Candour. For the children.

Candour: open, honest, frank, the quality of being honest and telling the truth, especially about a difficult or embarrassing subject. All in all, a good thing.

Openness and honesty are some of the Nolan principles of public life, the ethical standards those working in the public sector are expected to adhere to. Openness and honesty are key values for health and social care in NI. Everyone agrees. No big deal. What are you on about, Speccy?

Imagine this. The worst thing. Your sick child is at the the regional children’s hospital. They may have been sent there from somewhere else, because that’s where the experts are. Something happens and your child dies. Imagine the horror, the grief, the loss.

What if information about your child’s treatment was deliberately withheld from you? What if there was a cover up? What, even, if you discovered that your child’s death was avoidable?

Imagine that your child’s death was avoidable and that the behaviour of individuals contributed to their death. What if the arrangements to ensure quality and the culture of the organisation contributed to the death?

Imagine that very experience happening to other families.

The loved ones of Adam Strain (4), Raychel Ferguson (9), Claire Roberts (9), Conor Mitchell (15), and Lucy Crawford (17 months) don’t have to imagine. Those children died. Their deaths were avoidable. Some of the people involved in their care lied. Rather than tell the families the truth, people acted to protect reputations and avoid blame.

Adam, Raychel, Claire and Conor. Lucy’s family chose not to release a picture.

People who choose to work in health and social care generally do so because they want to help, support and care for others. They don’t set out to be the bad guys, but shit happens. The organisation wins.

Clearly, it’s not just me saying this. Mr Justice O’Hara spent 14 years investigating what happened to the children. It took so long because the health organisations involved were reluctant to release any information. 14 years.

The O’Hara report is a gripping read. Gobsmacking. What happened was truly awful. O’Hara didn’t just tell the tale, he provided 96 recommendations to ensure it couldn’t happen again.

Key recommendations are for a legal Duty of Candour, for both organisations and individuals. O’Hara’s experience taught him that professional ethical guidelines/ standards aren’t always enough to protect patients. That’s why he recommended that it should be a criminal offence to breach that duty.

“All that is required is that people be told honestly what has happened, and a legally enforceable duty of candour for individuals will not threaten those whose conduct is appropriate.”

The Department of Health have been leading preparatory work on the proposed Duty of Candour. Now they want to know what you think. Do let them know.

Do you want medical professionals & organisations to be able to continue to withhold or destroy information, mislead, or lie when something goes wrong. Or do you simply want to know the truth of the thing?

The Not Exams, a failure to care for our children

Northern Ireland has an education system that likes to test its children. Not only do we have a majority of schools segregated by denomination, but the post primary schools are often selective, choosing pupils based on optional testing. Obviously, not all selective schools use the same test- why would the ‘catholic’ and ‘protestant’ schools use the same system? Others are better placed to talk about the transfer/ selection process and the impact on 10 and 11 year olds, but it’s not all good.

After the wee folk have done a few years at secondary level, its time for more testing, similar to the system in England and Wales. There are GCSEs at 16 and A levels at 18. GCSEs allow schools another chance at selection, and A levels are the selection tool of universities. Both GCSE and A-levels are 2 year courses, with testing half way through. The children are tested by state bodies at 15, 16, 17 and 18.

The pandemic brought change. Last year a hugely discredited algorithm gave way to school produced predicted grades. There was to be no such confusion this time. Oh no. We were on top of things now, normal testing would resume, don’t even think of the alternative. *fingers in ears* lalalala, testing is good, testing is normal, make no preparations.

Until it was announced that there were going to be no exams. Schools should continue with virtual learning, and lots of assessment, because we haven’t worked out the alternative.

The alternative turned out to be assessments. No, not those ones. New exciting assessments, done in ‘high quality situations’. These assessments would be school created, but the exam board would issue a sample paper which might be useful. Yes, of course, you’ll need 3 examples of work done in these high quality situations. Probably best to do them with all the classes at once, maybe in a big hall, with a supervisor. Perhaps you could issue guidance on Malpractice in Assessment before hand. But no, these are not exams, you understand, just assessing what the children know.

Of course these are exams, sat in exam conditions. Instead of the local exam board setting and marking the papers, the school is doing it. And all will be completed by the end of next week- before the original exams were due to start.

It’s a mess. Children are stressed out. The communication from the school suggests that the principal has had more than enough of this shit, but doesn’t quite say that. Guidance and info updates for schools were released on a Friday evening, via social media. Teachers had no time to get their heads round requirements before trying to explain to the children. The schools have had a huge amount of extra work.

Goodness only knows what results will look like in August. For Girl 2, the predicted grade she got last year counts for nothing, rather than the 40% of her final grade it was designed to do. Her result will be based on 1 term virtual teaching only, one term face to face with four weeks out for isolation, and the current term of assessments.

Remember, this chaos applies to 4 year groups at secondary level. Across the region, thousands of pupils in years 11, 12, 13 and 14 are dealing with this nonsense. That’s more than half of the secondary school cohort. (I can’t find precise figures, but the cohort has 145,000 pupils. It’s not as simple as divide by 7 and multiply by 4, but it could be in the region of 75,000- 80,000 children. Many thousands.) Because they’ve had nothing else to worry about for the past year, because our Education Minister thrives on testing, because our children are being failed by the system every day.

Rites of passage

You know the sort of thing- a child takes a step, gets a sticker, stands on a stage, passes a driving test, gets dressed up for a formal occasion, joins in a riot. All while you stand proudly by, beaming at their progress, revelling in their joy. Great stuff all together.

Go back a bit. Look at the video I took from Twitter. I’ve not been able to get it out of my head. I’m old enough to remember the marching band coming down along Main Street for Billy, the tales of people being waved off to war, but I’d never imagined that sort of celebration for a riot in Belfast.

There are many reasons for the current tensions in NI. Poor leadership and governance, criminality, chronic deprivation, inter generational trauma, the need for a night out. There are genuine concerns about the impact of Brexit. Children are being encouraged to ‘earn their stripes’ by those involved in organised criminality, drug dealing and paramilitarism.

More of this sort of thing

Unionist politicians have stirred trouble, met with loyalist paramilitaries, raised the temperature. Now they’re tut tutting and staying at home, well away from the affected areas. That distance highlights one of the problems, lack of representation. Other issues continue to be educational & health inequalities. There’s been no ‘peace dividend’ for many in NI since the Agreement of 1998.

As I was writing this, news broke of the death of the Queen’s husband, Prince Philip. Oh, we wondered, surely those protesting their loyalty to the Crown would stop? Most did. Not all, of course. Some had been looking forward to some Friday night action, so went ahead. I don’t know how that affects their loyalty ranking.

It appears that paramilitary gangs will receive public funding to ‘transition’ to community groups. I thought we did that already.

Simply throwing money at such groups doesn’t work. Sustained investment in education, youth work, family support is required. Create opportunities, allow communities to move away from the control of drug gangs. Give it time and support. Believe that it’s work worth doing. Believe the people are worth doing it for.

Believe in people.

Celebrating: words

These collections of letters are incredible things. They can prompt us to emotion or to action. They deepen our understanding, or add levels of confusion.

Are we using the appropriate two/to/too? Or their/there/they’re? What does invalid mean? Does anyone readily grasp homonym/ homograph/ homophone? Do we really care?

At the weekend I was ‘helping’ Girl 2 with a piece of work. By which I mean, I messed it up. I was not helpful. I had tried to be, but I misunderstood my task. I reworded sentences and chopped out chunks thinking I was doing the right thing by reducing her word count. She had wanted me to help increase her word count…

In rectifying, I discovered a little bit of joy in letting her material sing. The shortened version was to the point, abrupt. Like bullet points. Using more words gave the information space to be seen and considered. Prose. Her research, her language, her personality, her self.

We can all enjoy words- fiction, lyrics, poetry, TV scripts, chatting, talks, discussions, papers, apps, websites, crosswords, word search, Scrabble, Countdown. I avoid word games and mostly read fiction- a mixture of commercial fiction, crime, literary fiction and whatever random stuff catches my eye. I watch television ‘bookclub’ programmes, and it costs me a fortune. I’m doing a brief online course on feminist writing. I read a neighbour’s book on professional arboriculture (not my usual fare) before its publication and had a grand time. Reading about Regency gardens while watching Bridgerton definitely worked. I wasn’t just looking at fancy frocks and handsome men, I was gaining an understanding of how society and arboriculture interact. Really. Stop laughing.

Storytelling is a big part of who we are, sharing and defining our experience. A tv show discussion between Damian Barr and Fern Brady had me shopping again. I‘m going to learn something. I might even be able to tell you a story.

Will Storr, the Science of Storytelling