Wanted: Leadership in the NHS

I’ve been going round in circles this week.

I’ve spoken to a lot of people. Including the Guardian, ITV News, my mentor and old friend Dr Gyles Morrison, my therapist, my husband, my friends, my dad, my whole fantastic community of ex-doctors, and some fellow coaches. I’m like a decision pendulum – one moment I’m so sure I’ll go back, the next moment, I’m certain of the opposite.

I even flipped a coin last night – and then again. And again. (Best of three!) And then I got the email informing me that my licence to practise had officially been reinstated (not because I had definitely decided to return, you understand – they did this automatically). Fuck. Way to pile on the pressure, GMC.

Here’s the thing that’s bothering me at the moment though…

We’re hearing about things changing. There are reports of PPE supplies finally slugging their way to the frontline, and today that testing for frontline workers has been started (no doubt because of the amount of media coverage that myself and other healthcare professionals have been pushing for in order to raise this issue – sad that it had to come to that, but hey, not surprising).

We’re also seeing the nation express gratitude towards the NHS like never before. I joined in on last Thursday’s Clap For Carers round of applause and it was truly moving. It’s also incredible to see that already, over 700 000 volunteers have joined up to help support care efforts, and uplifting to hear reports of restaurants dropping food off at hospitals for staff, and businesses giving up their time and space to help support staff.

BUT – there appears to be on thing that has not changed. One incredibly critical thing: leadership within the NHS.

From up and down the country, I’m hearing reports from friends, former colleagues and on social media groups about the culture of bullying, blame and sheer managerial incompetence that is pervading the health system, even at a time like this: F1s being bullied for wanting to wear PPE; PPE protocols changing every five minutes, causing mass confusion; SHOs being yelled at for raising PPE concerns; consultants being threatened with fitness-to-practise tribunals if they refuse to see a patient on the grounds of inadequate PPE; retired doctors being charged GMC fees before their licence is returned… The list, no doubt, goes on.

You know something is seriously wrong when the Lancet – The Lancet one of the most impartial scientific journals known to the medical profession – call this situation a ‘national scandal‘.

Last week the Doctor’s Association spoke of how they feel like ‘cannon fodder’. All I can say is, thank goodness for the Doctor’s Association, because if they didn’t speak up, no one would. The BMA is being deafeningly quiet, now that there’s nothing in it for them, and my friends on the frontline tell me that managers have warned them that if they go to the media to discuss their local situations, their careers will be damaged. Professional blackmail, how classy!

I’m not scared for myself. If I go back (and that’s still very much an if), the system will have little power over me. What are they gonna do, strike me off? Be my guest! They’d be doing me a favour! I have no intention of returning permanently, and therefore I can’t be threatened in the same way.

But I’m angry. This, more than anything, is a time where great leadership is essential. And I can tell you, from my experience in the management consultancy world, that great leaders make the welfare of their employees an absolute priority. It’s not rocket science. As Simon Sinek said, if you look after your staff, they will make your customers happy, which in turn will make your shareholders happy – in that order.

And in these times, this leadership principle is even more critical than ever, because we desperately need NHS staff to be well cared for, not just so they can be there to run the health system, but also because if proper infection control measures are not adhered to, they risk spreading the virus even further! This snide, small-minded, power-centric attitude is killing people in real time.

This was always going to be a challenging time – no healthcare system in the world was ready for Covid-19 – but in war, it’s not necessarily the biggest army, or the army with the most guns who wins. It’s the army with the best strategy, the best tactics – in other words, it’s the army with the best leadership. And shitting on your troops is not exactly a shining example of that.

To get the best out of your men, they must feel that you are their real leader and must know that they can depend upon you.

General of the Armies John J. Pershing, U.S. Army


2 thoughts on “Wanted: Leadership in the NHS”

  1. I have only just found this blog after reading recent your article in the Guardian, Disillusionedmedic.

    Like you and others, I never really wanted to do medicine and was better at writing and languages. I was compelled to leave clinical medicine in 1998. I cannot say I was disillusioned as I was never illusioned in the first place. After that, I went into junior doctors’ hours management, project management and audit work.

    I am currently a freelance writer and lecturer and I am also thinking of returning to the NHS. It would have to be some sort of management or clerical job on the staff bank, in a back office nowhere near the front line. It is not a noble calling, simply a possible opportunity. I do admire people working clinically but I have got no desire to re-join them.

    I am not asking for my licence back, and it is more than three years since I gave that up anyway. I don’t trust the GMC either and I will never, EVER, forgive them for the vindictive way they treated Dr Bawa-Garba. In 2011, I was doing some bank medical secretarial work and happened to type some clinic letters for her. She was the last person I would have expected to be done for manslaughter. Many people are sympathetic to Dr Bawa-Garba’s plight but fewer have actually met her and worked with her. She was really nice to me and I will not forget that. I also thought that, from her letters, she was very competent and thorough (bearing in mind that I was a qualified doctor myself when typing those letters).

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