Abstract
In medicine we are taught that common things are common, as exemplified by the example that canaries are not common in the UK. I enjoyed Hadridge and Pow's article in January (
Hadridge and Pow talk about tuning into the deep culture of an organization. In the NHS there are three alternative discourses. One is the orthodox management line emphasising ‘clinical engagement’. It is exemplified by glossy newsletters and mission statements that the workers know do not reflect reality, but only the management's distorted version of reality. Another is the formal medical discourse which hardly trusts management and its motives, but expresses itself carefully. The frank expression of the medical view is given on the medical blogs by Dr Crippen (http://nhsblogdoc.blogspot.com/) and Dr Rant (www.drrant.net/) and in the discussion fora at www.doctors.net.uk. The stories that doctors tell of the NHS speak of despair and disconnection. Doctors struggle to make sense of what is happening in their organization, and the suspicion is of hidden government agendas.
The deep diagnosis of the NHS is of an organization divided. There are clear disconnections between good medicine and what the NHS provides, and between what the leadership say and what is actually happening.
I see no flamingos taking flight around here. That large, ungainly, flightless Mauritian bird, the dodo, comes more easily to mind. And for Dutch explorers read United Health Europe, aided and abetted by former journal editors and government advisers.
Footnotes