Who will speak up when the chips are down?

 

Between 1996 – 2001, the US energy company Enron was voted ‘America’s most innovative company’. It was truly world-beating, a blue chip company in fact. A blue chip company is generally thought to be one with a reputation for quality, reliability and with the ability to operate profitably in good and bad times. It is the kind of company that you might consider using your grandparents’ inheritance to invest in. So, Enron was a company you could trust. But it wasn’t. It maintained the illusion of profitability through some very ‘shady’ accounting processes, condoned by Non-Executive Directors (NEDs) who were too cosy to challenge such practices.

There was another group that were too cosy to ensure good governance, and that was Enron’s external auditors, Arthur Anderson. Their complicity with Enron, bordered on outright fraud. Yet Arthur Anderson were one of the ‘Big Five’ consultancy and accountancy organisations in the world. The others were Price Waterhouse Cooper (PwC); Deloitte Touche; KPMG; and Ernst and Young. It was a financial scandal that rocked the world. Arthur Anderson were convicted of accountancy and audit fraud and such was the damage to its reputation, the company never recovered.

In a strange coincidence, last week I joined a panel that heard a presentation from Deloitte colleagues who were bidding to become our Trust’s external auditors. It’s a very expensive business and finding the fit with the organisation can be difficult, something one of my NED colleagues was at pains to tell me. He should know, having worked for many years for Accenture, the phoenix organisation that eventually rose out of the ashes of Arthur Anderson. It must have taken a great of hard work to regain the trust that had been lost as a consequence of the Enron affair.

Losing and regaining trust was the focus of another meeting I took part in last week. This was a gathering of NHS NEDs from across England. The meeting aimed to explore the challenge of maintaining public service values in a world which appears to be on the edge of a serious shift in what is acceptable in terms of ethics, truth and accountability; where even abiding by the law seems to have been abandoned.  

The pandemic revealed the extent of this shift. We don’t have to look far to find the evidence. There has been corrupt procurements involving large sums of public money; a non-world-beating test and trace system; the exam results fiasco; inconsistent pandemic advice; a decision to renege on the Brexit deal; and of course, that eye-testing trip to Barnard Castle. And if your missed the story that the Chief People Officer, Prerana Issar, hadn’t heard that there was a problem with staff getting tested, you can read it here. If that wasn’t bad enough, read Shaun Lintern’s story in yesterday’s Independent newspaper.

It seems to me that the very people we should be looking to for value-based leadership are choosing not to demonstrate this, or to step up and be counted. If it sounds as if I’m having a bit of rant, I probably am. I’m angry with the cognitive dissonance that has grown exponentially over the course of the pandemic. Day after day, week after week, the public have been told XYZ, when the reality being experienced is ABC. I only have to think about the problems there were with the supply of PPE for example, to note the difference there was in what was being said and what was being experienced by colleagues working in hospitals, care homes and the community.

Being angry is not a good place to be. It is nearly always destructive and unhelpful. Better to harness the energy that cognitive dissonance can bring, rather than be overwhelmed by it. But as those in my meeting last week noted, to do something, anything, can be difficult giving the prevailing political and societal zeitgeist. However, not to do anything is also unacceptable! I, and I’m sure many more people like me, do not want to be one of those that history shows as doing nothing, while trust, ethics and respect and other public service values become eroded. I’m fortunate to have a voice at Board level within two major NHS Trusts in the north-west of England. I will continue to use this voice to do two things. One is to ask those challenging and sometimes difficult questions. The second is, whilst doing so, to also empower and support my Executive Director colleagues to get on and do what is possible and what is right. If that sounds a bit like what you would expect me to do, just think back to the Enron scenario. Whilst the NHS is not a profit-based entity, there are a large number of ‘must do’s’ that get issued from the centralised command and control top-down approach in place right now.

Some of these are beyond challenging and ambitious (two words I have heard over the past few weeks in justification of these ‘must do’s’). For example, the targets set for restoration and recovery of all NHS services. There is widespread acceptance that these are probably unachievable, and unachievable for very good reasons. Buildings need to be modified to allow for Covid and non-Covid patients to be seen separately; donning and doffing PPE adds a great deal of time to procedures; many patients are still afraid to come into hospital; and there is an almost unmanageable waiting list of people with serious health problems to work through. I don’t believe anyone working in the NHS doesn’t have their patients’ best interests at heart, but these are difficult problems to resolve.

Listening to the swirl of discussion at that NED meeting, and the call for some kind of collective response to the issues raised, I wasn’t left feeling deflated, but more determined to seize every opportunity to push back on what I see as injustice, and the erosion of trust and respect in public service. The Nolan Principles, great in their time, are in need of an overhaul. Perhaps in so doing we could include courage as the virtue that makes all other virtues possible. Whilst courageous speech and action should be grounded in reality, ethics and integrity, it is important too if we want to defend truth, goodness, justice and what is right. This blog is dedicated to my colleague from down the road, Professor Donna Hall, Chair of Bolton NHS Trust, who last week, courageously and very publicly, spoke ‘truth to power.’