Senior managers are fond of saying we need to change the culture of the organisation.

They are saying it now in response to the introduction of commissioning and greater use of the private sector in the NHS. It has been repeatedly stated in local authorities as part of efficiency initiatives and outsourcing services. Now I hear it said in relation to the culling of posts and the focus on competence in the civil service.

Commentators have expressed concern about the macho management culture in the NHS. Trade unions have complained that public sector employers have adopted a more confrontational culture in response to a harsher financial climate. Yet ask a manager about the culture within their organisation and they will struggle to define it other than a rather cynical reference to a “blame culture” or a “performance culture”. Most employee seem to be unaware of their organisation’s culture.

The simplest explanation of culture is the way we do things round here. Certainly there is a lot of time and energy going into changing the way the NHS does things, what local authorities do, don’t do and get others to do and how the civil service will do things in the future.

However culture isn’t so much about who does what, it’s about a set of values and beliefs, how we behave towards other organisations, are we about competition or cooperation are we about quality or cost, effectiveness or efficiency, niche markets or wider population.

As an old fish said to a young fish: “What do you think about the water you’re swimming in?” And the young fish replied: “What’s water?”

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