Today the UK media are, rightly, exercised by a report into the care of the elderly produced by Ann Abraham, the National Health Service Obudsman (find the Guardian’s newspaper report here).
BBC Radio 4’s Today programme (starts at around 2 hours 10 minutes of the whole programme) included an interview with a man whose mother died in hospital of dehydration, despite there being a glass and a jug of water beside the bed. Nursing staff did not think to help her to drink. Subsequent interviews with Jo Webber, Policy Director of the NHS Confederation and Professor Raymond Tallis, former Professor of Geriatric Medicine at the University of Manchester, focussed on the “lessons to be learned” and how it was that this and other cases demonstrated a failure of “basic compassion.”
What was striking to me about Prof. Tallis’s contribution was his acknowledgement that this was a matter of ethos, not only within the NHS but within society at large. He pointed to a culture whose priorities value what can be counted and measured, which uses a business model which often undermines professional considerations, and which values glamour at the expense of the distinctly unglamorous need to provide care to the most vulnerable. Referring to trying to change the ethos within hospital to ensure that compassion was paramount, the interviewer, John Humphries, asked, “Can you teach that? You can’t can you?”
Well, I think you can – but not as a classroom exercise. Compassion and kindness can be taught, but only in an environment where it is being consistently modelled and valued from the top down as well as from the bottom up. It cannot be taught as a kind of add-on extra. One of the joys of my job is visiting one of the primary schools within my benefice. As soon as you walk in the door you can feel that this is a place where kindness and care are valued. It is consistently modelled by the head teacher and the staff, it is consistently reinforced by positive messages and action and the children quickly catch on. It is part of the ethos of the place. If all the NHS do is to include the above case, along with others, in a classroom syllabus it will be forgotten once on the wards. Change in ethos will only be achieved by consistent leadership by example.
And this, I think, is a major issue with the government’s agenda to promote the Big Society. I find it rather ironic that the same political party whose leader told us over 20 years ago that the was “no such thing as society” now recognises the falsity of that statement. In the intervening period, volunteering has decreased seriously owing to a number of factors, including legislation that had good intentions but is felt to be burdensome, increasing other demands on time and energy, population mobility and a decreasing sense of commitment to a geographical location. If progress towards the vision of a Big Society is to be made it will require a considerable and widespread change in our culture to re-establish caring and compassion as genuine values. This needs to take place not only in the outlook of individuals but in the wider social environment. If volunteering is increase it needs a society which values this, employers who will not seek to wring the last drop of time and energy from their employees, but who will encourage them to give some of that time and energy be involved in civic and social good.
This will only come about if it is consistently modelled by our leaders, starting with our Prime Minister and Deputy Prime Minister and Members of Parliament, but including leaders of business and other walks and institutions of life. And it will take time and patience. It cannot be pushed through if it is to bring about truly radical and lasting change in our society. If David Cameron is as passionately committed to the Big Society as he claims, than he and his colleagues need to do more than simply talk and legislate. They must be the change they seek.