A bit of culture.

Well now. Much has been written about Mazars report into Southern Health’s failings.   The anguish and eloquent anger of LB’s family has touched me greatly.  Their poise and determination in the face of brutal onslaughts is amazing.

In the last 20 years as a social worker I have seen brilliant practice.  I have seen appalling practice. I have seen lives transformed.  I have seen lives destroyed.  Over the last few months I have had particular cause to reflect on what it is that determines how people are treated by organisations.


That’s it.  Pure and simple.  Culture dictates attitude. Attitude dictates quality of service.  Culture is determined by leadership.  Large health organisations and social services departments are top-down organisations.  Hierarchical wilderbeasts, stampeding in discombobulating circles at the whim of their political drivers.

Such frenzied behaviour is destroying services.  It is ruining lives. Its prime focus is on the survival of the organisation. Accountability and responsibility appear to have been crushed in the crass new world of managerialism.  Populate the spreadsheets, present the data, please the politicians. Whether the figures are accurate is not the point.  The figures must be pleasing.  Departments must be under-budget. The workers must be toiling harder, faster.

Quality?  Who cares?

There cannot be a single social worker in the country who has not pointed out to their managers that if their authority had adequate administrative staff and effective IT systems they would be freed up to engage in community based preventative practice, instead of sitting in front of a screen most of the day. We even give them a financial reason to agree with us: prevention is cheaper than cure.  Yet when social workers present managers with this truth, they are dismissed as ‘old-school’ or ‘resistant’.  Why aren’t managers succeeding in persuading politicians to let social workers do what they are trained to do?  Are their arguments ignored? Or are they so far removed from understanding the needs of people using the services that the very values that brought them into social care are forgotten?

Service users and carers who complain are branded ‘challenging’. Workers who raise concerns about safety and inadequate practice are victimized, isolated, forced out.  The survival  of the organisational hierarchy is paramount. Southern Health are not alone in their dangerous adherence to the totally flawed belief that managerialism must be right.

Enough now. Organisations must stop blithely spouting the jargon of vision and values, and start believing that the people who use their services actually do matter. Frontline workers already know and believe this, and all they want is to be able to do their best to support them.