Monday, 31 August 2015

Doing leadership differently

Hit the ground kneeling is the unlikely  title of a surprisingly helpful and short book on leadership. Written by  Stephen Cottrell, the current Bishop of Chelmsford, it proposes a rather different approach to the average thrusting, self confident view of leadership. Although written from a Christian perspective it has much relevance for leaders in any context.

Our wonderful and yet ailing NHS is in much need of good leadership and I  suggest that members of CCGs and other GP colleagues would gain much benefit from taking time out to read and allow the ideas in this book to bed down and influence their working pratices.

Take chapter one and Jumping off the bandwagon. The language may not be classic Harvard Business School, but so what?
'Creativity is usually cultivated in the soil of contemplation. The ability to act decisively (and correctly) often arises from a well of stillness....it is said that during difficult meetings that ran late into the evening Abraham Lincoln lead his cabinet outside and bid them contemplate the night sky for a few minutes. He would then share with them his knowledge of the make up of the galaxies, reckoning that when they were put in touch with something beyond themselves, they would be better able to deal with the business in front of them.'
How crazy it is that our MPs go on debating into the night, and making poor decisions as a result. How sad it is that the average GP spends no time at all just thinking. The 10 minute consultation is just too short for the myriad of undifferentiated problems that many of our patients present with. I suspect that mich of the increasing stress between doctors in partnerships arises from lack of contemplation and reflection. Partnership meetings are squeezed between surgeries or held in the evening when everyone is tired. No wonder stress in GPs is leading to the ultimate response of more and more tragic suicides. You just want to scream that the emperor has no clothes. Stressed doctors are not good doctors.

Of course there are no easy answers, but somehow as a nation we need to adequately fund primary care giving its frontline nurses and medics time to think and reflect and replenish. Sadly it seems the decision makers are type A driven personalities who plough on and over others, creating mayhem all around them and ironically not caring for their fellow workers who are expected to deliver the care with targets at the forefront, and the individuality of the patients at the rear.

We need a reapplication of the good old Green Cross Code, Stop, look, listen, if GPs and other health care workers, are to survive.

Saturday, 29 August 2015

Assisted dying yet again

A very helpful article this week in the Spectator on yet another attempt at legalising euthanasia (or 'assisted dying' which is the latest euphemism for providing the means for a person to terminate their life prematurely, since euthanasia had become a toxic word).

It is a helpful article since it is written from an atheist perspective. There's no particular virtue in that fact other than to hold a view which is consistent with Christian convictions is somehow regarded in contemporary thinking as flawed. But everyone has convictions based upon something! It just so happens that secular Western culture at this time in history has decided to deride any views based upon faith, no matter how rational.

So Douglas Murray writes,
'The principal objection to euthanasia is a slippery-slope argument — and many people profess to disdain such arguments. Nevertheless, anyone doubting the slipperiness of this slope should consider the places where euthanasia is already legal.'

He then recounts the experience in Holland, Belgium and Oregon.  Quite frankly the precedents there are worrying. 'The Falconer bill is based on legislation passed in the American state of Oregon 20 years ago, but its timing could hardly be worse. Just this week, one of Oregon’s most senior doctors, Professor William Toffler, declared the legislation a ‘disaster’ which has, among other things, led to ‘a profound shift in attitude toward medical care’ and fundamentally changed the relationship between doctors and patients.'

There are so many reasons why the situation should stay as it is. There are so  many potential unintended consequences, including a lessening of the value of those with disabilities, growing pressure on the frail elderly to 'do the right thing' when the costs of their care are rising and the grandchildren need a deposit for their first house, and the acknowledged downgrading  of the excellence of palliative care, which all agree is so much better here then Holland and Belgium.

For these and many other reasons, please leave the matter alone.

Don't lose the shock!

I was talking to a patient this week who has worked in very senior positions in a number of companies. We were discussing how new employ...