Decarbonising healthcare will take everything we’ve got and affect everyone working in the NHS. But well-meaning national strategies are struggling to have much impact on the ground. I spoke to pioneering surgeon Aneel Bhangu about the barriers to change and ask why NHS staff and unions aren’t more involved in meeting our greatest long-term challenge.
Domestic violence and abuse blights the lives thousands of NHS staff every year, and the problem has only got worse since the start of the pandemic. But work can be an important refuge and source of strength for people experiencing abuse, and good support from managers and employers can be a lifeline.
The annual deliberations of the NHS Pay Review body have been a fixture of industrial relations in the NHS for nearly 40 years. But declining trust among staff, high inflation and a marked failure to tackle spiralling staff shortages have put the NHS pay system under severe strain, writes Craig Ryan. Has the review body run out of road? And what could take its place?
Published by Managers in Partnership, October 2020. Picture: Cheryl Samuels
Cheryl Samuels, deputy director of workforce transformation at NHS England, talks about her experiences as a black manager in the NHS. Interview by Craig Ryan.
The first taste of injustice in my career came at the Ministry of Defence. The director agreed to fund my postgraduate studies, but my line manager was determined to discourage me and refused to authorise it. There were only three black women in our team and it was very clear they were not permitting us to proceed through the so-called ‘glass ceiling’ – which looked more like concrete.
That was my first experience of the disconnect between the strategic vision coming from senior management, who wanted to train and develop staff, and operational managers who don’t get the vision, feel insecure and use bullying techniques to keep people ‘in their place’. This brought the saying “we have to work three times as hard” much closer to home.
Working in the NHS has been a largely positive experience, but I’ve come up against the usual stereotyping and unconscious bias — like turning up to formal meetings and senior colleagues assuming I’m a note taker or asking me, “Can you make me a cup of tea?”, because they assume I’m an administrator. I remember as a deputy director going to meet staff with our white male recruitment manager, and staff ignoring me and only talking to him because they assumed he was the deputy director. As the social and cultural commentator Afua Hirsch has mentioned, in certain spaces assumptions and stereotypes prevail – in this case that a black woman couldn’t possibly be the deputy director.
As a black woman, there are lots of ‘micro-aggressions’ that manifest themselves in the workplace, especially when you critique, query or challenge the status quo. Managers can feedback that “Cheryl was a little bit aggressive”. You’ve got white people doing exactly the same thing but their critique is accepted as “challenging and authoritative”. Those micro-aggressions build up, leading you to become more constrained and controlled, which means adjusting your authentic self to fit in with everybody else, rather than being genuinely accepted and able to come to the table as you are.
I’m conscious that if I make a mistake, it’s not going to be tolerated in the same way as a white person’s mistakes — the threshold is much lower for people of colour. I think that’s because some people lack confidence in working with people who are different — it’s easier to be compassionate towards those who are similar to you. When you look at the statistics on how many black staff are disciplined, it’s obvious that some white managers feel more at ease hiding behind formal processes.
I’ve been fortunate to have some ‘good eggs’ — supportive directors who’ve encouraged me to build a profile and take on responsibilities outside my role. Now we need those white allies to step up to the plate, do their homework, understand systemic and behavioural injustices and actually start calling them out. It needs to become socially unacceptable — not just corporately inappropriate — to treat a group of people in this way because of the colour of their skin.
We also need to try to humanise the black experience, so other people understand what it’s like to have the security guard follow you around a shop all the time. Talking to my team recently, I found out that none of them has ever been stopped by the police — not one!
With Black Lives Matter, I do think things feel different – we will probably take some strides forward. But when I think of my grandmother’s experiences as a psychiatric nurse — she was one of the first black nurse tutors — and then look at some of the things that have happened to black staff during Covid, I’m not confident that the next generation will see systemic change towards a society that values them.
My dad, Don Ryan, was a World War II veteran, London fireman, electrician, DIY superhero and the best dad anyone could wish for. He would have been 100 today. To mark his centenary, here’s the eulogy I wrote and read at his funeral in 2009.
I would like to thank you all for being here today. At times like this, words are cheap. But they’re all we have. Words are my trade, and Dad loved words too. He was a big crossword man, scrabble too, and he had a particular fondness for puns – the cheesier the better. And he loved to regale us with obscure London slang – though I think he made some of it up.
A few words, then, for my Dad.
He had a long and happy life but it wasn’t always an easy life. Poverty, the great depression, and then war, made for a difficult start.
A few weeks ago, I went to look for the house in West Norwood where Dad was born. It’s gone, of course, the site is now the Lambeth Council municipal dump. Dad laughed when I told him. ‘I’m not surprised,’ he said. ‘It was already falling down when I lived there.’
When Dad was born there was no TV to watch, no radio to listen to. Money was still made of silver and, as Dad would no doubt say, tea was still made of tea. No one had ever heard an electric guitar, put milk in a fridge or seen the West Indies play test cricket.
In his lifetime, Dad saw four monarchs and 17 prime ministers. And I don’t think he was greatly impressed with any of them.
Dad wasn’t famous, but his was a big life, an important life. He was a modest man; he didn’t ask for any special recognition. ‘I was a bit of a coward, to be honest,’ he would say about some incident in the war. He never even bothered to collect his war medals and he wasn’t interested in ceremonies or reunions. He was quite happy to talk about the war, but his life was more than just that war.
He knew war is a ridiculous situation in which to place human beings, and if you couldn’t laugh at war, see it for what it was, it would take over the rest of your life.
But let’s not forget Dad saw things that none of us can even imagine.
Near the end of the war, Dad was with the Royal Armoured Corps advancing into Germany, when the Nazis sent batallions of old men and kids – some as young as 12 – to fight them.
The old men, no fools, surrendered en masse. The kids, pathetically brave, did not. The British troops refused to fire on them. They had to use heavy artillery from behind the lines, so the gunners couldn’t see whom they were shelling.
Dad thought he’d seen everything.
And then came the horror of the Belsen concentration camp – which he could hardly bear to talk about even sixty years later – where the survivors were so traumatized and hysterical that they had to be locked up again by the British troops who had liberated them.
Nothing in our lives can compare to those experiences.
Dad also played a small part in the Cold War. In fact, I sometimes think Dad might have started the Cold War himself.
In late 1945, he was stationed in Helmstedt, running a railway station right on the border between the British and Soviet zones of occupied Germany. The Russians were blocking an important convoy from Berlin, so Dad went across the frontier to see the Soviet Commissar at Marienborn, to try to persuade him to let the train through.
‘Nyet, Comrade,’ said the Commissar.
Dad went off and came back with his interpreter, a six-foot-six guardsman nicknamed ‘Lemon’. He waited on the platform while Lemon went into the office to speak to the Commissar. After few minutes of shouting, the Commissar crashed through the plate glass window and landed on the platform on his backside, pursued by Lemon, who stood over him, abusing his paternity in Russian.
The Soviets let the train through – grudgingly – but it’s probably a good thing for all of us that Dad’s methods of diplomacy weren’t used more widely in the decades that followed.
In the 1970s, Dad crossed the Iron Curtain again to work in Eastern Europe. He would spend weeks on end in such mysterious places as Moscow, Prague and Sofia. Some Russian engineers even visited our house in Frimley, accompanied by their KGB minder.
In the paranoid atmosphere of the 1970s, this led some of my schoolfriends to think that Dad was a Soviet spy. We were Labour anyway, so it wasn’t hard to make that leap in some people’s minds. When the Bulgarian dissident Georgi Markov was murdered with a poisoned umbrella on Waterloo Bridge in 1978, one of my friends asked me – quite earnestly – if Dad had anything to do with it.
The funny thing was, and this says something about the tragicomedy of the Cold War, no one seemed that bothered. I never told anyone Dad was a spy. But I didn’t deny it either.
Dad was many things in his life. But being a husband, father, and a good friend, was what he excelled at and enjoyed most.
It’s been a difficult couple of weeks, but I can never think about Dad for long without smiling.
The ridiculous sideburns he sported during the 1970s. The Denis Healey eyebrows he always refused to trim. The glint in the Eric Morcambe glasses askew on his face. His Shirley Temple fancy dress outfit that made him look like Miss Piggy.
However you picture him, I’m sure what you’ll remember most is his good humour, his optimism, his warmth and his sheer humanity.
The way he always saw the good side of things and the best side in people.
How he took things as they came, and people as they were.
And how his remarkable life was so rumbustious and full of fun.
But let’s not be sad for more than a few moments when we think of Dad.
When he died, I felt that everything associated with Dad was already falling indelibly into the past.
He meant, quite literally, the world to me.
But the past never leaves us, and neither do the memories of those we love. The past is always part of the present, and our lost loved ones become part of who we are, now and for the rest of our lives.
We began with words and I’ll end with one word.
This is something I was reading the night before Dad died. It’s from the novel Underworld, by the great American writer – Dad’s namesake – Don DeLillo. And it’s somehow become associated in my mind with Dad’s life and with my own. So I’d like to share it with you.
You glance out the window for a moment…and you try to imagine the word on the screen becoming a thing in the world, taking all its meaning, its sense of serenities and contentments out into the streets somehow, its whisper of reconciliation, a word extending itself forever outwards, the tone of repose, the tone of hail and farewell…a word that spreads a longing through the raw sprawl of the city and out across the dreaming bourns and orchards to the solitary hills.
Peace.
Don DeLillo, Underworld (1997), p827
Thank you for listening and may peace be with you.
Through my company Lexographic, I’m working with Timebanking UK to design and develop a brand new website, which we hope will go live in August 2020.
Timebanking UK (TBUK) is the national charity that supports time banks across the UK and promotes the concept of time banking itself. The new website will provide a wealth of resources on timebanking for general readers, time banks, sponsors and funding organisations. Available resources will include videos, infographics and case studies of people whose lives have been transformed by timebanking.
My job is to advise Timebanking UK staff on content, develop and maintain the content plan, edit all copy and to generally keep the project on track. Design and technical stuff is mainly handled by my business partner, James, working with TBUK staff.
We are planning to begin a second phase of development in Autumn 2020, once the new site has gone live. This will involve a dedicated area for member time banks, a discussion forum and online booking for training and events.
While working with Timebanking UK, I became interested in the potential of timebanking to build stronger communities and tackle social isolation, loneliness, poverty and mental ill-health. In 2019, I accepted an invitation from Timebanking UK to become a trustee of the charity.
To find out more about timebanking and TBUK, visit the charity’s old website (and you may get some idea why we’re replacing it).
I act as editor for the Managers in Partnership (MiP) website, working with MiP staff, the elected national committee and MiP members to plan, write and publish all the content on the site.
As part of the development team, I helped to plan the site content and structure, contributed to the technical and visual development of the site, and wrote or edited many of the content pages. Since the site was launched in October 2018, I’ve worked with MiP to maintain and develop the website, and to keep the content fresh, up-to-date and relevant to the union’s 7,000 members.
I plan and edit most of the site content, contribute many articles myself, write news updates and advice pages, and work with head office on social media promotion of the website content.
At the moment we are working to integrate our content production, with a single content pipeline for the union’s website and magazine, Healthcare Manager (of which I am also editor). I’m also now reviewing the site structure and ‘static’ pages, to make sure we are providing the information, advice and guidance that members need.
Public Service Magazine (PSM) is a quarterly news and features title published by the FDA, the union for the UK’s top civil servants. I launched PSM in 1998, when I was head of communications at the FDA, and was editor for several years before going freelance . I’ve continued to work with the FDA on PSM and other projects ever since. In 2017-18, the union invited me back to the editor’s chair while the current editor took maternity leave.
Back in the nineties, we wanted PSM to be a radically different trade union magazine. We felt conventional union journals, like the FDA’s existing newsletter, were aimed too much at activists rather than ordinary members, and tended to treat readers solely as trade unionists rather than professionals. Our guiding principle at the time, much chewed over in the pubs around Whitehall, was that we were ‘moving from Pravda to The Times’.
We produced content that focused on careers, professional and policy debates, advice and guidance as well as bread and butter employment issues. We sometimes published articles that challenged the union’s official line or which tried to stir up debate. We introduced colour photographs and graphics for the first time, and far higher standards of editorial and design. And we published a lot – eleven issues a year in those pre-digital days! Although the look and feel of PSM has changed much over the last two decades, the magazine remains true to the same ethos today.
Over the years, I’ve contributed hundreds of articles to PSM, including features, news reports, interviews, book reviews and analysis pieces. You can read some of them in my cuttings section, or see some of the issues I edited recently below. Through my company Lexographic, I’ve continued to work with the FDA on projects large and small, most notably on the union’s centenary project, Our Story, in 2019.
I have been editor of Healthcare Manager since 2016, and have worked on the title as a consultant editor since it was launched in 2009. The magazine is published by Managers in Partnership (MiP), the union set up by Unison and the FDA to represent senior managers in the NHS and social care. We (usually) publish four issues a year, offering a range of news reports, features and advice on professional, employment and trade union issues.
As editor, I plan and commission content for each issue (as well as the MiP website), research issues that might interest our readers and sub-edit all copy, as well as contributing news reports and features myself. I work with MiP staff to make sure the union’s priorities are covered and help staff to produce content themselves. I also manage the work of our freelance contributors and photographers, and control expenditure on the magazine within the overall budget set by my bosses at MiP.
Design, layout and production is handled by my colleague James Sparling through our company, Lexographic. I work closely with James to finalise the covers and inside pages of the magazine, including writing headlines and captions, selecting images and signing-off of the pages for print. We also liaise with the printers and distributors to ensure everything runs smoothly and the magazine gets published on time and on budget.
During the Covid-19 emergency, we have suspended publication of the printed magazine and moved to publish content directly online. But Healthcare Manager will return in autumn 2020, with issue 45 due to be published in late September.
If you would like to know more about Healthcare Manager magazine or work with us on a story, please drop me a line.
I’ve been a professional writer for more than 25 years and there aren’t many things I haven’t worked on. Using a professional journalist or copywriter can be a much more effective way of getting the content you need than taking on an expensive PR agency (and we’re usually a lot quicker too!).
The writing and writing-related services I can offer include:
So if you need get something written, re-written, edited or just knocked into shape, drop me a line and I’ll see what I can do. And, as I work with a graphic designer and web developer, we can offer a full design and production service too through our company, Lexographic .