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26 June 2013
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Moral leadership in medicine

Professor John Ashton CBE, joint director of public health for NHS Cumbria and Cumbria County talked on the TV news recently of a crisis in moral leadership in the public sector. I wonder if he has been reading one of the most inspiring books I have read over the last year: Moral Leadership in Medicine, by Dr Suzanne Shale (CUP 2012).

The author based her book on a series of structured interviews with medical leaders and defines the biggest problems they faced in terms of moral conflicts between differing proprieties, fiduciary, bureaucratic and collegial, ie balancing the need to do the right thing for patients, their organisation and their colleagues. Probably the most interesting aspect of the book for me is around the proprieties associated with medical harm, inquisitorial and restorative propriety, that is doing the right thing in investigating harm and then in making amends.

I see that Sir Duncan Nichol, NHS chief executive between 1989 and 1994, at the Select Committee talked about the culture of defensiveness in the NHS. This, in my view, is related to the poor restorative propriety of the service. In particular, both collectively and individually, doctors and NHS organiations are poor at dealing with the consequences of harm in their dealings with complainants and potential litigants, particularly in allowing those harmed to be their moral interlocutors.

Attention to inquisitorial propriety in the development of the NHS would also tend to a more open, fair and honest investigation of incidents, putting the interests of service users before the service and the profession.

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About the author

Michael Roddis's picture

Michael Roddis

Mike qualified as a doctor in 1978 from Manchester University and became a consultant chemical pathologist in 1985 in north London. He became clinical director in 1988, gaining his MBA in 1990. In 1994 he moved to the Homerton hospital as clinical director for surgery and clinical support services and became medical director of The Princess Alexandra Hospital in Essex in 1996. He left the NHS in 2002 to become an independent medical management consultant.

His company, which currently has 15 associates, specialises in working with doctors to improve their performance, focussing on individual and team coaching, behavioural coaching, diagnosis and interventions in dysfunctional teams, leadership development and working with trusts to identify problems with capability and conduct. He has extensive experience in undertaking case investigations and helping Trusts prepare for conduct or capability hearings of consultants in the NHS and in investigating performance concerns in the independent health sector.

Mike runs workshops for the MDU and others on communication skills, ethics and medical law, professional challenges in medicine, preparing for consultant roles in the NHS and in setting up in private practise.

He teaches peer review skills for the NHS’s National Screening Programme.

Mike sits on the CORESS (confidential reporting system for surgery) Advisory Committee at the Royal College of Surgeons. He is a consultancy advisor to the Royal College of Pathologists.

His publications include articles on moral leadership in medicine, dealing with difficult doctors, senior medical career development, image management, the need for medical management skills, team working and doctor-employer relations for the Health Service Journal, the BMJ group and Independent Practitioner Today.

Mike is also Group Medical Director for BMI Healthcare Ltd, the largest provider of
independent hospital care in the UK.


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