In today’s Viewpoint on the BBC website, England’s Chief Medical Officer Sir Liam Donaldson argues that
Sixty years after its foundation, the NHS needs to learn to apologise more often. And it needs to learn to mean it
Sir Liam’s piece deals with the lack of apologies and action by the NHS when things go wrong for patients and their families. I have some experience of this from my grandfather’s final days. The conduct of certain staff around that time and during the aftermath shaped some of my beliefs in what was a very dark and challenging period of my life. My family and I have moved on but our faith in the NHS was shattered by those events.
Sir Liam’s piece, being aimed at hospitals, is specific to the National Health Service. However, there are lessons for us all in what he writes. Whether corporate or not for profit, professional or private, businessman or personal, we all need to be able to accept that we have made mistakes and to apologise sincerely for them. Note the word “sincerely” there. Sir Liam offers an examination of what a sincere apology is.
When the British bankers recently appeared before the House of Commons Treasury Select Committee they apologised. But afterwards, some commentators remarked: “Their apology did not seem sincere”.
So what is a sincere apology? How is a patient to know whether the apology means anything to the person delivering it? Can the apology be judged on the way that it is spoken, the presence or absence of a look of compassion in the eyes? Is it all in the timing?
Sometimes apologies are used superficially, to deflect criticism. A statement may initially look like an apology – “We are very sorry that you are unhappy with the service you have received” – but on closer inspection there is no apology at all.
A true apology faces up to the reality that somebody has suffered due to the actions of others.
A real apology has the power to transform. The person receiving the apology knows that they have been listened to, and that there is true regret.
The person making the apology accepts their own or their hospital’s part in the error, and feels empathy for the person who has suffered.
Apologies can be transformative for the whole National Health Service as well.
When an institution offers a genuine apology, the victim of the error is placed at the centre of its concerns. No institution can change or improve until first it recognises there is a problem.
This can and should be easily transferred to every other aspect of life. When I wrote about call centres and customer service I mentioned the unacceptable conduct from an operative in a well known bank’s outsourced call centre and how I had to challenge the call centre operative and demand to speak to his supervisor. And I mean demand.
The supervisor apologised for his subordinate’s actions. Quite whether the supervisor acknowledged that his subordinate’s conduct had caused suffering and felt empathy towards my partner I do not know. Sir Liam continues:
Apologies also need to be followed by action. Repeated surveys show that when a mistake is made, what patients want is not only a full apology but to know that action has been taken to prevent it from happening again, so that no other family can suffer in the same way.
The supervisor said that a formal complaint would be logged and that the operative would be reminded of his duties and commitment to customer service. Action following an error and a challenge to that error. Again, this is something that is easily transferred to the worlds in which we live and work.
I once had cause to make a formal complaint about a senior colleague who had overstepped boundaries and, in my view, had done so in a way which was professionally embarrassing to me. Eventually what purported to be an “apology” was forthcoming but was, in my view, an attempt to jutify the conduct about which I had complained. By Sir Liam’s definition, that “apology” was nothing of the sort.
Any organisational culture which does not ensure that people – particularly senior officers – recognise when they have made mistakes or caused offence and apologise sincerely for those mistakes is deficient.
In conclusion, the lesson is clear for all of us, regardless of where we live and work. When we make mistakes, we should apologise. Apologies should be sincere recognition that wrong has been done to a person or people and a commitment to learn from that mistake so it isn’t repeated.
It’s not rocket science. Sir Liam’s article continues and has more excellent content. It is well worth reading and bookmarking.
Update, 18th March 2009
In the US, Senator Charles Grassley has not held back in his criticism of the executives of troubled insurance group AIG:
“I suggest, you know, obviously, maybe they ought to be removed,” Grassley said. “But I would suggest the first thing that would make me feel a little bit better toward them if they’d follow the Japanese example and come before the American people and take that deep bow and say, I’m sorry, and then either do one of two things: resign or go commit suicide.
“And in the case of the Japanese, they usually commit suicide before they make any apology.”
Now whether or not you agree with Senator Grassley’s comments about executives committing seppuku there is an excellent point here. When Japanese executives apologise (as in one case here and a discussion here) they are seen to do it publicly and seem to genuinely understand that their failure has inconvenienced people. The “honourable thing” to be seen to do in cases of major failure is to apologise and resign.
If one looks at ToryRadio’s Tweet about today’s Prime Minister’s Questions, we can see that Gordon Brown has apologised for the failures at Stafford Hospital which led to over 400 people “dying needlessly” but not for the economy’s problems and the news that there are now 2 million unemployed and claiming benefit.
Was Gordon Brown’s apology genuine according to Sir Liam’s definition? I’ll let you decide.