Cultures of caring: healthcare ‘scandals’, public inquiries, and the remaking of accountabilities Seminar

Event details

In the UK, inquiries into high-profile 'scandals' repeatedly point to the pivotal role ‘culture’ plays in healthcare failures. Notably, the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (2013) was overwhelmingly a comment on culture; the Trust was characterised as having an 'insidious negative culture involving a tolerance of poor standards' (2013: 10). More recently, the Report of the Morecambe Bay Investigation (2015) provides a stark illustration of how uncompromising working relationships between different professional groups, unwillingness to question taken-for-granted practices, and zealous pursuit of professional ideology combined to produce an organisational culture so dysfunctional as to culminate in the deaths of eleven babies and one mother. As a sociotechnology of accountability, public inquiries signal a step change in how personal accountabilities of healthcare professionals are being configured. By focusing on problematic organisational cultures, these inquiries apparently resist the individualising of accountabilities, and seek to make visible and distribute a collective responsibility for healthcare failures. Drawing on The Report of the Morecambe Bay Investigation (2015), I question what it means to make culture accountable and examine the tension between individual and collective incarnations of accountability. I show how the inquiry report enacts new and old forms of accountability: conventional forms that position actors as individuals, and actions as having distinct boundaries that can be isolated from the ongoing flow of care; and transformative forms that bring into play geographical location, professional ideology, as well as a collective cultural responsibility.