Will the new Hospital Groups make magic?

In many ways, being in a rock band is a lot like being in a hospital group, writes health manager, Laurence Nightingale.

The most anticipated delivery in the history of Professor John Higgins’ distinguished obstetric career has been finally welcomed into the world. After a period of confinement worthy of an Indian elephant the much vaunted report on Hospital Groups has at last been inducted into the Hawkins House Hall Of Fame. Despite complications, it can proudly take its place amongst the growing number of doe-eyed publications which have been produced by Health mandarins in recent months.

So what does it look like? Well its genetic lineage means it bears an uncanny family resemblance to its predecessors – the Fitzgerald Report (1967) and the Hanly Report (2003) – and more than a look of its not so distant cousin,  the Integrated Service Areas (2009).  However by all accounts, Mother and Baby are doing well………..

Stratifying hospitals into networks or groups is not a radical idea. Ireland Inc. has been pursuing that strategy more or less for nigh-on 50 years. But group dynamics are extraordinarily tricky to negotiate – no matter how close the group is. Think Noel and Liam Gallagher. In fact in many ways, being in a rock band is a lot like being in a hospital group. Some groups last for years, some end abruptly, some result in ill-advised solo projects. At least one or two end up in bare-knuckled fist-fights. Whilst our hospital group colleagues may be abhorred at the prospect of throwing a TV out of a window or trashing a ward, there’s a long way to go yet as they reach for the stars……

Consider the manner in which the Groups have been arranged. Some have been working positively together – or jamming together – for a number of years. Case in point: Lennon and McCartney. Others, more curiously, resemble those contrived boy bands which are thrown together at open auditions; some make the group because they can sing and dance, some look good, others write the songs. But of course there’s always one or two that are there to make up the numbers. These groups may tick all the boxes but their longevity is about as dependable as a Bus Eireann timetable. Any student of popular culture who has studied the dynamics of rock band relationships will warn of the inevitable pattern of behaviour and the ensuing stress placed on interpersonal dynamics by success.

Groups will always have a front man; someone with a magnetism that represents the lion’s share of popular appeal. They will also, more than likely, have a creative force – the one that writes the lyrics and composes the arrangements. These key ingredients orientate the group towards success. Invariably however somebody has to play tambourine. And it is the dynamic that emerges through this period of development and success which ultimately sows the seeds for eventual implosion. Those members of the group – viewed as peripheral and incidental to success – are no longer happy to bask in the reflective glory of the brand and, seeking validation, assert their own importance. Cue all out war and experimental solo projects.

Fundamental to achieving this will be a principled approach to change; respect; straightforwardness and honesty.

With success comes ego; not something we are necessarily short on in the health system. As our Groups bed down and hopefully become commercial success stories, we need to be mindful of those tell tale signs of discord. Regulating group conflict is, of course, a preoccupation of health managers. However how they deal with the emotional fall out of life at the sticky end of a ‘hub and spoke’ model will be the ultimate determinant of success.

Last Tuesday Croke Park was, once again, heaving with sweaty Groupies, eager to be part of the folklore of the most radical reform of the history of the Irish health service since, well,  I guess the eh…. last most radical reform of the Irish health service a couple of months ago. Whilst the post gig reviews were mostly positive, there was a definite air of reserve about the whole event. They came to see Zeppelin; they got Status Quo.

We all want the Groups to work because we are tired of singing the same old song. We want sparks to fly and magic to be made. We want them to be epic. Fundamental to achieving this will be a principled approach to change; respect; straightforwardness and honesty.

Everybody wants to the front-man but remember, in the band of life somebody’s always left holding the tambourine.