Addiction Economy industries lack of trust

Addiction Economy thought for Today - Addiction Economy companies we know are fundamentally untrustworthy. They are fully aware of the design of their products will cause harm, but make strenuous efforts to hide that from the world.

But cover ups are a widespread problem, as we have seen from the appalling tragedy of the Infected Blood and Post Office scandals and so many more. All sorts of seemingly trustworthy organisations contort themselves to hide the truth about serious problems with tragic results.

I wrote this short paper for the Irish national health service the HSE as part of a project I was doing with them on trust, trustworthiness and the health service. The biggest cause of public distrust in health services is the belief that they are not being open about problems when they happen, owning up to mistakes, admitting responsibility. As we can see with the infected blood scandal and others, this fear is not unfounded.

"Reviews of serious healthcare failures in a number of European countries have all identified failings in the 'culture' of organisations as a major underlying cause. To anticipate problems or respond effectively, an open or ‘just’ culture is required — one which welcomes early warnings of issues, encourages people to speak up about concerns and responds without blame and retribution to problems when they happen.

"At the heart of the problem is a fundamental and outdated view of the motivations of human nature and what works to prevent future mistakes. The mental model behind blame cultures (and the legal system, regulation and social justice too) starts from the incorrect belief that people are the problem and deterrence is the key. (RE ADDICTION ECONOMY - another example of lack of understanding of system conditions and blaming people)

"Deterrence and sanctions are the starting point for its approach to preventing medical accidents. The system focuses on compensating victims through a fault/liability rule and a deliberately designed adversarial process which assigns blame to individuals alone. It was created because at the time it was considered the most appropriate way to stimulate future improved conduct. It actually impedes it. The Medical director of the Swedish Patient Compensation Scheme goes as far as to say that looking for scapegoats through a litigation systems based on fault is ‘a very efficient way of killing more people.”

The system focuses on blaming individual doctors and doesn't consider that as research finds “Safety issues and related incidents are often the result of complex local, organisational and system-wide processes, with similar events recurring repeatedly in different places across the healthcare system."

I was doing a bit of work on this with regulation and dispute resolution guru Christopher Hodges OBE before he got a bit busy with sorting out the Post Office Compensation Scheme (!) and I draw on his work to outline the issue and explore what can be done instead.