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Last Days of Dr Raj?

7/7/2012

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“Extracting fines from your own employees – just for coming to work! What organisation outside the NHS, could get away with it?”

A question asked of me by Raj, a very capable doctor who occasionally visits our department from his regular haunt in South London. He had parked “illegally” at his employing hospital, squeezing into an unmarked space to avoid either taking up room normally designated for patients’ relativees – or being late for work. A common dilemma faced by plenty of staff in plenty of organisations.

When he questioned the trust estates department about his ticket, got two answers:

  1. The ‘Fine’ was actually a “breach of contract” notice issued by the organisation to which the trust had “outsourced” (ie contracted) the parking management. Sorry, but it was out of their hands.
  2. Dr Raj should know, however, that the trust board was insistent that the parking policy should be “strictly enforced”.
Let us leave aside the dubious legality of such private parking-control devices. The arguments for and against dodgy-sounding outfits such as the “Parking Parnership” can be found online ad nauseam. Let us also pass over without comment the hand-washing that is implied by such “outsourcing”.

Let us instead take a moment to examine the second of these statements. The idea of “strict enforcement” takes a form of words which indicates a “muscular” style of leadership now in vogue in much of the NHS. By taking a stand in the manner of Jack Welch, the board give the impression that the they are not to be trifled with. We should respect their policies – parking not least among them.

There are, of course, less muscular – more compassionate, more human – approaches the trust could take to Dr Raj’s parking problem. For instance, some trusts elect, rather than sticking wayward drivers with a fine to stick their car with a sticky note. Half an hour with a scourer is considered enough deterent without maknig too much of an impact on the driver’s goodwill – staff or patient.

“But this is ridiculous” – I hear you cry – “parking is a nuisance to all trusts. It’s a fact of life. And How they deal with it has no bearing on anything important.”

You may be right – but I’m not so sure.

Because this “muscular” tone becomes a habit. It pervades the conversations that are had between leaders and therefore between staff.  Problems are “escalated” rather than shared. The breaching of targets is more important than the expereince or the welfare of the patient. It’s not difficult to find ways in which NHS trusts act uncaringly towards the dilemmas and pressures under which staff need to work.

What can then happen is that staff will find it necessary to act less caringly towards patients. That may be the unintended consequence of this ‘muscular’ style of leadership.

And in this case? What unintended consequences could we point to?

Due to the “strict enforcement” of the parking policy, Dr Raj is be leaving. “Such nonsense is the last straw”, he told me. “I’m going to find a job where they don’t treat their staff like that.”

+He may need some luck.

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