Rules that create environment of fear can’t be good

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Bernadette Bowness
Bernadette Bowness

It’s a perilous business, opening your mouth to speak. Talk out of turn and you could find yourself swept up into a storm of untold unpleasantness.

Plagues of frogs, falling skies, crashing waves of abuse, a carpeting by the boss, career collapse – the possibilities are endlessly scary… when you say what you think.

Take Cumbrian midwife Bernadette Bowness, for instance. She was summoned to appear before her bosses and explain herself after speaking in a television interview of her continuing concerns for local maternity services, following Whitehaven’s consultant-led unit’s year-long reprieve from closure.

She was, you might think, ideally placed to offer an informed opinion – she being a long-serving professional and all.

Uncertainty was her principal worry. Would 12 months be long enough to recruit staff and prove the unit’s worth? Or had the sword of Damocles been threateningly positioned over west and north Cumbria’s hospitals?

 Anne Pickles

Anne Pickles

She wasn’t nasty. Far from it. There was no name-calling, nothing deliberately or provocatively loaded with snide accusation. Quite the opposite. Hers were the questions which, in all fairness, almost everybody was asking after the Success Regime delivered its conclusions on how and when to shake up the county’s ailing NHS.

But it’s fair to say they didn’t go down well in the offices back at base, where managers responded by boiling kettles for the hot water in which Mrs Bowness would inevitably find herself when accepting their invitation to tell them why she spoke at all.

One has to assume that the answer “Because it’s what I sincerely believe” wouldn’t do. Not on this occasion anyway. Is it an answer that’s ever appropriate now or must we all button up obediently and do as we’re told?

Stephen Eames, the North Cumbria Hospitals Trust’s chief executive, has made it plain there are clear policies, all neatly drawn up, to dictate the perilous matter of speaking. Not to mention internal staff management issues – which he did. And they are confidential. Of course they are. Not for the first time, the message appeared unambiguous.

Don’t do it. If you can’t say something agreeably flattering about us, zip it – or face the consequences.

Sad that. A great and worrying shame; in shame’s truest sense. It’s a shameful position particularly where health services are concerned.

There couldn’t be anything more solidly community rooted than concerns for the best possible delivery of adequate care.

We’re all involved in those, because we are the community. Whether professionals, patients, happily in full health (for now) or not, shouldn’t we all be talking and working together for best outcome, without fear of reprisal?

It was never like this on Call the Midwife. It’s so disappointing when the very people who know most about how the NHS works – and sometimes doesn’t – aren’t allowed to join in what should be a grown-up conversation about clawing it back from crisis and securing its future.

At least not without a carpeting for stepping outside of “policy”. And just to be clear, there’s a big difference between contributing knowledgeably to a crucial, continuing debate and sounding off without foundation to appear clever – on social media, for instance – before later admitting you didn’t actually mean what you said.

My suspicion is Mrs Bowness spoke with the conviction of long-held professional experience. She knew what she was saying. And she was right to speak.

Is that a subjective view? Of course.

Opinion always is. But I wouldn’t mind taking a punt on the majority of Cumbrians, those of us who worry about the future of our health and social care, hoping she and others like her will not be silenced.

Policy or no policy. Good rules bring order and workable structures to all sizeable organisations. It doesn’t take much, though, to turn good rules into bad ones.

Rules that won’t allow anyone to say anything are invariably bad. Furthermore, institutional policy anywhere – especially in public services – that leans towards an environment of fear for its expert front-liners can’t possibly be good.

That’s subjective too. And sincerely believed.

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