Timstevensshh’s comment on Surplus Safety really gets to the core of the issue…
Bill makes a good point as did Emerson: “things are in the saddle and ride mankind”. For two generations enterprise risk management has been riding mankind beyond the point of moral fatigue.
Thus exemplars like the “fall prevention strategy” have evolved into an end in itself. Surplus safety reminds us that while these tools have a rightful place, they should be seen as a means to protect a life worth living not vice versa.
Meaning lies at the heart of our work. Without meaning even the best intentioned systems degenerate into tyranny.
Tim Stevens says
April 16, 2012 at 9:02 amThanks Bill for putting my post on your blog and for your generous comments. It was great to meet you and see June and Paul again in Ireland. We did not really have time to discuss regulation at great length. So I will expand a bit here. I’m rather taken by the writings of Michal Albert. However I’m far too bourgeois not to be a wee bit dubious about how practical or even desirable his alternative to capitalism would be in practice. However I think the principles of participatory democracy that he and others like Noam Chomsky have beautifully articulated in Parecom are highly relevant and achievable as a mode of governance in extended care settings.
Unfortunately in Ireland real democratic oversight that ensures that the voice of residents, their significant others, and people in their wider community have due influence on service design and delivery has diminished over the years. This is because executive powers have been ceded to a bureaucratic gravy-train called the Health Information and Quality Authority. No doubt this is in line with a highbrow global scepticism about the effectiveness of local networks of interpersonal trust that have traditionally and in fact will continue to bind sustainable communities.
I’m afraid in the medium term the order of the day is a rather grey and drab apartheid; on one side of the tracks you have a gated community of scrutinizers. On the other side of the tracks you have the scrutinised that spend half their life covering their backs with soul destroying tick boxes, copious care plans, meaningless narrative notes and pointless policy’s. The rest of their working life is spent with one eye constantly trying to disengage from those warm human interactions that keep distracting us from penmanship. In other words the human subject has been captured by systems, processes and slogans like “accountability”, “auditability”, “patient safety” and “good governance”.
Most of it is proselytised in good faith and not all of it is unreasonable. But like most things it can have unintended consequences. One might even use Milton Friedman’s favourite euphemism: “Externalities”. And I am not simply talking about deforestation (the deciduous kind) and polluting the environment with information overload and paper pulp. It has placed enormous pressures on institutions. Fortunately, in places that have experienced the benefits of the Eden philosophy it also creates a great deal of cognitive dissonance. This may be uncomfortable but it is also vital because it encourages critical engagement. Indeed that is why I have taken your council and started to scribble down my thoughts. It really would be unbearable to see a return of a nameless ageist malady whose symptoms have, thanks to your organisation been taken more seriously. But making the pathology of loneliness, boredom and helplessness credible is one thing, understanding its aetiology is quite another. I think “surplus safety” is a useful conceptual device in this regard. It reminds us that we are dealing with a social disease; a churlish condition or canker that ends up targeting the very people who provide employees like me with such rich, meaningful and rewarding work.