Monday, 2 January 2012

Time


I've been reflecting on the value given to time in our society just lately. This was partly brought on by the depression I felt at reading the Care Quality Commission's October report which found that half of all the hospitals they looked at were failing to care properly for elderly patients.

http://www.nhs.uk/news/2011/10October/Pages/report-on-elderly-hospital-care-released.aspx

The two areas most commonly cited for concern were nutrition and personal dignity. In the Health  Service, we seem to have locked ourselves into a system in which there is quite simply insufficient time to do the things that are needed to help people who might be slow or confused or frightened or uncooperative; this trend began many years ago. I remember as a very junior nurse when the overlap between shifts was cut as 'unnecessary'. This meant that reports between shifts were hurried and small aspects of attention to care disappeared -  long term patients no longer got their hair washed, deaf and blind patients had to manage appointments in other departments of the hospital unaccompanied and equipment was not so regularly inspected and cleaned. Tiny, seemingly insignificant little things that contributed, over time, to a great avalanche of care not given - care that, if you listened to them, mattered very much to patients. Seemingly, now, levels of staffing in many hospitals have reached the point where it is not possible to take the ten minutes needed to feed a patient their lunch or to deviate from the work plan should someone need immediate attention to go to the toilet. 

Last week's paper brought the news that GPs' pay will be increased take account of the fact that they are going to be directly responsible for commissioning and organising hospital care for their patients. The aspect of this news that alarms me is the fact that we are asking already stretched GPs to do yet more work - paying people more does not produce more time in which they can get things done.

It's not just in the area of health and social care that time is squeezed - speak to teachers, sales and delivery sevices, lawyers, local government officials. It seems that the concepts of management which largely shape our working lives give a value to (and often spend time measuring) almost every aspect of our lives except time itself. I recently taught a module for a university whose systems of evaluation and examination were so complex that I spent more time reading the regulations than marking the papers. All this eats into the time available for preparation and consequently into the quality of the learning experience for the students. It's always very difficult to argue in this way because those who manage, inspect and appraise will point out that unless there is constant accurate inspection we do not know what quality of service is being achieved. However, I think that we are beginning to discover that too much measurement in ways that are driven by targets often questioned by members of the trades and professions concerned is not producing the required results. This is sadly becoming all too clear in the case of the care of the elderly by health and social services. We have created systems that control individuals and try to sqeeze out of them more than the time avaialable can deliver. Meanwhile others are unemployed and can find no way to make a contribution to society - over a million young people without jobs.

 Of course managers are only servants of the social expectations that are laid on them. I am not singling them out for blame. And I am not arguing that we should not make good use of our time and be held to account. But let's ask a few questions about what 'good' means. William Penn once wrote that time is what we most want but what we use worst. In our society, we have the odd situation that we complain about being under pressure of time most of our working day and we say we struggle to have enough time to spend with our children and families, yet the self help section in bookshops is crammed with books giving advice about how not to waste time or how to avoid procrastination.  This paradox is mirrored in the unhealthy balance in our attitude to food - we are bombarded constantly by a ridiculous choice of foods, yet we, as a society, are fixated on dieting. I have friends from other cultures who are as frankly bewildered and even affronted by our dependence on diaries, watches, 'timeslots' and schedules as they are by the overwhelming range of foods available in our supermarkets.

At the start of another year, then, you can guess what my resolution is going to be! Ministry as an archdeacon calls for a lot of careful forward planning to fit things into the diary. Many of the things I do support occasions and projects that are important to the people concerned. As with everyone, I cannot simply fail to keep commitments. However, I would like to adopt a pace that allows more time to respond to the unexpected, to linger and listen, to be caught in the kind of 'doing nothing' or 'wasting time' that results in deeper relationships and new ideas. Isn't it usually heart-warming when someone appears to want to spend time with you - to linger and ask one more question or tell you something that certainly would not have come out in a rushed and scheduled exchange? So this is going to mean starting the day with more time for prayer, cramming less into the diary, being willing to say, not 'no', but 'please could you wait a little?' It's going to mean expecting things to take as long as they take and not trying to get more things done in a morning than can be done well. I guess the key to all this is taking responsibility before God for my own time - not allowing myself to become so much a slave to expectations that I allow myself to blame others for my lack of time. In 2012 I'd like to make a small stand for a more healthy attitude to how we use our time!    

Mervyn Morris, the twentieth century Jamaican poet and academic, puts it like this.

Give T'anks
Anodda year of love.
Give t'anks. An' pray
dat God-Above
will seh to time, No way.
No way:
de word is love.


         

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