It Was Always Thus

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As I follow Sara’s terrible account of her slow ongoing torture by the Health Trust whose systems and employees caused her son’s preventable death, I am continually reminded of Dickens’ Bleak House, the first book I studied when I went to university.

It might seem a depressing choice, but it is a good preparation for dealing with the law and other public bodies.

Sara, in her last post, asked how people experience working for public services today.  I fear many of them would recognise Dickens’s Court of Chancery all too well. Cases drag on interminably,  “complainants” become increasingly desperate, their anger either fading into depression, or taking over their lives to the detriment of every other facet of their existence. Relationships break down under the strain.The only beneficiaries are the legal firms growing fat on fees.

Yet today’s LA and Health Trust employees surely cannot be likened to the miserable clerks inhabiting Dickens’s dark world, aware of the situation and sufferings of their clients, but powerless to make any change?

While today’s offices may be brighter and have more ergonomically designed seating, power relationships still remain the same and all the information technology in the world doesn’t change that. Basically, just like Bob Cratchit, employees do what they are told. They know from the example of whistleblowers that, if they don’t, all the employment legislation in the world won’t protect them from being rendered unemployable.

In any office there are nasty people who will take advantage of every regulation and directive to be deliberately obstructive, just as there are others who will do their best, within the constraints of their situation, to be helpful. The majority simply grow indifferent.

That is why #deathbyindifference is so accurate.  Indifference is the default setting for any institution where the majority of employees feel little commitment or calling to their work, where they are powerless to change things and/or have cut-back practises imposed upon them. Patronised (at best) by their employer through tawdry rewards and dumbed down “training”, they soon grow cynical and bitter.

No amount of external inspection or internal paperwork can safeguard clients if the workers simply don’t care. Situations go wrong because nobody bothers to check or to follow up some concern in a timely fashion, or to make sure some point of information was accurate. In the end, somebody lies dead.

In Bleak House Dickens decried the indifference of his own day

Dead, your Majesty.  Dead, my lords and gentlemen.  Dead, Right Reverends and Wrong Reverends. Dead, men and women born with heavenly compassion in your hearts.  And dying thus about us every day.

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Yet we don’t live in Dickens’s times. Change has been made for the better. It was brought about by the determination and campaigning of individuals who cared. Those who campaigned to force the law to take children out of the mills and the mines, to free the enslaved, to educate the poor.

In JusticeforLB, and JusticeforNico, we have a campaign for our own age. It is daunting and depressing at times, but we tread in the footsteps of all those who battled against the entrenched practices and injustices of the past.

It isn’t easy.

Fighting for the little people never was.

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On Smiling Villains and Beacons of Hope

Life’s lessons 11 on Betrayal, Hope and Staying Sane

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I always knew that people you loved died. My mother kept one photo by her bedside, the one of a beautiful child I never knew, the sister who died of meningitis before I was born.

I suppose I came into the world in a bid to take away some of that pain.  I certainly provided a bit of noise and distraction. I was never an obedient or obliging child. At the very least I must have tormented my grieving family in such a variety of ways, that they were diverted from dwelling on their sorrow.

In those days you didn’t talk about things. You just got on with it. I don’t know whether it was better or worse. 

When my father died suddenly I remember the teacher who drove me home saying gruffly “Well, I don’t envy you the next days, but we all have to go through it, sooner or later.” I didn’t need him to say more. I knew his words were kind. He was a good man and he had been through the war.

But now, coming towards the end of life, I think that sudden death is not the worst thing to bear. The hardest thing to carry with you, the hurt that defies healing, the lasting bitterness that weighs you down and oppresses your spirit, is betrayal.

So often in the posts related to Justice for LB you hear that pain expressed – that people, who should have cared or protected, betrayed the trust placed in them. They then multiplied the hurt of that betrayal by lying and denying their actions.

Grief, allowed to take its natural course, becomes liveable with in time. It is something we all have to face, like my old teacher said, and in one way or another we muddle our way through to a bearable sadness.

But the cruelty of having to struggle against the odds to establish the truth of a neglectful, untimely, preventable death removes the opportunity to come to terms with loss, obstructs the channels of regaining joy in life.

That the NHS, the service that once shone like a beacon in a naughty world, should be the monster we have to fight, is the grossest betrayal.

Yet somehow this fighting has to be done without losing our sanity. We have to be able to find courage for the battle and believe that we will achieve peace of mind in the end.

Sara has to talk to the Chair this afternoon. We wish her strength and discernment. He may well be a decent man lost in the mire of corporate spin.  He is trapped, restricted in what he can possibly say, but he deserves the chance to act for the good. Sara is giving him that opportunity. Let us pray he is brave enough to take it.

Nowadays I always speak to the people trapped in call centres as human beings. I say to them “Look, I know you have to say these things and it’s not your fault, but this is the help I need.”

It’s surprising how people can act well, when their humanity and the reality of their situation is recognised. Fortunately psychopaths are in the minority, even if it doesn’t always seem so these days.

When my first email account was hacked, I set up another Yahoo account and emailed the hacker at my own address. I explained I was an old lady who hardly went anywhere and that nobody would ever believe I was trapped in Lagos and needed £2000 to get home, so I would be really grateful if I could have my contacts back.

From some distant corner of the developing world he emailed me back to say he was really sorry. He was ashamed of what he was doing but he did the job to fund his way through college as he had no sponsor.

He sent me back my account.

On Injustice, Exhaustion and Tough Love

Life’s lessons 10:  Hard choices for hard times
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I used to think that, if people only knew about something going badly wrong, they would mobilise against it.

But I grew up under the lingering influence of World War 2. We were the brave little island that had held out against the evils of fascism and set up free universal secondary education and a National Health Service. We were the dragon-slayers.  We were the good guys.

Postwar childhood games, played out on overgrown bomb sites, always involved shooting down the bad guys to emerge victorious.

It took me a very long time to realise that knowledge alone doesn’t stop bad things happening. You need courage, spirit and commitment to confront monsters.

After reading Kara2008 (whobyf1re.wordpress.com) this morning I got to thinking about LB and all the others killed or damaged by health professionals in one way or another. I’d bet each one of us has experience of family, a friend or colleague affected. There is a stack of anecdotal evidence around. There is research evidence too. Think of the data circulated to hospital trusts about death rates. Think of the number of civil cases instituted against them.

We all know at every level that something is badly, systemically wrong and also that nobody, apart from a handful of lowly scapegoats, has been called to account.

As a teacher I had to call various culprits to account.  I remember one stubborn, little red-haired toughie, who had stolen some money from my purse. I usually kept it locked in my filing cabinet but I had been called out of my office suddenly and hadn’t stopped to turn the key.

I saw the set of her jowl and knew it was pointless to rage or accuse. The evidence was incontrovertible, but she would never back down. Then my anger and frustration lifted. I felt very sad for both of us. I asked her to imagine that she had done it. We would think about it as a purely hypothetical situation and consider the possible outcomes.

I can’t remember the detail, but at one point she protested that if she was able to walk away uncondemned, nobody would know anything bad about her.

“But that’s not true, is it?” I pointed out. “Somebody would know, wouldn’t they? Think about it!”

She thought.  “I would know,” she said at last.

And that was the thing that mattered most. Not the money. Not the punishment. Not her admitting anything. It was her looking honestly at herself and deciding what path she wanted to walk down. Did she want live a life based on feeling clever and pleased with herself for doing somebody else down and getting away with it? It was her choice to make. 

And, this morning, it seemed to me that, at an individual and systemic level, the NHS has reached a similar point.

For a range of reasons, individuals collaborate or collude with bad practice and organisations block or stifle concerns, protests and avoid the investigation of incidents.

Yet I can’t believe that the majority of workers in the system are happy about it. I can’t believe that the majority of managers are workplace psychopaths. I can’t even believe that the majority of elected representatives in the Commons are smugly complacent about it.

So why is it happening? 

I said at the start that you need strength, spirit and commitment to change bad things and it is clear that many within the system are too worn down to do it on their own. There are outstanding pockets of good practice, scattered examples of excellence, honourable individual practitioners, but as a whole the NHS is failing.

We have to help it envisage the way ahead, not just as a financial and organisational spreadsheet, but as a moral choice. Who really wants a shoddy, showy business, lacking integrity, getting away with minimum standards by the skin of its legal teeth?

We on the receiving end have already tried to highlight the need for an honest look at realities, rather than spin.

We’ve tried “consulting” nicely and so far it hasn’t worked.

I fear it is going to take a conviction for corporate manslaughter to strengthen the good guys, inside and outside the system.

In the sixty odd years from post war optimism and good intentions, it has come to this.

It should make us all very sad.

Then we should look at LB’s quilt and commit ourselves anew.
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This Is For All The Little People

Life’s lessons 8  Beware of the “I” word

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Sunflowers for Nico today – Nico who died because the basic routine care and therapy he needed to keep him alive were not provided.

Make no mistake, they had been allocated funding from the money you and I pay all our lives in taxes. But, at every level, the organisation of how that money was spent was so confused, and the process of ensuring he received the support he needed so convoluted, that his young life was ended.

We do not, and cannot, know the detail, because the inquest process is so slow, especially should the organisation responsible for his care fail to provide the required documentation.

Nico’s story and Connor’s story ( mydaftlife.WordPress.com) need to be viewed alongside a letter sent by Katrina Percy’s letter to Connor’s mother. This encapsulates just why the current NHS situation is so desperate.

In this letter the “leader” of the Health Trust states she cannot be influenced by the views of any group or interest, no matter how loudly they protest or how much long they persist.

There is absolutely no recognition given to the possibility that a group or interest’s protest could be valid. They could be shouting so loud and so long because something is very wrong.

No – that doesn’t come into it, because she has to act “in the interests of all parties”.

Please pause to think for a moment about the implications of the statements above

In management, as in life, some parties or interests are right and some are wrong and some are a bit muddled and hard to sort out. If I had preventable deaths occurring in my line of business, I’d want to be doing a bit of sorting.

And remember, this is a letter addressed to the mother of a healthy young man who drowned just one year ago in a bath in an institution her organisation ran.

It is written to be shared with the family’s supporters, who are fundraising to pursue this matter through legal process, as the only way to ensure that proper accountability can be achieved.

It is written for sharing with any other patients, care residents or their relatives (like Nico’s family), who group together to try to raise issues or protest about how their beloved children, or friends, or parents have been, or are being, treated.

The message is clear. Don’t bother, because it’s being placed on record that the leaders won’t be swayed. Their word is law, though you’re welcome to come in for a cosy little chat now and again.

The letter says the organisation is doing lots of things right and has lots of hardworking employees. I’m sure it has. That’s not the point.

As far as the NHS trust is concerned, we, the little people who pay the taxes, are regarded as no more than vexatious complainants.

Our views are there to be mocked in the office amongst colleagues, our reputations disparaged and insulted, our concerns glossed over and, wherever possible, silenced.

Practically every paragraph in the letter begins with the word “I” – “I believe this or that”, “I support this or that”.

But it is not about what one individual “I” believes or supports.  It is about best and rotten practice. It is about taking proper, justifiable pride in a job well done and facing up to a botched one.

It’s about right and wrong.

This Is For All The Little People

Life’s lessons 8  Beware of the “I” word

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Sunflowers for Nico today – Nico who died because the basic routine care and therapy he needed to keep him alive were not provided.

Make no mistake, they had been allocated funding from the money you and I pay all our lives in taxes. But, at every level, the organisation of how that money was spent was so confused, and the process of ensuring he received the support he needed so convoluted, that his young life was ended.

We do not, and cannot, know the detail, because the inquest process is so slow, especially should the organisation responsible for his care fail to provide the required documentation.

Nico’s story and Connor’s story ( mydaftlife.WordPress.com) need to be viewed alongside a letter sent by Katrina Percy’s letter to Connor’s mother. This encapsulates just why the current NHS situation is so desperate.

In this letter the “leader” of the Health Trust states she cannot be influenced by the views of any group or interest, no matter how loudly they protest or how much long they persist.

There is absolutely no recognition given to the possibility that a group or interest’s protest could be valid. They could be shouting so loud and so long because something is very wrong.

No – that doesn’t come into it, because she has to act “in the interests of all parties”.

Please pause to think for a moment about the implications of the statements above

In management, as in life, some parties or interests are right and some are wrong and some are a bit muddled and hard to sort out. If I had preventable deaths occurring in my line of business, I’d want to be doing a bit of sorting.

And remember, this is a letter addressed to the mother of a healthy young man who drowned just one year ago in a bath in an institution her organisation ran.

It is written to be shared with the family’s supporters, who are fundraising to pursue this matter through legal process, as the only way to ensure that proper accountability can be achieved.

It is written for sharing with any other patients, care residents or their relatives (like Nico’s family), who group together to try to raise issues or protest about how their beloved children, or friends, or parents have been, or are being, treated.

The message is clear. Don’t bother, because it’s being placed on record that the leaders won’t be swayed. Their word is law, though you’re welcome to come in for a cosy little chat now and again.

The letter says the organisation is doing lots of things right and has lots of hardworking employees. I’m sure it has. That’s not the point.

As far as the NHS trust is concerned, we, the little people who pay the taxes, are regarded as no more than vexatious complainants.

Our views are there to be mocked in the office amongst colleagues, our reputations disparaged and insulted, our concerns glossed over and, wherever possible, silenced.

Practically every paragraph in the letter begins with the word “I” – “I believe this or that”, “I support this or that”.

But it is not about what one individual “I” believes or supports.  It is about best and rotten practice. It is about taking proper, justifiable pride in a job well done and facing up to a botched one.

It’s about right and wrong.