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Health Minister preparing for battle against "vested interests" at Hospital

Health Minister preparing for battle against

Friday 07 October 2022

Health Minister preparing for battle against "vested interests" at Hospital

Friday 07 October 2022


The Health Minister has said she is prepared to face hostility at the Hospital as she attempts to change what she described an “entrenched culture” there.

Deputy Karen Wilson has launched her plan to make changes in “clinical governance” in Health, which she says will be “wide-ranging and delivered at pace”.

Her plan follows a report from Professor Hugo Mascie-Taylor, who has reviewed health care systems around the world. 

Based on interviews with more than 70 staff, the senior clinical lecturer’s report claimed that bullying, a “bias against standardisation” and “vested interests” were dominant in the health service.

However, he said that he said it was a “minority that are bad apples” and he did not single out any one department or individual in his report.

He called on the management at Health to be more assertive, something Deputy Wilson seems prepared to be.

Health Minister Karen Wilson.jpg

Pictured: Health Minister Karen Wilson.

“What Prof Mascie-Taylor has done, very cleverly and astutely, is unpick some of the issues around that, and being objective in his assessment about that as to what some of the core issues are,” she said.

"Learning to survive in a system with entrenched ways of working"

“That, I think, is not just a feature of history but of how people learn to operate and learn to survive in a system that has some very entrenched ways of working that have not been open to some of the scrutiny in which most modern health systems operate now.”

So, does the minister expect conflict, particularly with those who hold the “vested interests” that Prof Mascie-Taylor identified, including some clinicians who allegedly make sure their private patients rise to the top of waiting lists. 

“There may well be conflict, and I think that’s the reality when you’re trying to bring in what I would call a patient-focused change programme,” said Deputy Wilson. 

"I will not be frightened to stand up and address that"

“My orientation around this is patients, and if that means that people have to change the way that they practise because the impact of the way that they currently practise is having an effect on patient safety and quality, then I will not be frightened to stand up and address that.

She added: “What I would hope is there is an appetite and that people see the opportunity to try and put this right in a way that actually allows some of the superb clinical practice we have already to be brought into an accountability framework.

“That framework should be is open and transparent, so people can see where the quality is, what affects safety, what makes work joyful, productive or meaningful, and delivers good clinical outcomes for the people.

“At the minute, we can't give any assurance any of those fronts because I think there are systems and arrangements in place that mitigate that. 

“We have a high number of areas where we want to bring standardisation, so that there is an agreed set of standards to which people work to, and it’s not open to individual practice. 

“We want to make sure that we’ve got the best clinicians doing the best work and that means putting data and systems around their work, so that they can account for it opening transparently.

“It also means that we need to make sure that staff are supported, so that they’ve got a good job plan, supervision in place, and that the workforce mix is right to help deliver the best outcome for patients.

"At the moment, we are fighting fires"

“At the moment, we are fighting fires and the reason is because we are carrying on with the way in which things have been, and clearly this is now starting to reveal that we’ve got really serious problems about the way care is governed and we have to do something about it.”

Deputy Wilson said she did not believe her programme would prompt an exodus of staff from Health, and potentially make recruitment more challenging.

She said: “I am calling on the clinical experts that we have in the system to work with the Government to bring their quality and expertise to the fore, and it is not distracted by some of these issues which have been revealed in the report. 

“I think this is something that people welcome and I have had a lot of positive response to this. [The report] is the experience of staff in their own words, and this is the view that patients have been expressing for so long."

Six weeks on from the publication of the Mascie-Taylor report, what has been the feedback?

"I have had really good feedback"

Deputy Wilson replied: “To be honest, I have had really good feedback. I have had senior clinicians come and say ‘I want to help; I want to be part of this’. 

“I’ve had some people who have remained silent on it but I have also had people who have been so pleased that this has been made public because they have been felt oppressed in a way and not able to express their views.

“People have nothing to fear from this report. My job is to put the right conditions in place for people to do their best work. The most important thing is, I want to retain the talent and skills that we have. 

"We cannot continue in a culture of bullying and harassment"

“But I have to be really clear: we cannot continue in a culture of bullying and harassment, poor job planning, lack of supervision, lack of evidence-based practice, and ineffective team-working because, ultimately, that affects the patient experience and it also impact patient outcomes, from a quality and safety perspective. 

“That is a no-go area for me, I’m afraid.”

The Minister denied that her ‘transformation’ would lead to Jersey simply adopting UK NHS standards.

“This is not the NHS, this is Jersey, and we have our own way of doing things but what we are aligning with are the best practise standards that are available, not only in the NHS but also internationally.

“The reason I say that is these are evidence-based; they are not developed out of a unique view or opinion that somebody has. They are absolutely grounded in evidence.

"The standards are grounded in evidence" 

“If you have a look at some of the American systems, for example, they have a very strong emphasis placed on the patient experience and how they measure it. I want to emulate that and be really customer-centric in that regard.

“The clinical standards are the clinical standards wherever you go, so if you go to France, Spain, Italy, Germany or the UK, treatment for cardiac conditions or asthma, there is an international evidence base that drives practise and that’s what I want Jersey to be in a position to utilise.”

READ MORE...

Q&A: How will the Government act on the Mascie-Taylor report?

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Comments

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Posted by Tobias Philpott on
What if it is the Senior Managers who are the culprits and bully and intimidate people?
Change has to be bought into, not rammed down peoples throats willy nilly.
What about listening to the front line workers instead of Managers?
There is severe anxiety generated by a report whose author is known to be close to incumbent Senior Managers. Isn't that a potential "vested" interest or even worse stitch up to divert attention away from high level cover up of numerous cases of bullying and harassment by Managers.
If the Minister wants to weed out the bad apples, an INDEPENDENT enquiry by someone not close to either incumbent Managers or staff is urgently needed.
Posted by Private Individual on
About time.
Posted by Tobias Philpott on
What if it is the Senior Managers who are the culprits and bully and intimidate people?
Change has to be bought into, not rammed down peoples throats willy nilly.
What about listening to the front line workers instead of Managers?
There is severe anxiety generated by a report whose author is known to be close to incumbent Senior Managers. Isn't that a potential "vested" interest or even worse stitch up to divert attention away from high level cover up of numerous cases of bullying and harassment by Managers.
If the Minister wants to weed out the bad apples, an INDEPENDENT enquiry by someone not close to either incumbent Managers or staff is urgently needed.
Posted by Private Individual on
About time.
Posted by David Kingham on
The concern is that the many Consultant's /Clinicians that work for and indeed are paid for by the Jersey Health system (Tax Payer) also have their own Private practicies, often carrying out their private treatment at the General Hospital. It doesn't take a rocket scientist to work out who gets the preferential treament. Money Talks
Posted by Tom Hirundo on
David Kingham is entirely right. Health in Jersey is responsive to the personal finances of clinicians, rather than to patient care. This is - of course - the last thing that clinicians want you to think, and so they will lash out in all directions (eg claiming senior management bullying) rather than see their personal financial wealth compromised.
Posted by Keith Marsh on
Let's be honest here ~ the Hospital is in a mess.
It is understaffed ~ we need more Consultants, Junior Doctors, Senior Nurses and positions all the way down the scale. The Care system as a whole is very underfunded.
The New Hospital gets further and further behind, and there is now hope of using it in 2026.
The Jersey Healthcare plan, is a joke ~ there are not enough staff and financial resources.
We need NEW Senior Management at the hospital together with The Minister, can move the required changes into REAL ACTION.
Posted by Stathia Ekdikisi on
Tobias is spot on. There is a widespread bullying by several of the senior managers and directors. Everyone knows it, they have been protected if not encouraged by Caroline Landon (the sponsor of the anecdotal 'report') and Patrick Armstrong. HR leaders provide air-cover ensuring that bullying investigations get protracted, that evidence is selectively used. Professor Mascie Taylor did not interview 70 staff, he talked to 53 individuals and majority of them being the managers and directors. Not a single frontline nurse or healthcare assistant was talked to. It is nice that Deputy Wilson gets 'really good feedback' from senior clinicians. Is it possible that her meetings with senior clinicians are being well prepared, with expectations shared with participants upfront, with senior clinical leaders attending to control the extent of positive feedback?
Her enthusiasm could have been even more contagious if not the longest ever waiting lists exceeding 12 thousand patients and growing. The number of patients waiting for elective orthopaedic surgeries (Mr Patrick Armstrong?) reached the highest ever level of 570 patients in August. It is more than for any other surgical area.
The interpretation of the clinical governance anecdotal report by Deputy Wilson seems to pave the way for even more repraisals, more heavy handed style to coerce and intimidate the 'bad apples' who dare to criticise the management. As the Deputy Wilson says in her comments above 'this is Jersey, and we have our own way of doing things'. Indeed, it is called Jersey Way.
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