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Authoritative Leadership and Relational Power

 

An opportunity for Theresa May and Jeremy Corbyn

A few years ago I wrote an editorial on authoritative practice in child protection. The concepts I explored in that editorial, and later developed in our 2011-14 Triennial Review of Serious Case Reviews have formed the basis of what I have striven for in my own safeguarding practice. It seems to me that these principles of authoritative leadership are what is so badly needed in today’s political storms.

At the heart of authoritative leadership are three values of authority, empathy (or compassion), and humility.

 

In her speech yesterday, Theresa May reached out to the leader of the opposition, Jeremy Corbyn, offering to work with him to try and find a way forward for Brexit. In doing so, I believe that she was showing the marks of a true leader, and opening an opportunity for both of them to display the kind of authoritative leadership that our country so badly needs. She has come under intense criticism for doing so, both from the media and from her own party, with her approach being condemned as a sign of weakness.

Far from being a sign of weakness, I think Theresa May has shown both courage and integrity. I hope that Jeremy Corbyn will show the same courage and integrity in response.

 

Authority

In my 2013 Editorial, I suggested that

‘Authority, properly understood, is not assumed or unregulated power, but something that is earned, and is dependent on the holder’s character, knowledge and skills as much as their position.’

I may not agree with everything that either Theresa May or Jeremy Corbyn say, do, or stand for, but one thing I admire in both of them is their integrity. It seems to me that they both hold strong principles and genuinely are striving to do what is best for this country and its people. They have held to these principles, even in the face of criticism from within their own party.

It seems to me that true authority arises not from unilateral, assumed or unregulated power but from relational power, and this is what is needed in our current political climate.

‘Relational power may be seen as including three elements: the ability to be actively and intentionally open to the world around us; the capacity to create ourselves out of relationships with others; and the ability to sustain internal relationships, to influence others by having first been influenced by them.’ (Mesle, CR. 2016 Relational Power, Personhood and Organizations)

 

Empathy

To be open and attentive to the rights and needs of those around us, to actively listen and learn from them, and to support while being prepared to challenge and not collude are marks of true leadership. This is the kind of political leadership we have seen recently in New Zealand Prime Minister, Jacinda Ardern in her response to the shootings in Christchurch.

I was challenged recently to listen more to those who are arguing in favour of Brexit, rather than remaining entrenched in my own views; to seek to understand why others take the position they do, and to see that in terms of those who see leaving the EU as a route towards greater justice. I may not agree with their conclusions, but my friends were absolutely right – I do need to look at the other side of the coin and not dismiss those views that run counter to my own.

In her speech, Theresa May described Brexit as something ‘that the British people voted for’. It may be just a small change in language, but this came as a breath of fresh air amidst the ongoing claims that Brexit represents ‘the will of the people’. By referring to leaving the EU as what the people voted for acknowledges that this was what 17 million people voted for 3 years ago, in response to what has been shown to be a flawed referendum. It leaves the door open to recognising that this may not any longer represent the will of the people. Perhaps in this, our prime minister is showing the seeds of empathy and listening.

 

Humility

Humility is the value that is perhaps most misunderstood and frowned on in relation to authoritative leadership, and yet I believe it is the most crucial component of such leadership.

Humility needs to be understood, not in a derogatory or self‐deprecating way, but as a positive quality that enables leaders to recognise their own limitations, to acknowledge and use their skills and strengths, and to seek to improve their leadership. 

Humility recognises that none of us possesses a monopoly of knowledge and skills; that we are interdependent on each other; and that we all have weaknesses as well as strengths, so we need to be constantly seeking to learn and to grow.

So much of what I see in parliament at the moment is arrogance, entrenched positions and self-interest dominating the debates. I long to see confident humility displayed in our leaders. I believe we caught glimpses of it in Theresa May’s speech yesterday. Jeremy Corbyn has the opportunity to take the same path. And, if they come together, I believe they could find a positive way to take us forward, whatever the final outcome may be.

 

A second referendum?

If Theresa May and Jeremy Corbyn wanted to show real leadership, they could do far worse than seeking to ascertain what the British public want now, in 2019, with the full facts before them and clear options to choose from. It may well be that a majority would still want to leave the EU and would support a deal to achieve that. If so, the government would have a much clearer mandate to proceed. Conversely, if a majority now voted to remain, a clear reappraisal would be needed. The government has respected the outcome of the referendum by seeking to come up with a deal; true democracy should now return to the people with that deal and any alternatives. That would be authoritative leadership in action.

 

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Presenteeism and the culture of indispensability

After stepping down from my clinical work in November, I received a lovely card from one of my patients thanking me for being his doctor and expressing his hope that ‘my new doctor will be as nice as you’.  Six weeks on, and we are no closer to finding a replacement, nice or otherwise!  So, while I don’t regret cutting back on my work and dropping my clinics, I do feel both saddened and frustrated: my decision is leaving my patients unsupported, my colleagues stretched, and my secretary struggling to troubleshoot and keep things ticking over.  I knew this was a possible, perhaps even likely scenario, but inevitably I feel some responsibility for that.

And yet, I am not indispensable.

 

Why doctors don’t take sick leave

bmj cover sick leaveA leader in this week’s BMJ highlighted how doctors tend to have much lower sickness absence rates than other healthcare workers (typically 1-1.5% compared to 4-5% for all healthcare staff).  There are many reasons why this might be so, but one of the most significant ones is a culture in which doctors avoid taking time off sick so as not to let others down – whether their patients or their colleagues.  This is admirable to a degree, and yet it betrays a deeper, potentially destructive culture of indispensability.  We have a tendency to believe that the service won’t function without us.  That, in turn, feeds a driven-ness that leads to long hours, apparent busyness and a kind of bizarre pride in always being overstretched.

This isn’t limited to doctors but seems to be a culture that pervades all professions.

It seems to me that this is an inherently dangerous and damaging culture.  Clare Gerada, medical director of the Practitioner Health Programme, commented that

“a common personal impact on doctors who are ill is that what goes isn’t their competence, it’s their compassion for patients”

 

Being overstretched

I suspect the same is true, not just for doctors who are ill, but for all of us when we are overstretched.  We can carry on performing our roles, but find it hard to offer that human touch: something that has perhaps been reflected in some of the scandals in care homes for the elderly and vulnerable adults in recent years.

I suspect that another element that goes by the board when we are overstretched is humility.  When we are constantly struggling to get things done it becomes increasingly difficult to acknowledge our own limitations, to take time to reflect, to learn and improve, to accept our need of others.  And ultimately, to recognise and value the very real contributions that we, uniquely, bring.

Ultimately what goes is also competence, though typically this comes some way down the line.  The reality though is that a driven culture of indispensability threatens effective working and patient safety.  I still remember the feeling, half way through a 104 hour shift as a junior doctor, sitting at a nursing station to calculate a drug dose, and realising that I couldn’t even think straight enough to carry out a simple 2-digit addition without the aid of a calculator, and recognising just how easily I could make a potentially fatal mistake.

That is why I am supportive of my junior doctor colleagues in their dispute with the government over a new contract.  The proposed industrial action is not just about pay – I would find it difficult to defend if it were – but about patient safety, and about challenging this pervasive culture with all its inherent dangers.

 

Challenging the culture

And I, too, will continue to challenge it, in my small way, by attempting to live and work in a way that isn’t indispensable.  I know I will continue to feel some responsibility for the gaps created by my cutting down my hours.  But I know, too, that since doing so I have felt more motivated and inspired, and been able to give myself more fully to those aspects of my work which are continuing.  I hope, ultimately, that will be of far greater benefit to my colleagues and to the children and families I am seeking to serve.