“plus ça change, plus c’est la même chose”

6 07 2010

When I was a child our dentist was really, really poor. One day, during a general anaesthetic I woke up. He left broken teeth in my mouth that took months to fall out. I had baby teeth filled without any anaesthetic. He promised to stop if I felt pain; he never did. Even now I can still see the broken plate of glass in the bottom right hand corner of his lamp any time I visit my new dentist 300 miles and many years away. I struggle to forget.

When I was a surgical trainee I was abused so badly by one senior that in a moment of deep depression I’m ashamed to say I considered suicide. Any time I see a Volkswagen Scirocco like she owned I feel the shame.

Large numbers of clinicians have had and continue to have very negative interactions with managers. I suspect the converse is true too.

None of this means that all dentists are poor, all Scirocco drivers are abusive, all managers useless and all consultants bitter but you can understand why many hold negative opinions at least some of the time. This (sadly) is source of the permanent mutual resentment I mentioned earlier between managers and clinicians. It was even was twittered about!

18 months ago our Trust undertook to try and communicate with all employees by staging “The Big Conversation”. This was an event to which everyone was invited to come and share their thoughts on the organisation; a brave and very positive move. Virtually none of my consultant colleagues went. I asked many why they wouldn’t go the simple answer from virtually everyone was, “Why bother, nothing will change.”

The more I look into this, the more sad I feel; this situation isn’t going to change suddenly, it is crippling development and progress. I mentioned it at the meeting itself and was met with disbelief and even a degree of disdain from one of the Executive Board members. I mentioned it within our directorate to similar effect. To resolve such denial and bitterness and then develop engagement will take a lot of talking, understanding and forgiveness on both sides otherwise the permanent mutual resentment will remain (and grow) and no-one should be surprised.

The Trust encouraged us at the meeting to “write a postcard to your future self” saying one thing we’d like see happen. I wrote, “I will remain positive and look for the change.” I wrote this blog post immediately after “The Big Conversation” but, as a commitment to change I resolved not to publish it; one has to remain positive.  The postcard arrived 6 month ago and I have to confess I feel even less positive than I did way back when I originally wrote this piece. I still resolved to remain positive. Six more months have passed. Sadly, nothing has changed, both sides were right.

Clinicians do not trust or believe the signalling of management. Management do not trust the intentions of clinicians. There is a significant, almost total lack of effective engagement. Is it any wonder that little changes? I wonder what Sartre would have said?


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