This blog is the 2nd of two linked blogs and was written on 2 July 2017
In the 18 days that have passed since the awful disaster of Grenfell Tower we have learned that the type of cladding used to refurbish the block was to blame – that and a faulty fridge on the 2nd floor. We now know that the Public Inquiry will be focused on the technical aspects; how the fire started, how and why it spread so quickly and what internal precautions were in place for alerting residents. And the incompetence of the local leaders (and national policy-makers) whose watch this happened on is revealing itself daily.
No wonder people are angry.
What the authorities are failing to grasp is that Grenfell was the result of a monumental failure in listening and responding. The residents of Grenfell Tower knew there were issues with fire safety and raised them repeatedly … but they weren’t listened to. Not only was nothing done about the fire issues they knew about but decisions were also made to make their homes even less safe by fitting less expensive and flammable cladding. This ignore-ance (as opposed to ignorance) had led, over time, to a culture of indifference and contempt for people and their wellbeing and the consequences are continuing after the event, with very painful consequences. This is what people are angry about.
The real cause of Grenfell is a culture among those in positions of power, of ‘not listening’ which led to a lack of understanding and a lack of trust. This is a common problem – more common in places or professions where the differential in status between those who do and don’t hold the power are stark.
If there is just one thing that the NHS must learn from Grenfell, it is how to listen and respond, not just to the main arguments but to the nuances of what people are saying. The health sector badly needs a revolution in listening not just to prevent a large-scale incident but to improve people’s lives and health on a daily basis. Here’s what needs to happen now.
First, we need to acknowledge that indifference to the realities of people’s lives and not addressing the root causes of their health issues or distress is harmful to them. The NHS’s indifference comes from it’s almost total focus on fixing the illness, rather than on addressing root causes. An extreme but not uncommon example is discharging a rough sleeper back onto the street following treatment, rather than collaborating with housing services to provide accommodation with support.
Second, NHS frontline staff must be trained in how to hold a different sort of conversation with people. Genuine listening is critical because it enables trust to be built and that leads to a greater understanding both about the underlying problems and of what potential solutions.
Third, we need to work directly with people and their networks and communities to find different types of solutions – because given the right conditions people are infinitely resourceful and can solve many issues themselves and they can tell service providers precisely what they need to enable them to do that.
And finally by changing our systems so that NHS staff can act to meet their requests in an equally nuanced way. This is the most difficult bit, because it requires systems to be flexible and this doesn’t fit comfortably with a rigid guidance-led approach to service delivery. But it’s also the thing that makes health creation possible!
Merron Simpson is Chief Executive of Health Creation Alliance and its National Executive Lead on Housing.
Politics
We need a revolution in listening and responding
This blog is the 1st of two linked blogs and was written on 17 June, 3 days after the Grenfell Tower fire
The people of Grenfell Tower died because the people in power didn’t listen to them and didn’t care about them.
This is the conclusion I am coming to as I listen to the reporting on the tragedy. There are some people who will try to tell you that the fault is ‘tower blocks’ and we simply shouldn’t be building them or human error installing the external cladding. And it’s true that the tightening grip of austerity over the last 9 years has driven cost-cutting to dangerous levels. But it’s becoming patently obvious to most of us that decisions were taken at various times by several people operating at different levels of government that compromised safety, and that the concerns of the people who were most affected by those decisions fell on deaf ears. By far the biggest problem that this awful disaster has exposed is a shocking disregard for people who are not in positions of authority.
As someone who is closely connected to the housing world, I know that the repercussions of Grenfell will be far-reaching. In addition to the Public Inquiry into the incident itself, this will trigger reviews of building regulations and fire safety at the very least and will reach into reviews in procurement practice, regeneration, governance and beyond. It will make housing departments and associations revisit their evacuation procedures, tenancy sign-up procedures and property management plans to explore whether they should decommission more high-rise blocks. And hopefully it will lead to a resurgence of genuine ‘tenant scrutiny’ by which tenants get to scrutinise and have a say in their landlords’ plans.
But if the influence of this disaster is limited to the housing sector, we will be doing the victims of the Grenfell Tower tragedy a gross injustice.
At the heart of this is a deep problem that is endemic to many professions, including the health service. Grenfell was no accident; this is what happens when we stop listening to each other. The health service has had its own share of large-scale disasters (think Mid-Staffs) and every day, many small personal tragedies happen because we don’t listen and because even when we do, the systems don’t respond: the person with mental health problems who needs help to make amends with one or more members of their estranged family; the community that knows why the children growing up in their neighbourhood have poor health prospects and, moreover, want to do something about it; the patient who wants to die at home, but who is caught up in protracted hospital discharge procedures. The system is so often incapable of offering people what they really need and want.
‘Listening and responding’ is one of 5 features of health creating practices that Health Creation Alliance has identified in its Manifesto for Health Creation as enabling people to become and to stay well. Listening is not a soft, fluffy skill that those lower down the health hierarchy can do while those higher up get on with the serious business of planning ‘systems of service delivery’. Listening and responding – yes, both are required – is the most powerful thing a health professional and the system can do. It is what makes the right things happen.
We need a ‘revolution in listening’ across our public sector including our health service. And this means making our systems flexible so we can respond. Because people know what’s wrong and they often know how to put it right. All professionals need to do is to find out what people need in order to be safe and well, and then give them that.
Merron Simpson is Chief Executive of Health Creation Alliance and its National Executive Lead on Housing.
@merronsimpson