I haven’t posted much here over the last year and most of my posts have been about looking back rather than looking forward. 2013 was an important year for me in a lot of ways. By moving out of a social work job, I’ve developed new layers of understanding about what social work is and what it means to me, and to us all to have strong and value-based social work practice in society. Also, despite having worked in an NHS team for years, by moving out, I’ve learnt a lot more about this messy, wonderful healthcare system that we have in this country. It’s something to be thankful for as a concept but we can’t shy away from being critical at the details where necessary. Criticism can come from people who have broader political agendas but sometimes it comes from people who have been damaged by poor care and treatment and sometimes it comes from people who want to be ‘critical friends’ and we shouldn’t confuse the motives for criticism. Sometimes those who love us the most can be the harshest critics – not because we want to destroy but because we want to improve – for ourselves, our families and for those who have the quieter voices and aren’t able to raise them. Sometimes.
I worked in the same geographical area for ten years – the same local authority, the NHS Trust which covered the same area. As my focus became broader and I saw, up close, how things operate in other local authorities and in other NHS Trusts, I have come to realise how narrowly I focused on extrapolating the general from the particular. My main theme of 2013 has been one of learning and really, that’s an incredible opportunity. To me, there is no greater privilege and opportunity than to learn.
For 2014 I have a further opportunity to learn and to use the learning I have gained to good effect. I want to focus and share some of my thoughts on the year ahead how I got to where I am now.
Everyone working in health and social care has power. Everyone. Because we see and work with people who have vulnerabilities at the stages of their lives when they need to use the services which are provided. A dentist can see the most confident politician shifting into a blubbering mass of fear at the sight of their drill. A care worker on minimum wage, not being paid for travel time, can have the measure of someone’s entire day, week, month in their hands with rough handling, a harsh word, or worse. Sometimes when we feel we are ‘on the frontline’ we forget about the power we have. I’m definitely guilty of that. I think back to my previous job and how we used to grumble and moan about ‘managers’ never listening to us – while forgetting the immensity of the powers over people’s lives that we held in our hands. We can fall into the trap (and I’ve done it myself so this isn’t me intending to preach) of thinking we are powerless in organisations when we have enormous power in our own hands.
Now I’m in a position where the power I have is more explicit. I’ve never been entirely comfortable with the thought of having power. I laugh it off sometimes, because honestly, sometimes it scares me. When I stop to acknowledge it, I have to deal with it. I have to use it well and I have to use it to improve services and advocate better for people who use them. This year, I’ve found myself in rooms with ‘important’ people and often thought “what on earth am I doing here?”, “why would anyone be interested in what I have to say” and no one else (to my face, anyway) seems to be thinking it. So I’ve had to grapple with my own change in ‘status’ although the more I think, the more I see the power I had before but never acknowledged as fully. If I don’t feel comfortable with it, that’s my problem and if I don’t realise it, I’m not using it to its best. So this year has been a year for me to get to grips with it. I still need to work on my self-confidence and not running out of meetings, into the bathroom to look in the mirror and wonder if I’m still the same person that they all seem to see and treat with respect, and listen to with interest. I know I need to work on that but I’m coming round to it.
This year I started a creative writing class which runs weekly. I don’t really see myself as a budding novelist. I’ve had that dream sometimes but I think if it was going to happen it would happen by now. We are a disparate group of people who have different jobs and move in different circles and are different generations. Each week, we write one (or more) pieces and then bring them back to the class where we critique each others’ work. It’s taught me an interesting and useful lesson about constructive criticism. Sometimes when you write sometimes, particularly if it has an autobiographical tilt to it, then you can be very sensitive to criticism. One of the first weeks, someone in my creative writing class wrote a story about the death of her son. I was asked to provide constructive criticism. It was very hard. It wasn’t the most beautifully written piece but the rawness and heart in it together with the honesty was something I will never forget. It reminded me of some of the ways we react to criticism and how we can be constructive in our criticism of services without tearing them down or destroying the people who you are criticising. Being a social worker, I’m used to press criticism. My view was always that we should worry less about what right wing commentariat and government ministers say and get our own act together to develop more professional self-confidence and that will batten back some of the foul and most unfair criticism. People will never love social workers as long as social workers whine about not being respected or mutter about press conspiracies against them. People don’t know and understand what we do and often see the ‘iron fist’ of state functions as the ‘velvet glove’ of tirelessly working alongside people to get to grips with systems isn’t as interesting a story.
Now we see more entrenched criticisms of other professions in the health and social care sectors – GPs, A&E, mental health services, nurses. I hope they learn from us as social workers. We can and should never, ever defend poor practice for a start. It shows no credit to anyone. We should accept there are people out there who share our professional background who might not be committed to the same values that 90+% of us share. If we defend them BECAUSE they are social workers, doctors, nurses – we do everyone a disservice. We have to prove and show how the good works and not allow the bad to define it. But that means we have to condemn the bad too, alongside the press. We have to learn the skills of constructive criticism of organisations that we love. We have to teach the public about the role we have so it doesn’t become defined by a press with an agenda – especially as we move into the election period. We have more channels now to share what we do and how we do it – we can take advantage of that.
I’m probably not the one to harp on about ‘change management’ as I’ve never had to manage anyone else – but the coming year is going to be a significant one for me in terms of changes and mostly managing my own changes. These changes will come through work and out of work. I’m about to move house and leave an area I’ve been living in for many many years. Both these things terrify me. Although I can come across (to people who know me) as quite laid back – I’m actually terrified of uncertainty. I will deal with it. I always have and will continue to because we can’t and wouldn’t want to construct lives in tiers of certainty I guess. Keeps me on my toes. How I deal with change will very much define my year though. I am not the only one – again, this is common in the sector I work in. We might not all be moving house, but we all have to deal with endless reconfigurations, rewriting of roles, adjustments of responsibilities. I joke that I have got good at it but that doesn’t make the underlying anxieties disappear.
Then I think it’s a microcosm of life. We all have to deal with unexpected changes and being asked to deal with things we never realised we had it in ourselves to do – a weird analogy with death. I remember when my dad was very unwell and near to death. His health went up and down like a yo-yo and there were many times when we thought he was close to death and then, he managed to continue on, despite all the odds. I often had thoughts about wondering how on earth I could imagine a world where he was dead. I tried to imagine it in my head sometimes and found it too difficult. He had always been there. I knew, obviously, he wouldn’t always be, but I couldn’t understand how I would continue to manage in a world where I couldn’t pop round to my dad’s or where he wouldn’t be on the end of the phone when I needed to talk to him. Of course, he died. And I went on. It’s a kind of ‘change management’ isn’t it? I didn’t know how I would do it, but I have, and I do continue in the world where I can’t pop round and where I have photos to replace the reality. So it is with other kinds of changes – sometimes we can’t imagine it beforehand but we deal with things because we don’t have any choice and we deal with it well, because we have to – we are human and resilient. In some ways, my experiences of bereavement as much as reconfigurations at work – prepare me to change. I don’t know what it’ll be like, but I’ll deal with it because I have to.
This possibly isn’t apparent to too many people, even those who know me quite well but I’ve probably lost a lot of my hope this year for various reasons. I have become more cynical and developed a more pervasive and lingering sense of despair about where services that I love and have been a part of over many years have gone or are going. I have to force myself to believe more now and I worry that I have lost hope. This is an area I am going to actively rather than passively focus on for the next year. I need hope and I miss hope. Yes, the financial situation has been dire and local authorities, NHS Trusts, voluntary sector organisations and central government are all strapped for cash and this is having a real impact on people but there are genuinely decent people doing fantastic work in all these sectors. Money is important and I can’t forgive some of the funding and political decisions made but on a micro level, we can all improve lives and experiences for individuals and that’s what I need to focus on more. Sometimes I forget.
2014 is going to be an interesting year, for sure, and my wish is that we all have a chance to realise how we can make a difference and recapture hope –even on a small level – but preferably on a much larger one – and what we can each do with the power we have to make these sectors whom people rely on, much better for 2014 and many years beyond.
Happy New Year