Health care and politics

Well, we ended up causing a bit of media flurry ( I wouldn’t call it a storm.. that would be a bit of an overstatement!). We didn’t set out to do that but these things happen. The issues underpinning this are worth a bit of unpicking.

We are in the middle of a complex public consultation about paediatric and maternity services in our local area. Not a fight we chose to have but one the local trust asked us to become involved in because the doctors and nurses were concerned about safety and quality standards in the hospital. It has been a long and sometimes challenging journey over more than 2 years. From the beginning we have chosen to do it differently- to get out there and talk to the public with the consultants- at playgroups, childrens centres and sixth form colleges, working with local interest groups and local politicians.

During the present formal part of this we have had about 250 people attend 9 meetings, out of a population of around 120000. After one of the meetings we lodged complaints with the county council about the behaviour of two local councillors. We did that the way we were supposed to, as it told us to on the website. We didn’t “go public” we wrote to the council formally raising our concerns. One of the councillors then chose to share the contents of the complaint with the local press and suddenly we found ourselves in the HSJ and everyone then has a view about the rights and wrongs of it all. Some think we are “naïve”, we need a thicker skin.

I am completely committed to democracy.. .that means I will do everything in my power to make sure that someone who has the opposite opinion to me has the right to express it, as loudly and fully as they wish to. I enjoy debate and discussion and the reasoned development of consensus. I am not intimidated by those who hold opinions entirely opposed to mine. That is how it should be. My job is to clearly express our views, our interpretation of the situation. In those discussions though, we should be able to express our views without unwarranted and baseless attacks on our motives and our integrity. The debate should be about the issues NOT the personalities. We were not “upset” by the behaviour. We are tougher than that. We felt however that behaviour of that sort damaged still further public confidence in all of us who work in the public sector. The people I was with that evening were clinical professionals: those nurses and doctors who have spent their professional lives dedicated to serving their local population to the best of their abilities. They have done so with integrity and professionalism. They were there to talk and to listen. The views they expressed were based on evidence and professional knowledge.


We as a CCG believe we must do the right thing, not the easy thing but the right thing. We are a values driven organisation and have explicitly committed ourselves to developing an open culture that is necessarily different from that pervasive culture of bullying and secrecy that has existed in the NHS for the last few years: the outputs of which are constantly in the news and bring shame to us all. We judge our progress and our success by our values: Integrity, Transparency, Collaboration, Focus, Action , Energy, and Courage.


In a wider context I see the need for same debate. Recently I had an interesting discussion with my kids, now young adults, and their friends about why they don’t vote. They tell me that have nothing in common with the politicians they see on TV: the jeering and point scoring during debates in the Houses of Parliament, the behaviours, the language, the endless sniping, the inability to answer a straight question. They have no confidence in any of them. Neither do they have much confidence now in those who run the health service, or education and social care, for that matter. Interestingly last week there were similar debates on the PM programme on Radio 4 after comments by Jeremy Paxman and Russell Brand.


If we are going to re-establish that trust we have to be different and that means BEHAVE differently. WE all have to behave better and expect better. If we tolerate poor behaviour we are in the end implicitly condoning it. If we as a CCG are committed to treating everyone we come into contact with well, to being open and honest, even when that is difficult, to be respectful and demonstrate integrity. We demand to be treated fairly. We do not expect to be given an easy ride. We enjoy robust and challenging debate. We do not need to be taken care of. But we should expect to be treated with respect. Why should we be accused of being naïve to simply expect to be treated decently? Whilst we as a CCG are busy trying to challenge and change the culture in our corner of the NHS we need also to focus on changing the culture more widely in public life.


It would have been easier to put up and shut up. As everyone has done in the past: oh it is just how they are..it is what you expect from politicians. Why should we do that? If we do nothing – nothing changes. It is important to be brave enough to challenge the status quo. That is why we chose to make that complaint. Not from a place of weakness but from a place of strength. We knew it might make waves but we wanted to put a marker in the sand that says we ( NHS, county councils, politicians etc) as servants of the people shouldn’t treat each other badly in public. It does none of us any favours. Is only makes us all look inept and petty. If we have to resort to personal comments about motives and lack of integrity we have already lost the argument AND lost the respect of the public who watch and listen to the pantomime. I would not tolerate that sort of behaviour in my private life so why should I condone it in my public life?


None of us, know what the public really think. Local politicians are voted in by small percentages of the public. We, in the NHS do consultations, surveys and focus groups but the truth we all have to face is that none of us know what the silent majority, those who don’t come to talk to any of us, really think. If we are ever to improve that situation we have to grapple with this issue, we have to persuade them it is worth participating, that collectively we are worth listening to. We therefore all have a role to play in changing the culture not just of the NHS but of our public life.