The Voice of Occupational Serfdom?

Artwork by Ursula Von Rydingsvard. Photographed by Peter Johnson at Yorkshire Sculpture Park, 2014

I recently attended an event organised for the benefit of those who work within, or who have an interest in the provision of healthcare. I'll say no more about it as I really want to protect the innocent – they seemed like nice people with their collective hearts in exactly place where the specialist, looking at the x-ray would expect to find it.

They were seeking to initiate new conversations about the way in which healthcare services are provided and run, and I, with my book to promote thought that it could be a useful opportunity to generate some interest in Making Light Work.

While doing the enforced networking thing with a bunch of people (I thought that was so 2008, but anyway), I mentioned "top-down" to gauge reaction to my favourite topic and the people around me groaned, smiling and making clear their recognition of the bane of their lives. However, as the event progressed I realised that although many were frustrated with - and felt disempowered by - "the hierarchy", very few seemed willing to muster up the courage, or to accept the human responsibility needed to challenge it.

They seemed concerned with conversations and networking, the goal of which were to take the best ideas to lay at the altar of management approval. At one point I suggested that perhaps instead of producing ideas to carry – genuflecting - to these apparently superior beings, why not seek to dismantle the system altogether and to replace it with something less hierarchical, more complex, and more chaotic. They didn't like this at all and suggested that in healthcare things can go wrong (the implication being that they needed others to decide and take responsibility on their behalf). One amazing person sat next to me, who I later found out didn't work in healthcare, retorted with an impressive fire that things go wrong at the moment even with the hierarchy in control. The lack of a clear response to this was deafening.

If ever a collection of people required reminding of the finer tenets of existentialism or Soren Kierkegaard's exhortations to take responsibility for our lives and to exist authentically, then it was these. They appeared afraid, broken and occupationally damaged. I certainly encountered some lovely people there but even the best of them, while articulating their concerns and needs, seemed utterly unable to rise above their institutional serfdom.

I discussed similar topics with another group of people. There was a lovely articulate and passionate youngish woman who discussed her lack of confidence in situations where she wanted to challenge management. Once again I discussed (a little more gently this time) the reasons why staff taking responsibility and doing things for themselves might be a good thing. She kind of agreed and mused that the aim of the networking group should be to help her, and others like her, to gain the confidence to occasionally plough their own furrow in opposition to management.

I know little of the ins and outs of the healthcare industry. I've never worked in it, and these are, after all, simply the impressions of a (somewhat tired) outsider at a industry talking shop. However I left the event asking myself - just what does this sector do to people? These are the folks who will be looking after us when we are old and infirm. They are nice people who want to do good, but, if they feel that they are needing to develop confidence in order to to challenge management, to follow their own moral law within (as Kant would have it), then I am concerned and not in the slightest bit surprised that we have had the poor healthcare episodes of recent years.

I wish these people luck and really hope that they succeed in their aims.