Are institutions on life support?

Institutions on life support

Institutions in crisis?
Battle of Ideas 2013
Cinema 2, Barbican Centre,
Saturday 19 October 2013 

From the failures identified by the Francis Report into Mid-Staffs NHS Foundation to the fall-out from the Savile scandal at the BBC, Britain’s institutions seem to be in the grip of perpetual crisis. From Leveson to the Hillsborough and LIBOR inquiries, high-profile stand-offs between Conservative ministers and the civil service and police seems to indicate considerable internal disarray.

Little wonder, perhaps, that the whistle-blower is hailed as the last true public servant. Why have Britain’s institutions, once famed for their strength and resilience, now become so vulnerable to criticism?

Can anything be done to restore or rebuild trust, or do we require entirely new institutions fit for the challenges of the 21st century? Do the now familiar calls, in the wake of a new controversy, for a public inquiry and tougher independent regulation offer reassurance, or only foster further suspicion of wrong-doing? Can constantly affirming a commitment to transparency lead to damaging public rows rather than effective change?

Jessica Crowe
executive director, Centre for Public Scrutiny
Jon Holbrook
practising barrister, writer on law
Ben Lucas
principal partner, RSA2020; chair of public services, RSA
Alastair McLellan
editor, Health Service Journal
Robin Walsh
graduate medical student; co-founder, Sheffield Salon
Robin Walsh graduate medical student; co-founder, Sheffield Salon
Tiemo Talk of the Town review

British institutions apparently are in crisis and this is due to the public’s declining trust, political representation drawn from two narrow a vocation and therefore unable to represent the mass and a lack of honest conversations according to Jon Holbrook (Barrister).


According to Ben Lucas (principal partner of RSA2000), we need a strong sense of coherent values. However the government has replaced internal coherence with external forces i.e. regularity audits such as OFSTED and Litigation and this approach will not work.

Too much regulation/targets are not helpful as it removes public sector workers from the real work of offering a quality service to support those in need. The whittling down of some of the functions that institutions perform is the way forward. It will restore professional autonomy instead of undermining professionals and their expertise.


An interesting thought was that given by Alastair McLellan (editor of Health Service Journal) who believes that the real crisis is existential in nature. Apparently the in-patient mix is dominated by people who are aged between 70-80 years old and are predominantly women. He states that these individuals expect to get ill as they get older and therefore the health services/hospitalisation is a natural progression.

Jessica Crowe (Executive Director – Centre for Public Scrutiny) argued that we may be “over doing it” with our concern in relation to a crisis; customer satisfaction is high. It is also not a bad thing to be sceptical and distrusting. However she did acknowledge that there is a rising concern about the level of dissatisfaction!

One thing is evident, in my opinion…..there is a crisis. Jackie Tapley (principal lecturer and associate head – University of Portsmouth) reminded us that in all institutions there are different professionals ‘cultures’ and languages used and this adds to the mix I guess when we consider objectives. It therefore seems logical to take the first steps of having a dialogue between those “in the field” doing the jobs and government. Transparency is simply not enough i.e stating what government want, we need to have an understanding of the situation and whether expectations put upon institutions are realistic or not.

Tiemo Talk of the Town

Further reading from Battle of Ideas 2013

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