The end of certainty…?
There was a time, say the popular press, that a life sentence meant – well, life. At least 20 years, possibly 30.
There was also a time when you trusted doctors implicitly and believed that drugs prescribed to cure illness, cured that illness. This was probably the same time that employees believed in, and companies promised, a “job for life”.
No longer, it would appear.
In 1966, Ian Brady received three concurrent terms of life imprisonment for three murders and is still in gaol, 39 years later. Today, mandatory lifers – that is, murderers – get an average of 14 years. There are calls to reduce this further, as prisons become overcrowded.
In the last decade, there have been some horrifying accounts of doctors – and nurses – harming patients in their care.
Harold Shipman was found guilty of murdering 15 patients, although he is suspected to have murdered more than 200 patients in his care. Nurse Benjamin Geen was found guilty of injecting vulnerable patients with drugs to bring on respiratory failure – resulting in the deaths of two elderly patients in Oxfordshire.
The ideal of the Hippocratic Oath in these instances has been severely tested, and with the erosion of trust between carers and patients has come an increase in complaints brought against hospitals for negligence. In May 2001 the National Audit Office estimated that the number of cases between 1990 and 1998 rose by 72% and estimated the net present value of claims outstanding to be £2.6 billion – double the 1997 estimate.
The introduction of NICE in the UK (the National Institute of Clinical Excellence) heralded the increasing scrutiny of the effectiveness of medicines.
For drug companies to market drugs that are don’t deliver the cures they promise seems preposterous. And yet, with tighter health care funding, NICE has taken a good, hard look at the marketing promises of the pharmaceutical industry and found some of them wanting, making UK doctors unable to prescribe certain drugs on the NUS.
The end of “jobs for life” is often said to date back to the late 1980s and the dockers’ strike. Then Employment Secretary Norman Fowler scrapped the 1947 National Dock Labour Scheme which gave dockers the right to minimum work, holidays, sick pay and pensions. Registered dockers laid off by companies bound by the scheme had to be taken on by another or be paid £25,000, meaning they virtually had a “job for life”. Despite strike action by workers, the scheme was scrapped.
So – have the certainties our parents knew disappeared? The story behind the statistics is always more complicated than the bare numbers...
For example, while 14 years might be the current average sentence, “life” can now be given for more offences than murder – not the case when Brady was sentenced. Life sentences are now given for serious sexual offences and other violent crimes and the number has more than doubled from 273 in 1995 to 625 in 2005. In 1963, only six men had been in prison for longer than 10 years. Seen from this perspective, justice might seem to be becoming more severe, not less.
The number of clinical employees in the NUS has risen more than 31% between 1996 and 2006 – so if there were “bad apples” in the NHS, even in terms of basic statistics, they’d be more of them. The rise in complaints of clinical negligence is likely to be caused – at least to some degree – by the new processes in place for patients to raise concerns. The discovery of the deadly Dr Shipman will also be due in part to increased monitoring.
And finally, evidence to support the disappearance of the job for life is scarce, despite the prevalence of the concept in work culture. According to figures from the ONS Labour Force Survey, from spring 2001 to 2005/6 there was an overall decline in the number of people in temporary employment, from 1.6m to 1.4m. And although tenure of the average job has declined, the decline is small. According to a Labour Market Trends article, the average job tenure in 1996 was 93.5 months but only fell to 90 months in 2001. Conversely, the proportion of people employed for 2-5 years has increased by approximately three per cent.
Perhaps the issue is less that the future is more uncertain – but that we are unconvinced by the figures and we feel insecure.
Despite a generally stable work environment, a 2006 global study about worker confidence identified the UK as having the world’s most pessimistic workers. It also found that the UK had the biggest percentage increase of employees who thought they might lose their jobs in the next 12 months, more than 30% of respondents.
This fear is not productive, and it’s not healthy. Perhaps “uncertainty” needs to be re-framed as an opportunity.
In times of wholesale change, presenting challenges as opportunities is seen as a cynical reframing by management of difficult times to reduce resistance. But, almost regardless of the motivation, perhaps a change of attitude towards ambivalence might be helpful, even liberating. There are times when uncertainty can be a good thing.
For example, while death and taxes are probably still the ultimate certainties, medical science can now postpone or even cure conditions that once were fatal. Once, you were certain to die from some forms of cancer. Ditto rabies and HIV.
Now, for many forms of cancer, treatment has evolved to either cure them (particularly through surgery) or to increase the life span of the patient. Prostate cancer survival rates have increased dramatically in the past 10 years, and survival rates for breast cancer are improving.
Steve Jobs has said publicly that being fired from Apple was the best thing that ever happened to him. He went on to start NeXT and Pixar, and met the woman he would marry. Eventually, when Apple bought NeXT, he returned, ironically, to Apple.
In the workplace, there are ways of helping people embrace uncertainty and enabling employees to find the excitement in the unknown.