Tempest_michelle_1Dr Michelle Tempest (blog) is a psychiatrist and editor of The Future of the NHS.

Management guru Sir Gerry Robinson was the star of a BBC 2 series last week when he was set his ‘biggest challenge’ – to reduce hospital waiting lists.

For those of us who work within NHS hospitals, the stories seemed all too familiar. Delays getting patients in and out of theatre (or in reality anywhere), different specialties not working in harmony, committees and sub-committee’s having endless meetings with no conclusions or outcomes. 

He admitted, that after spending just 2 days a week in a hospital environment, he returned home feeling “depressed”, “frustrated” and even doubting his own self-belief to make simple changes. Another familiar tale. In an interview, he said:

“It’s actually quite hard to explain, the psyche…you had any number of people saying well we’ve been talking about this for two years, or I’ve brought this up with this committee for the last 10 years.” 

He understood that hospital workers were all highly dedicated to their
patients, skilled, and often worked long hours under stressful
conditions. But what he was describing without actually the coining the
term, was that the members of the NHS were exhibiting signs of what
psychologists call ‘learned helplessness’. This describes when someone
has learned to believe that they are helpless. They think that they
have no control over their situation and that whatever they do is
futile. As a result, they are passive when the situation is unpleasant
or damaging. Another description it might be to say that the NHS was
suffering from institutional depression.

Whichever term one chooses, this is not mere psychobabble. It pinpoints
one of the major problems with the NHS, that of morale. As with any
institution in such long term decline, the way out of a pattern of such
helplessness is to give it a kick start, make it believe in itself
again. This is exactly what David Cameron did for the Conservatives.
Sir Gerry might well be the person to do it for the NHS. If he can help
inject a spirit of enterprise into this centrally controlled
command-style economy, he will have achieved far more than any of the
innumerable amounts of well-intentioned tinkering which the government
has undertaken in recent years.

Sir Gerry was open-mouthed at some of the practices and bad habits
which had been allowed to develop within the particular hospital which
he was visiting. He was absolutely clear that they would not have
survived in any business in any form whatsoever, and in the right hands
it is clear that the NHS may well have much to learn about how a good
business works.

However, this is not to suggest that what the NHS needs is Enron-style,
unbridled capitalism. The injection of a ‘can-do’ attitude and a
shaking up of old habits might do wonders and at the very least could
be the catalyst towards breaking the vicious cycle of such learned