Dr Michelle Tempest (blog) is a psychiatrist and editor of The Future of the NHS.
Management guru Sir Gerry Robinson was the star of a BBC 2 series last week when he was set his ‘biggest challenge’ - to reduce hospital waiting lists.
For those of us who work within NHS hospitals, the stories seemed all too familiar. Delays getting patients in and out of theatre (or in reality anywhere), different specialties not working in harmony, committees and sub-committee’s having endless meetings with no conclusions or outcomes.
He admitted, that after spending just 2 days a week in a hospital environment, he returned home feeling “depressed”, “frustrated” and even doubting his own self-belief to make simple changes. Another familiar tale. In an interview, he said:
“It’s actually quite hard to explain, the psyche…you had any number of people saying well we’ve been talking about this for two years, or I’ve brought this up with this committee for the last 10 years.”
He understood that hospital workers were all highly dedicated to their patients, skilled, and often worked long hours under stressful conditions. But what he was describing without actually the coining the term, was that the members of the NHS were exhibiting signs of what psychologists call ‘learned helplessness’. This describes when someone has learned to believe that they are helpless. They think that they have no control over their situation and that whatever they do is futile. As a result, they are passive when the situation is unpleasant or damaging. Another description it might be to say that the NHS was suffering from institutional depression.
Whichever term one chooses, this is not mere psychobabble. It pinpoints one of the major problems with the NHS, that of morale. As with any institution in such long term decline, the way out of a pattern of such helplessness is to give it a kick start, make it believe in itself again. This is exactly what David Cameron did for the Conservatives. Sir Gerry might well be the person to do it for the NHS. If he can help inject a spirit of enterprise into this centrally controlled command-style economy, he will have achieved far more than any of the innumerable amounts of well-intentioned tinkering which the government has undertaken in recent years.
Sir Gerry was open-mouthed at some of the practices and bad habits which had been allowed to develop within the particular hospital which he was visiting. He was absolutely clear that they would not have survived in any business in any form whatsoever, and in the right hands it is clear that the NHS may well have much to learn about how a good business works.
However, this is not to suggest that what the NHS needs is Enron-style, unbridled capitalism. The injection of a ‘can-do’ attitude and a shaking up of old habits might do wonders and at the very least could be the catalyst towards breaking the vicious cycle of such learned helplessness.
