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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Lesson 107 The Disappeared

Lesson 107 on Being seen and heard

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One night, quite out of the blue, my daughter, by this time grown up, had a seizure when she was out. Her friends, who were much more sensible and competent than I would have been, got help and managed to contact me, but they didn’t know what hospital they were being taken to. They said they would let me know as soon as they could. It was before mobile phones.

As I lay awake, waiting and frightened, I had a sudden memory of the mothers of The Disappeared – the many, many women of South America whose adult children had been seized in the past by the political regime. The mothers whose lives had been spent never knowing where their children were or what had happened to them. Every year they gathered with photos of their sons and daughters to stand in silent testimony to show the world that these children had existed and been loved and mattered. They mattered.

In fighting for Justice for LB we are witnesses, but persistently noisy ones, to another kind of disappearance.

Because Connor and Nico were meant to disappear. An implacable authority, with plenty of resources to cover its tracks, tried to bury them too, but in mounds of spin and jargon and callous disincentives to their families to keep them alive and seen.

We fight for them, because they mattered.

We fight a system that increasingly seeks to disappear its most vulnerable members. The elderly, as well as the dudes and dudettes, are locked away, without respectful care and human consideration, denied treatments they need to keep them healthy, ultimate condemned to die.

However much this is dressed up in glowing vision statements and shiny aims and empty “consultations” and mutual back slappings for meeting “targets”, that is what is happening.

Yesterday I blogged about living in two cultures, but in only one do I feel valued. In the other I feel increasingly invisible, without worth and disregarded as an older person.

In the first one evening, I caught the last local bus home. It leaves quite early around 10.30 and its terminus is Magaluf. It was a bendy bus full of noisy teenagers, as you would expect, off for a good night out. But as we made our way apprehensively up the boisterous,crowded aisle, two lads immediately gestured to us to come and take their seats. They spoke to us cheerily, treating us simply as fellow human beings, not as old nuisances who should have been penned up in their homes out of sight and mind.

Today we think of Connor and Nico, of their lives, their families and their all too preventable deaths. But they stand for all the others with names known only to those who loved and cared for them.

All the others, young and old, our present system seeks to disappear.