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Questioning the habitual and taken-for-granted
  1. Deborah Kirklin
  1. Correspondence to Dr Deborah Kirklin, UCL Division of Medical Education, Whittington Campus, Highgate Hill, London N19 5LW, UK; d.kirklin@ucl.ac.uk

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In the fifth of a series of papers, Alan Bleakley and Rob Marshall1 “use thinking with Homer as a medium and metaphor for questioning the habitual and the taken-for-granted in contemporary [medical] practice”. The importance of being prepared to challenge the status quo has been brought into sharp and painful relief by the on-going scandals about the care, or rather lack thereof, provided to some National Health Service (NHS) patients, most notably in The Mid-Staffordshire NHS Foundation Trust.

The status quo in Mid-Staffordshire was one of poor care, high mortality rates and widespread patient concern, compounded by managerial and clinical inaction. Appalling care had, quite literally, become habitual and taken-for-granted. As the inquiry report makes clear, there were many warning signs, but because of “an engrained culture of tolerance of poor standards, a focus on finance and targets, denial of concerns, and an isolation from practice elsewhere”, as well as professional disengagement whereby “clinicians did not pursue management with any vigour with concerns they may have had”, nothing was done to improve the situation.2

With hindsight, it seems all too obvious what should have …

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