I think one of the most noticeable changes in healthcare over the years has been the development of the culture of blame. Becoming ill is now something we have caused ourselves by taking the wrong substance (food, alcohol, tobacco, drugs) or else it is our environment. If something goes wrong in healthcare everyone seems to want to blame someone else. The nurse didn’t wash her hands properly, she didn’t have the appropriate knowledge, she was getting above her station trying to be a mini doctor. The doctors themselves cannot be without blame, they are paid too much, don’t work hard enough, aren’t keeping up to date, aren’t trained well enough any more. Then of course there is the government, responsible for our ill health, the fact that we can’t get hold of the drugs or other treatments we think we should have. They are the cause of targets and strange ideas for so called reform where nurses take on the work of doctors and doctors become health care managers which of course gets me onto the most blameworthy group. The manager is of course to blame for everything that is wrong with the health service today. Overpaid, under skilled, over educated with management courses and of course just plain useless.
Over the weekend I took a break from writing on my blog, but I did read other blog posts. To be honest some of the medical blogs I have read are beginning to depress me, and the reason for this is because there is an overwhelming feeling that all is not well with the world and the reason for that is someone or something else. Well as far as I can see it is time to take control, time to be proactive, time to stop this blame game, time for solutions not winging, time for proper debate not some of the ping pong like oneupmanship discussion that goes on in some areas of the blogsphere.
It might shock some people to know that there is some very good healthcare going on in this country, and that it is quite possible for a nurse to provide nursing care, know something of the anatomy and disease process of her patient as well as deliver care to a high standard. It is possible for doctors to learn something from nurses, but if either of them tell a patient something that is blatantly not right then the other has a responsibility to let them know that is the case. It is possible for a GP to be willing to take part in the redesign of PCT services, it is possible for managers to know what they are talking about and it is possible that not all of them are being over paid. It is possible that government have got pretty much everything they have done since 1997 wrong, and therefore every member of the labour party need to be called unpleasant names, but I somehow think not.
Lets stop running each other down, lets stop trying to get one up on each other, after all we don’t actually do this in the course of our daily work (well I try not to). Lets start to work out the answers not just winge about the problem or am I just being a naive nurse turned manager who has got above herself?
Well said Julie.
Incidentally I think moving away from a blame culture is a prerequiiste for creating a more adaptive, action orientated NHS where managers and clinicians have the confidence to make changes at a faster pace.
I’ll tell you who the former Minister charged with NHS reform (Lord Warner) blames – the NHS staff for refusing to accept his changes.
http://www.pickinglosers.co.uk/blog_entry/jg/20070424/you_got_us_in_to_this_mess_you_get_us_out_of_it
I agree that a blame culture is wrong and pointless, but at the same time there is no one taking responsibility for the vast wastes of money that is being poured away in the NHS and for a former Govt. minister to put the blame on NHS staff is neither helpful nor fair. It is no good “calling each other names” but surely the Government has to take some of the responsibility here and start to listen to the NHS workers rather than blaming them? The buck stops with them, if doctors are over paid it’s not their fault. If a nurse didn’t wash her hands, why did she not get the appropriate knowledge? If the wrong people are in the wrong structure, it’s not their fault – the government has such a hands on approach in something it know very little about and is their fault. So it’s all very well not wanting to blame anyone, but there really is only one group that can change anything and that is the government.
I completely agree we need proper open debate – but it’s something the government needs to initiate.
Thanks for your comment JG, interesting article and I completely agree with your sentiments. If Lord Warner really said those things then that makes me extremely angry and whats more makes him as bad if not worse than those he is attacking!
good article. I think a majority of people want to work together.
The problem is as JG points out above, the autocrats at the top are deliberately forcing through unpopular policy and reforms without discussing it with anyone beneath them.
I pity the managers in the NHS, they are the middle men caught between the autocrats in Whitehall and the workers on the shop floor. The manager cannot keep both sets of people happy.
A good system would work in a more bottom up manner allowing problems to be addressed and the grass roots to be involved in the management/development of the NHS. If you look at the best companies, some Japanese for example, the worker on the shop floor is of value and can have an impact. The NHS is unfortunately a totalitarian doctatorship and things will only improve when we get rid of those at the top.
http://pressposts.com/Blogging/who-takes-blame/
Submited post on PressPosts.com – “who takes the blame?”