As human beings, we tend to ignore the elephant in the room because we fear the consequences. Truth is a time bomb; the fuse is lit, and when it goes off we’ll all get blown to bits. Really?… It could just be that when it blows there’s nothing more than a lovely colourful (and perfectly harmless) foam fountain. Why do we fear the worst?
Duncan Brodie, a former NHS Director I interviewed for Undiscussables.com a while ago, questioned the logic of a health service that effectively works a Monday to Friday schedule when those who depend on it (i.e. require medical treatment) typically do not conform to an office hours only schedule when falling ill. I’ve also talked before about the notion that what is undiscussable in an organisation is, in and of itself, often undiscussable, and idea that stems from the work of Chris Argyris.
Reading a pointed (as ever) and thought-provoking post by Roy Lilley at NHSManagers.net recently, what struck me is that the two states of undiscussability that Arygris describes may need defining separately.
The undiscussable undiscussable
A subject that is taboo and has yet to reach the stage that it can even be alluded to.
Sexual and physical abuse, whether that alleged to have taken place by Jimmy Saville or within the Catholic Church, often seems to fall into this category. The difficulty that those who have been abused have in having their stories heard, let alone believed, might suggest that this pattern is particularly difficult to break. In organisational/work contexts, they can arise also.
The discussable undiscussable
The taboo alluded to, hinted at, ‘known’, tantalisingly out of reach
Writing that heading I question my logic momentarily, and it is this category that Roy Lilley describes powerfully in another post re mortality rates in the NHS. Analysis of three years of data and four million patient outcomes have revealed a statistically significant increase in mortality rates the nearer to the end of a working week you have elective (i.e. non-emergency) surgery.
It’s a bit like ‘Area 51’, the US Military…. It’s an open secret. Everyone knows it’s there but the US Government pretends it isn’t. Just like MI5. Everyone knew about it but it took the British government until 1994 to admit it existed. And, The Stig, BBC’s Top Gear test driver; apparently everyone knows who she is.
Elephant in the Room, Open Secret.
This is the ‘classic’ elephant: the thing we all know is there but do not want to acknowledge and/or discuss, yet there is tacit agreement that it exists. The undiscussable undiscussable is different: there is no agreement, tacit or otherwise, of existence because the consequences of doing so are too high for some of those involved. Or because those who witness what is happening cannot bear the consequences of even acknowledging it (the bystander effect)?….
There is no easy answer, although I am drawn to two suggestions, both sparked by Lilley.
Data, data, data… Give me more data
The mortality rate issue above was revealed and discussed in sharper terms because not only was there data available, it has been used to make sense of complexity to reveal an underlying pattern. With data, you get to a conversation that takes you closer to a decision based on reality rather than the shifting sand of opinion.
Truthfulness is a competency
In the post on mortality rates, Lilley laid out a challenge for leadership in and around the NHS, in the context of the recommendations in the Francis Report calling for a new approach to leadership practice.
Truthfulness emerges as a key competence when an organisation is faced with the unachievable. Soldiering-on, to protect reputations and careers, not confronting the real issues leads to an environment fertile for fraud, fictions and fabrications. Obsfucation, cover-ups and smokescreens disguise the actualite and defer the inevitable.
Relative to the NHS, and given my own experience working with people within the UK health sector, I would agree. What is more, I am not aware of any psychometric tests, competency frameworks or similar that explicitly seek to inquire into the capacity of individuals in organisations to speak the(ir) truth, relative to role and context (suggestions welcome if there are). And…
A challenge to leaders and leadership development practitioners
My experience of working with(in) organisations and with leadership teams is that the desire for simple answers and certainty undermines those who make the case for slowing down to seek more data in order to establish what is real and not real, what is fact and not opinion. This desire for simple answers and certainty, delivered in as short a time as possible, places a primacy on an illusory form of truth. ‘Directness’ and ‘honesty’ are not the same as truthfulness, the essence of which is grounding in fact or reality, and means you are exposed to the possibility that reality may not be how you imagine it. So a couple of questions, relative to the taboos and challenges in your organisation:
- To what extent do you know what is true (real), and based on what data?
- To what extent are you prepared for the truth, whatever it is, or to speak a truth?
- To what extent is your organisation ready for the truth?
- What are the consequences, all of them, of speaking out and not speaking out?
(Ed: This post was initially published on Undiscussables.com)