at Algeria from around the world following their very delicate rescue mission which they had to deal with as highly unpredictable events unfolded putting hundreds or even thousands of lives in very acute danger if the terrorists had managed to carry out their plans.

    It is very easy for those are not involved in particular situations or the heat of the moment to criticise and say it could have been managed better, implying in many forms of destructive criticism without overtly expressing it, that they believe they would have made a better job of it, when the true facts of the matter maybe that they are even less capable, or in the case of nursing less competent or lack the skills or training!

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  • tinkerbell

    'Please think of your patients and leave politics to the politicians. we should all be working together' Anonymous | 22-Jan-2013 9:53 pm

    Politics 'the activities associated with the governance of a country'

    far too serious an issue to leave to politicians alone. Politics is what is happening in our world. We should not be idle bystanders if we want to create positive change.

    They are meant to represent us and our society and are doing serious harm.

    I agree we should all be working together but to say 'No' on behalf of ourselves and our patients otherwise when we become patients we too will suffer the consequences of a privatised NHS. It is because some nurses are thinking about their patients that they are becoming politically aware and not leaving our fate to politicians.

    When a government decides to represent 'itself' rather than its 'citizens' you end up with a dictatorship and there have been enough of them throughout history.

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  • Tiger Girl

    Anonymous | 22-Jan-2013 9:53 pm

    Cuts are one thing, but the Goverment tends to assert without any proof, that it can spend less in future but get the same results as when it spent more. It hardly ever admits 'We intend to spend less, so the service might become worse'.

    There was an interesting piece in The Independent, when it interviewed the head of the new NHS Commissioning Board, Sir David Nicholson (this Monday (21st), page 1). Sir David:

    Pledged the new independent Commissioning Board would be prepared to challenge ministers over NHS budgets.

    In future, he said, the public would know how much the NHS believed it needed to spend to keep waiting lists down and improve life expectancy.

    “We will be saying, “If that’s the amount of money which is available, these are the sorts of things we will be able to deliver and these are the sorts of things we can’t,” he said. “That’s a big change.” He added: “We will be saying, “If you do this, this is what we think the implications will be.”

    The NHS Commissioning Board is accountable to Parliament but not to the Health Secretary.

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