You might not be surprised to hear that I was in the group that laughed heartily at HSJ’s April Fools’ Day joke last week, but I laughed even more heartily when I read the comments.    

The situation is an interesting one to muse about.   I don’t write (or at least don’t think I do) anything particularly controversial, yet some very senior people have suggested that I am pushing my luck and have warned me that I am taking unnecessary risks by not blogging anonymously.   Only a couple of weeks ago someone said ‘Kate, I would watch out if I were you, this could be counter productive.’  Well good grief!  If little old me just saying how I feel or provoking a bit of thought in a blog is perceived by some as controversial and taking an unnecessary risk then there might be limited hope for some achieving the radical change that we need to secure future of the health service.     

I still don’t (may never, and to some degree don’t want to) ‘get’ what is so terrible about being honest about how we, as people who work within the health service in various roles, feel about how it could be improved.  We observe the running of the NHS from our respective positions and if we don’t have opinions as to what could be done to improve this then that’s a problem in itself and an entirely different topic to address.   If we are not honest how can we, as NHS managers a. show initiative, leadership and change what is within our influence to change b. inspire, influence and be good role models to the teams we work with and / or alongside to do the same and c. enable those who can influence at a very senior level to truly know how it is and what they need to influence / change?   We are quick to criticise policy and very senior leadership frequently; how many times have you heard or even said ‘they do not get it’ or ‘they don’t understand how it is for us’ but at the same time how many of us actually do something about helping them understand?   The answer is very few, because most do not like to speak out, but boy do we like moaning about it.

I appreciate, although struggle sometimes to support it, why some people post anonymously, because I think (and appreciate this might be naïve) that if you feel so strongly that you want to write it you should put your name to it) but some comments to articles are so bland and not in the least controversial that I just can’t work out why people will not put their names to them, unless of course we have moved into an era where having an opinion is a disciplinary offence. Stranger things have happened. 

It’s tough in the NHS and it’s going to get tougher.  Are we (the royal we) the managers to lead the NHS through the next few years?   Are we sufficiently skilled and robust to see the NHS through this period?  Some of us might be, some will not be and that’s how it goes, but if people can’t even post a bland comment and put a name to it how will we be able to lead radical and tough change and deal with significant pressure and the increasing challenge?     

In relation to the outcry over last weeks April Fool’s Day joke, well how about lightening up and having a laugh at yourselves rather than taking it all a bit too seriously?   What is the fear anyway?   Ok, some things might be career limiting, these are few and far between, and essentially it’s just a smoke screen to hide behind.   Yes, there are ways to be open about how you feel about things and as with everything there are good ways to communicate difficult messages and less good ways, but not communicating difficult messages isn’t an answer.  

I sincerely hope that there is no front page apology as was requested (hopefully as a joke), the HSJ has better things to write about than to a group of rather too sensitive readers who are too fearful to write what they really think in the first place.   All those who got their bloomers in a twist should (after de-twisting them because it can’t be comfortable) have a bit of a think about a. why they post anonymously in the first place b. how they reacted to the joke and c. what they thought of the other comments.   My guess is that even if you posted an anonymous comment you will have laughed at some of the other comments and, yes, that probably means the joke is on you.

Perhaps this is career limiting, time will tell, but at least I am honest about how I feel and what I think can be achieved.   I have always been clear that I am not in any way suggesting my opinion is right but I would much rather be a bit uncomfortable at times, but be truthful about how I feel, than to shy away from dealing with issues that are so obvious they hit most of us square in the face on a daily basis.  

This is healthcare; yours, your family’s, your friends.   Now is the time to take some personal responsibility for improving it, starting with being honest about what the issues are, speaking out and being honest about your views, whether that’s through comments or saying what you think.   Go on, have some gumption; it might not hurt as much as you think it will.