While Children Go Hungry…….

Marcus Rashford gettyimages-1257626131

I love Marcus Rashford! His statement on child hunger is brilliant, but I don’t entirely agree with him. In his impassioned plea for us to take child hunger seriously (which I could not agree with more), especially through the school holidays, he says: “this is not politics, this is humanity.” The reality is that EVERYTHING IS POLITICAL. Politics is about how we see the world and how we live together. Economics is about how we share and manage the resources between us. Child hunger and child poverty IS a political and economic issue! We can’t hide away from this. We can call for political unity over the issue, we can appeal to the deep compassion of the human heart – but we cannot try and de-politicise the issue, however hard we try. Nor can we remain silent, in case it looks like we’re playing party politics. I am not associated with any political party. None the less this is a deeply political issue – political with both a small p and a very big one!

 

Listening to the debate in the House of Commons about whether or not children should be given meals, provided by the state, during the school break, there seemed to be four main objections to the idea proffered by some of the Conservative MPs.

 

  1. Rather than give children meals, thereby nationalising them, we should be actively promoting parents to take more responsibility, rather than being absent and encourage them to provide for their children properly. We need to deal with the causes of the causes.
  2. If the state were to intervene, it only encourages dependency and laziness by parents who can’t  be bothered to provide for their children properly
  3. The state is already giving out quite enough help already, thank you very much, via Universal Credit.
  4. We’ve all got to play our part in helping out. We’ve had ‘eat out to help out’ for the rich, now we need ‘eat nowt to help out’ for the poor…..(slight tongue in cheek point, perhaps….)

 

Let’s just examine these from both a population health and social justice perspective:

 

  1. Well….I don’t know of very many parents who don’t want to ‘take responsibility’ for their children’s wellbeing. In fact there is hugely weaponised stigma and societal shame (wrongly) applied to those who can’t. There is a massive difference between not wanting to and not being able to. I don’t disagree that we need to get to the causes of the causes of poverty and child hunger – absolutely right! But this will take a generational, focused, gargantuan and sustained effort and will involve us turning the tide on: Adverse Childhood Experiences, an unbalanced and unequal education system, spiritual and psychological degradation, ingrained and systemic racism, white privilege and abusive patriarchy, county lines, unaffordable land and housing (both to buy or rent), poorly paid work, a broken justice system (over 300000 children have at least one parent in prison) etc. We should definitely work on all of this! And as we do it will enable people to be able to take more responsibility and make more positive choices – I’m all for that. Unfortunately at present, the reality is that there are far fewer real choices available for people living in our most economically deprived communities. This is not about either/or – it’s about both/and. So, in the mean time, whilst we’re working on the causes of the causes, perhaps we could also guarantee that we don’t perpetuate the cycle further and ensure children are fed?
  2. The idea that by the state stepping in it encourages dependency, fecklessness and laziness is actually ridiculous. State intervention to provide for the hungry would actually show that we have a society and a government who care deeply for people who are struggling and having a hard time. It is one of the great debates about the role of the state, but the sad reality is that charity alone, simply won’t cut it. We need a state (be that city, regional or national – preferably all), that acts as a safety net for those who are finding life the hardest. Rashford puts it best: “……since March, 32% of families have suffered a drop in income. Nearly 1 million have fallen off the payroll. This is not dependency, this a cry for help. There are no jobs!! 250% increase in food poverty and rising. Nobody said this was simple…” Until we fix the causes of the causes, we are going to need to ensure we have appropriate interventions to the difficult realities so many in our communities face. Perhaps this might include children being fed through the holidays?
  3. Despite the ‘positive changes’ to the benefits system, with more people in work, we had rising poverty levels even before the pandemic, with more children in poverty, (worsening over the last ten years) and now we have massive job insecurity, higher
    Rise in use of Food Banks – Trussell Trust

    unemployment and we’re heading into a recession. At such a time, to imply those benefits are enough, when we know that the use of foodbanks (which are supposed to be a temporary measure) is rising, is somewhat short-sighted. I have heard so many testimonies of families who are on the ropes. Holiday food vouchers are a life line. However good you might think your benefit system is, when families are telling you they are having to choose between fuel and food as we head into winter, perhaps we might want to think about how we ensure children are fed? After all, nutrition is one of the key building blocks of a healthy and well child.

  4. It is simply inhumane to ask the poor to fit the bill of the ill thought through spending of public money over the previous several months. There have been some VAST pay outs (which will indebt the very children the government are refusing to feed) to many companies, with clauses protecting them should they not deliver on their contracts, (which is lucky for them, because they have failed, badly)….and yet we can’t find the money to ensure that children are fed. One might wonder whose side the government is on.

 

I make no secret of the fact that I am personally deeply motivated by the politics of Jesus. There are two really clear things that he had to say on the issue.

 

  1. “I have come to preach good news to the poor” (Luke 4v18-19) – and he backs this up by stating that He will restore ‘Jubilee’ – this is a radical economic redistribution of money and resources, to the poor, to combat greed and bring things back onto a level playing field.
  2. “Let the children come to me, for to such belongs the Kingdom of Heaven” (Luke 18v16) – Not only are we to care for children, because they are important – we’re supposed to become more like them (Matthew 18v3)!

 

In other words, if the politics of Jesus are to be taken seriously (and it seems that many conservative voters and MPs profess a ‘Christian’ faith), let it be noted that according to the Christian faith, the poor, the hungry and children really matter to God! And yes – there is space for the church, other faith organisations, charities, communities and local leaders to step into the gap and ensure children are fed, despite the government’s response – but there is also a ‘prophetic mandate’ to challenge injustice and hold leaders to account. The truth is that the need is great – 1 million children across the UK will be hungry over October half-term – they don’t want this to be ‘relooked at for Christmas‘ – they want their bellies fed now. The national government’s arguments fall flat. While children go hungry, they find themselves defending their senseless ideologies and punishing the defenceless. They urgently need to change their minds!

 

 

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Building a Culture of Kindness in the NHS

My morning surgery began today with a patient of mine, who works as  Health Care Assistant (or Band 3) in our local acute hospital trust. As we find across the board in the NHS right now, there are pressures in her department with under-staffing and a very high and demanding work load. She started her day in tears, telling me about the sleepless nights, but even more so about the lack of support she is feeling in her work environment. She feels unable to understand why huge fees are paid to find locum consultants, when posts are not covered, but money cannot be found for the absence of staff at her level, when the numbers are down, leading to an increased pressure and low morale.

 

Now, this is not a criticism of the acute trust we partner with every day, because I actually know all too well the situation here, how complex it can be and just how dedicated to caring for staff the leadership of the trust are. However, when we read in the press today about sickness absence for stress among paramedics, and if I were to detail more stories about the number of cases I am currently dealing with as a GP about stress in the workplace for ALL grades of staff in the NHS and social care setting, then we have to face up to the fact that we have a problem. Stress in the workplace and low morale in our teams is not a problem we can afford to ignore. It not only causes high sickness rates, which then increases the pressure on teams, with knock on financial implications to the system; it also causes significant compassion fatigue (i.e. staff are literally less able to care about or for their patients), because they are emotionally overwhelmed, under-resourced and therefore become more numb, disengaged and unkind and this is detrimental to patient care.

 

The problem is actually really complex, but it is, in my opinion, primarily cultural, and particularly affects the lower pay-grades of staff, because they feel and are in fact less able, to influence change. If we do not develop a culture of kindness towards our own teams and have a sea-change within our working environments in terms of how we care for each other, we will only see the problems go from bad to worse. So, how do we create a culture of kindness, a culture of honour, a culture of wellbeing?

 

I would like to suggest six things (all beginning with H – the 6Hs), which are fairly simple, but make a massive difference to how teams function and therefore the morale within those teams:

 

  1. Humanity – First, we must recognise that hierarchy has the inbuilt tendency to de-humanise us. As we get higher in the pyramidal systems in which we work, we can easily lose our humility and compassion towards others as we have to cope with the greater demands from “above us” and if we’re not careful we can turn into slave drivers. Top down, controlling leadership is detrimental to good morale and stifles teams from working effectively.  There is a famous, ancient parable (told in the New Testament) about an unmerciful manager, who owed a huge amount of money to his master/CEO. The CEO called him to account and threatened to fire him. However, he begged for mercy and the master cancelled his debt and gave him a fresh chance. However, this same manager then went and found all the people who owed something to him, and instead of paying forward the mercy he had received, treated his own debtors shamefully, despite their begging and pleading for mercy. When the CEO found out about this, the manager was duly fired. I wonder how often we tolerate ‘bullying’ by managers, because they ‘run a tight ship’, without calculating the cost of this style of management on our teams and the patients we serve? Changing culture is hard. Even if the CEO sets a good culture, any one of us can bring a negative influence in the area we work. We have to make a conscious choice to keep our kindness switched on. As we climb the ladder of responsibility, we must continue to act with humanity. We must also remember that it works the other way round – we can start dehumanising those in leadership positions ‘above us’, or those who work in different teams. We make terribly unfair assumptions about people all the time. A little bit of understanding, kindness and compassion goes a HUGE way in treating each other with kindness instead of suspicion.
  2. Humility – For those in leadership, there can be a tendency to forget that when we were in in ‘lower’ positions, we often felt the same low morale and pressure from those ‘above us’. Leadership requires that we keep our love and compassion switched on towards those who we now lead. This means we must really learn to listen, and that means having the humility to recognise where we have been getting it wrong. If we are not prepared to change, then we are not really listening. It takes courage to create a culture in which we can receiving a challenge from those in our team and be able to make a change and not just use our position to squash the person who dared to speak out. It takes even more guts to admit where we have been wrong, say sorry and move forward differently.
  3. Help – one of the very worst things that can happen in any team dynamic is when we hear the words ‘it’s not my job’. I hear it so often and it makes me sad! We must never think we are above any task – whether that is cleaning up a mess, wiping a patient’s bum or picking up some litter. We must simply help each other out. But we also need the humility to admit when we are struggling and actually ask for help. We encounter terrible and unspeakable trauma at times, or may simply be going through tough personal circumstances. Sometimes, we need the humility to recognise where we are not coping, where we are struggling, when we’re not functioning and ask for help. And when we ask for help we need to have the confidence that we will encounter the humanity of those around us to help us at our time of need.
  4. Honour – Sometimes a situation may not be able to change, but in these situations the very worst thing leaders can do is close ranks, shut communication down and raise the levels of demand. No, vulnerability, openness and honesty, sharing the reality of the situation and communicating clearly why things cannot change currently at least allows the team to pull together and face the situation as one. However, there must be a very clear challenge here – Yanis Varoufakis puts it so well in his book “And The Weak Suffer What they Must” – we have to remember just how crippling powerlessness can be. Like my patient this morning, she has no access to the ‘powers’ or to the ‘purse strings’. She cannot up and leave, she simply can’t afford to, and so she works under huge pressure for very little pay, powerless to enact change, other than to put in place her own boundaries. A cultural shift towards a culture of kindness is to ensure that those with the least ‘honour’ are treated the most honourably. Leadership is about being able to take the hit, not self-protectionism at the cost of ones team. It is absolutely amazing just how far the words ‘Thank You’ can go, to keeping this sense of honour alive.
  5. Health – (by health, I mean wellbeing in its widest sense) – we have to actually care for the people around us. We have developed a culture in the NHS and social care where we will do all we can to care for our patients/clients, but will break the backs of ourselves or our teams in the process, which is actually entirely self-defeating! It is impossible to care for others well, when you are feeling exhausted and broken! I have said it on this blog before and I will say it many times again: we have to develop a sense of the health and wellbeing of the people in our teams. We need time in the craziness and business of each day to stop the mad rushing, be still and take notice/be mindful/be heartful. We all need time to get up off our chairs and stretch and be more active – #runamile every day (it only takes 15 minutes). We need time to connect with each other (do we really take time to know the people we spend an inordinate amount of time with and alongside and check they are actually doing OK?), to eat well, stay hydrated and keep learning, so we don’t feel overwhelmed. Building these as an absolute priority into our daily work routines is vital, especially as pressures increase. The tendency is that when the going gets tough, our health gets significantly worse. We must learn to protect this in the midst of our business, or we will suffer the consequences in multiple ways.
  6. Hope – there is an ancient proverb that says: “hope deferred makes the heart sick, but hope coming is a tree of life.”  Hopelessness takes root when we feel that nothing can ever change and we feel powerless to influence anything. Hope is born when we develop ways of working in which teams can work together on solutions to the problems they are encountering, rather than being dictated to from on high in a unrelational way. Hope is about being able to sense that the future is alive with possibility. It is a life line when things are tough, when the tunnel is long and dark – just a little glimpse of light – and then faith builds that together we can get there.

 

Not difficult. Actually pretty straight forward. We don’t need unkindness or low morale in our work places. We don’t want to be suffering with compassion fatigue because we are physically and emotionally drained and running on empty. We really can create the kind of culture we want to see and experience in the NHS and social care – a culture of kindness – sounds nice doesn’t it?! All it takes is for us to remember humanity, humility, help, honour, health and hope.

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