…you shouldn’t have fallen in love with? “You spurn my natural emotions, you make me feel I’m dirt, and I’m hurt. And if I start a commotion, I run the risk of losing you, and that’s worse.” (The Buzzcocks – 1978)
A few years ago, five to be precise, I started a relationship with an older woman, she’s nearly 70. She has a long-standing well-documented personality disorder, but she can still turn heads with her timeless classic appeal, she stands for values of collective responsibility for each other that are unfashionable in a world that is becoming less equitable for many. And though our relationship has been difficult and rocky at best, even abusive at worst, I fell in love with her. She has many lovers and no shortage of admirers and my love often feels unrequited. My wife tolerates it, she knows all about the older woman in my life and sometimes tells me I should leave her, but the NHS has a hold on me, she is under my skin and I’m still very much in love with her, and importantly, when she is at her best, what she stands for.
Nice people have been sending me congratulatory emails from my LinkedIn profile these last few weeks; Social Media has a handy habit of reminding you about your own as well as everyone else’s lives, which is great if you’re lousy at remembering birthdays. So LinkedIn was doing its thing and letting my contacts know it was five years since I joined the NHS in Cumbria…what a five year’s it’s been! I remember the slightly embarrassed face of the Chairman of the NHS Trust I joined when I applauded him after his speech at the induction; I understand now that it “wasn’t the done thing” and my being the only person clapping in a room of fifty people was a tumbleweed moment to cherish. But I didn’t care, I was so proud to have joined the NHS. As Ruskin rightly, even if not altogether objectively observed, “there is no wealth but life” and I thought surely, surely there can be no greater vocation than working for the National Health Service. I felt I had prepared myself and my time had come.
I joined the NHS in January 2012. It’s a quirk of fate that I come from a family with a tradition of working in the world of health, pre and post the NHS; my Mum was a Nurse, my Aunty was a Health Visitor, my Gran was a Matron, my Great Grandfather was a Public Health Official in Gateshead and his Grandfather was a bonesetter for the pit ponies and miners of the North East. For the first six months of my new role in the NHS, I was like a rabbit in the headlights…the traffic is still coming quick and fast and I’m not sure I have stopped blinking yet!
Working in the NHS and being paid for by the public purse is a privilege and I threw myself wholeheartedly into my work. I have given my commitment and have been fortunate to be blessed with good networks of great people who continually help me develop my thinking and try new approaches. I have led beyond my authority as an enthusiastic advocate for improvement; sometimes overstepping the mark…I recall that distributing copies of “Systems Thinking in the Public Sector” and Jan Carlzons classic “Moments of Truth”, much as an evangelist would hand out leaflets to the unwashed, did nothing to endear me to Directors and Senior Managers who already viewed the new addition from the outside world and the private sector with no small amount of suspicion and wariness.
Since coming into the NHS in Cumbria I have felt engaged, welcomed, trusted, stimulated, developed, fascinated, joyful, excited, energised and part of something fantastic. I have also felt disengaged, confused, ostracised, stymied, used, side-lined, stuck between a rock and a hard place, bullied, disappointed, frustrated, tired, angry, depressed and at times, very, very unwelcome.
My overriding experience of the last five years is of being in a place that needs difference, that intellectually knows and accepts it needs difference but finds it very hard to actually accommodate it. It’s as if the NHS seems unable to understand that you can love something whilst recognising its imperfections. Bits of the healthcare system seem like a dynasty from a Dukes of Hazard episode; hiding in the backwaters of transparency, knowing things are increasingly askew whilst never understanding or acknowledging their role in creating the situations we face. I can see that for many people, people who simply want to be part of something meaningful, bigger than themselves that makes a positive difference, that is effective that is transparent and is led by honest people with integrity and openness, I can see why these people become incredibly confused at the way the NHS behaves. She is a charming attractive and yet deeply paranoid mistress.
These five years have been a heck of a journey and so over the course of the next few week’s I will be sharing five thoughts from five years of my time in the NHS in Cumbria, I hope you enjoy reading them…