9 August 2020
Systemic injustice – (3) Reframing of reality My doctorate research identified the denial, reframing and redefining of reality present in the NHS. This behaviour is very pervasive and destructive to patients, their relatives and staff. Institutions are places where wrongdoing and perversity can flourish. ‘The NHS: Sticking fingers in its ears, humming loudly’ ‘Organizational Silence in the NHS: ‘Hear no, see no, speak no’’ I particularly appreciate Chapters 20-23 in Tom Bell’s book ‘Lions, Liars, Donkeys and Penguins: The killing of Alison’. There are many words and phrases in these chapters that describe different aspects of this reframing and distortion of reality. The widespread pretence that things are what they are not. Here are some of those interesting words/phrases Tom uses: Post-honesty, fake news, finely polished bullshit, propaganda, cover-up, constant unchallenged stream of unicorn fluff, dark art of spin, illusionists guide to life, feigning authenticity in the pursuit of self-interest, insincerity, rose-tinted messages of success, a spin doctors dream, distraction from reality, rose-tinted positivism, rebranding, misdirection and spin, duplicitous utterances, bury bad news, mental acrobatics, self-delusion, manipulation of data, gaming of numbers, reinterpreting NHS data, manage performance data, turn a blind eye, scrutiny was resented, polished positive messages, ramblings of the positivity gurus and bullshit merchants, deceptive behaviours and the subsequent doublespeak, duplicity masquerading as noble intent, drawbridges of denial, hiding of incompetence and charades of false contrition when things go awry… I totally agree with his conclusions and share his deep concern about the state of our institutions in the UK. ‘To me it seems the collusive self-preserving harm accommodating culture that infected the NHS…is still thriving today’ (p.216)’ ‘The real crime within public sector circles is seldom the act, it is being found out. Possessing and displaying humanity, humility and morality has become a disadvantage, a weakness and hindrance to career progression, not qualities to be cherished or encouraged’ (p.219) ‘Patients continue to be needlessly harmed, lives unnecessarily lost, and justice denied to the victims and their families of a self-serving bureaucracy that seems incapable of acknowledging or learning from its mistakes, unable to empathise with those it fails and unwilling to challenge and hold accountable’ (p.216-217) These chapters in Tom’s book clearly expose the underpinning rottenness, dishonesty and perversity in the NHS, and the resulting ‘systemic injustice’. The NHS does indeed seem to be a place where you have to ‘park your humanity and morals in defence of the indefensible’ (p.220). When an organisation becomes dominated and controlled by such behaviours it becomes very callous and dangerous. ‘The absence of a moral compass is [most definitely] costing lives’ (p.226) and causes much damage to anyone who dares to ‘shine a light’ upon the ‘dirty linen’. The NHS is a very ‘dark’ institution in the way it conducts its business. A major ‘clean up’ is required for the sake of us all. Brackets [] added by RP
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