I wake around 3am. Turn to my ipad for a cheeky scroll of happenings and see a link to an article posted a day or so ago about the Health Safety Investigation Branch. (Four words that should knock insomnia out of the sleepless park.)
Ex Health Minister Jeremy Hunt launched the Branch in 2016. In a speech (no longer available) he talked about mistakes made by good people and the need for a ‘proper study of environment and systems in which mistakes happen’. This was a patient safety first.
HSIB. An elite, ‘independent’ swat team of human factor dominated safety investigators proudly wearing no blame badges. Led by Keith Conradi. A human factors geezer plucked out of the aviation industry. A name oozing shaken not stirred gravitas and Branch profile referencing ‘fast’ jets, skiing and triathlons.
I squint at the ipad glare. What’s happened?
A Kings Fund report has found widespread bullying, sexism and a culture of fear in the organisation.
Conradi has resigned.
And with no apparent hint of irony blames the NHS England CEO. And unexpected challenges of managing diverse cultures within the organisation.
I find a post I wrote about HSIB in 2016. The Moon on a Dick. And feel a fleeting sense of blog title pride.
HSIB. Hunt. Blinkered by a human factors fascination, coaxed and coached by an ever ready, uncritical and largely white male chum club.
Hey! Don’t you be harsh missy, I was admonished at the time. [By people who should have known better.] HSIB is a groundbreaking body led by a serious man doing serious work you don’t understand. Let’s wait and see what this shit hot group achieve. We waited.
I try to go back to sleep. An hour, maybe two before a day of research meetings. Growing older with a learning disability. Living a flourishing life. Experiencing loneliness. Giving evidence at fitness to practice hearings. Experiencing inquests… Work that tumble-fills life with overspilling layers of graft, fear, reflection, doing stuff wrong, making right wrongs, fun, stumblings, work. And constant concern. Of not generating anything that makes a difference to someone.
And then I feel familiar anger and rage. Empty words, white noise, environments, systems, ‘good people’ and ‘mistakes’. Made up people channelled into made up jobs. Encouraged by self serving cheerleaders who collude in the erasure of sense. Rights. Integrity. Honesty. Humanity. Hypocrisy always waiting in the wings.
Nearly six years has passed since Hunt launched HSIB. Bereaved families continue to be brutalised by inadequate and punitive investigatory processes. And the world leading patient safety investigation organisation has generated its own brand of harm and trauma.
How long does this wait and see lark last?