Editor – In your editorial, Leadership and decision making: a skill for all? (Future Hosp J 2015;2:155–6), you point out the generational differences in approach to work and values. You describe those from three generations born between 1946 and 1978. Might I speak of the antediluvian ones born from 1930 – albeit from one having spent 35 years as an NHS consultant, having eight members of immediate family as practising doctors and also having a vested interest in the increasing prospect of being a hospital patient.
Reading current medical journals such as Future Hospital Journal, I can see the justification for the view that medicine is now the most regulated of all professions. In my contacts with young doctors I sympathise with their feelings of frustration as they seek to satisfy managers, the Royal Colleges, the General Medical Council, the deaneries and many other largely lay-inspired regulatory bodies – not to mention the government of the day. I suspect much of this serves to distract them from their sense of vocation – that is, until they in turn become caught as participants in the bureaucratic machinery themselves.
Shortly before I retired from the NHS, we had a chief executive officer (CEO) who became a convert to total quality management. This became the panacea for all ills with the meaningless motto that ‘quality costs nothing’. We were urged to attend conferences and meetings with management consultants on a frequent basis. This coincided with a time when true postgraduate education became increasingly difficult to obtain.
The October issue of Future Hospital Journal gives a good illustration of the problem. A CEO, a director of organisational development and a change manager-organisational development, contribute an article on organisational culture (pp 185–93). In this article, with the aid of multicoloured tables, we read of agreed core values. These include putting patients first, taking pride in what we do, striving to be the best, respecting others and acting with integrity. The amplification of these values in the text that follows would commend themselves to a highly self-satisfied individual. They are much more succinctly summarised in the Sermon on the Mount.