Posted by: Witch Doctor | February 19, 2013

Mid-staffordshire : the healing


There are the usual expected mutterings that more leadership is required within the NHS to change the culture, and so prevent the recurrence of what has been diagnosed as the systemic failures of Mid-Staffordshire NHS Foundation Trust.

For pities sake, the NHS is dripping with “leaders!” Leadership courses are rife. So rife are these away-day, role-playing, blethering, bonding junkets, that the public should insist they are told how much of their money is spent within the NHS trying to develop these so-called leaders.

It doesn’t work. True leaders emerge when it is necessary without any training whatsoever. Leaders always have their fingers on the pulse. They do not Creep. They do not follow. They know when and how to say “no.” Mid-Staffordshires do not happen when there are true leaders about.


Take for example three names closely associated with Mid-Staffordshire:

Sir David Nicholson:
Chief Executive of the National Health Service in England. Acted as interim Chief Executive of the SHA overseeing the Mid Staffs NHS Trust for a period when death rates were found to be high.

Cynthia Bower :
Former Chief Executive of West Midlands SHA with responsibility for Stafford Hospital Chief until she was promoted to Chief Executive of the Care Quality Commission. She resigned from that position a year ago.

Julie Bailey:
Daughter of Bella Bailey who died in Mid-Staffordshire General Hospital. Founder of “Cure the NHS.”

It would be interesting to know how many leadership courses each one of these people attended.

The Witch Doctor suspects the one that she regards as a true leader has never attended such a course. She could be wrong, of course, but we witches are seldom wrong on matters of leadership.

In the meantime, The Witch Doctor, is now firmly addicted to “Pinterest” It gives her some light relief from NHS matters. She much prefers it to Twitter and Facebook – social media that she regards as a bit trivial, voyeuristic, insulting and at times depressing. Pinterest is different. There she doesn’t need to think much, she just looks and marvels. She also comes across a remarkable number of things that she considers to be “Twee.”

Generally witches do not do “Twee,” although The Witch Doctor often “pins” Twee things on to her board to help her to escape into an imaginary world far removed from the life she knows.

Today she found this:


On thinking it over, she came to the conclusion it was not “Twee” at all.

The wording could easily be changed to:

“Every patient in your ward is, or was, someone’s whole world”

However the patients in your care are not YOUR whole world. They never can be. You have your own world that causes you love, happiness, pain and grief.

So, forget about Loving, Caring, and Leadership.

These are all modern utterances of fashionable jargon – a sort of “Twee” health-speak. Each word has lost its true meaning and should be ditched within the healthcare setting.

Professionalism, empathy, and the willingness to help every patient as an individual are the words associated with the true language of healthcare.

Only when this language, plus a consultant delivered service, and a clear system of professional accountability is reinstated, will the lesser “Mid-Staffordshires” throughout the NHS be healed.


  1. good evening – i have just stumbled across your jewel of a blog – it has brightened my day – thank-you.

  2. How can patients be treated as individuals when appointment lengths are ridiculously short? Most doctors do not even see their patients walk in, so would not be able to use gait as a diagnostic tool. They know very little about family circumstance and never seen how and where the patient lives. Moreover, doctors are further constrained by ‘NICE’ guidelines. The question most asked of the patient is “What do you think it is?” giving the doctor an excuse that s/he was misled into making an incorrect diagnosis.

  3. YL

    Agree mostly with what you say.

    Doctors should not shorten consulting times at the command of managers and politicians. A full medical history, examination and the organisation of investigations where the patient is seen for the first time takes 45 minutes or longer following the sound clinical procedures that every doctor is taught as a medical student. In some specialties, and with some patients it takes longer than this and in others shorter, but to push every patient into a fixed time slot is madness. There are ways round this by bringing a patient back for a longer slot if required but this may not be done.

    Hospital consultants can never be fully aware of family circumstances and always depended very much on the GPs’ deeper knowledge of family and local circumstances. GPs used to have this knowledge but often this is not true nowadays. Many GPs are part -time, some seldom do home visits, but also some patients demand that they can pop into a surgery nearer work than home, so not all the fault lies with the GP. That was one of the things that the Darzi polyclinics promoted by the last government was about.

    It is sometimes forgotten that ‘NICE” only produces guidelines. Medicine is becoming increasingly complex and so guidelines are welcome but they should never be used to threaten good medical practice.

    The question “what do you think it is?” is not necessarily asked for diagnostic purposes but rather to assess how much patients are worrying about their symptoms.

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