The Cost of Conflict in the NHS

NHSBy Ed Cooper, Retired Consultant Paediatrician, Relate Therapist

Some dozen years ago I was on an overseas trip with a small team of colleagues. After our work, relaxed evening chat came naturally. I mentioned the enmities among the team of senior doctors in my hospital back home, and how poorly we performed as a team as a consequence. There was immediate agreement that this was so common among the senior staff of NHS units that it was more the rule than the exception.  To me, this was a revelation.

I wont tell you the causes of the ill feeling in my hospital department, but I will tell you the pattern of progress toward resolution. It was good cop, then bad cop, and then productive cop; and it must have cost a lot of money.  It certainly cost a lot of time.

Good cop: The hospitals chief executive was naturally very worried by our dysfunctionality and his first hire to sort the problem was a management consultant who interviewed us all separately, spoke sympathetically, and then wrote a tepid and vapid report.  (I believe he was on about £1000 a day.)  Our acrimonious staff meetings and poisonous briefings continued, while our coherent teamwork remained as poor as ever.

Bad cop: The next hire was a lawyer. He was robust. His recommendation to the chief executive was simple: Fire that group, he said. There was consternation: You can’t just fire people, think of the Employment Tribunal. You can fire anybody if you’re prepared to pay enough money, he said.

Productive cop: Bad cop had changed the atmosphere and concentrated minds. We were now ready for the third external consultant, an actual mediator who listened to grievances, who allowed, but controlled, their communal airing, and then negotiated between the parties. Couldn’t we have started there?

By Ed Cooper, Retired Consultant Paediatrician, Relate Therapist

The Cost of Conflict in the NHS