Being asked to speak at the Quality and Safety in Healthcare conference in Paris. This is a significant event with 3000 delegates from all over the world focused on improving healthcare in many different systems. This was a great opportunity to share the lessons from Collaborative Leadership and to explore how this approach can help the health system improve. So how can it be that attending an event full of dedicated and enthusiastic individuals left me feeling depressed. I attended a series of lectures from significant healthcare individuals sharing best practice and new ideas and I heard horror stories of situations when the systsem fails and the impact on patients. By the end, the phrase that resonated most clearly with me was ‘patient-centered care’. there seemed to be a desire to engage and connect with the patient but also a realization that the health professionals and the patients were not listening to each other. How has it come to this?

As one the few presenters at the conference from outside the health system, I felt that the system is rather closed with a history of only listening to itself. In addition, the healthcare workers have become strangely separated from the patients – and the consequences are dire. As we know, gaps and interfaces are the challenges for leaders and, health, there can be no more critical interface than the relationship with patients. It is hear that health leaders need to encourage new relationships, effective conflict resolution and the necessity to share control over the patients health care plans. this seems obvious when looking into the system but appears radical when listening to healthcare professionals.

The way ahead may be found in a wonderful book written by a manager and clinician in the UK health system – Intelligent Kindness (Ballatt and Campling). In the absence of a magic wand, this book understands how a system which aims to care can become thoughtless and sometimes cruel. and, similar to the messages in Collaborative Leadership, this book prescribes a type of leadership which is focused but also sensitive to staff and to patients. Without some real change in how the health system is lead, there is a risk that this system will sink under the weight of new demands and limited resources. the consequences are not worth thinking about.