The new NHS needs first-class minds to succeed

According to the writer Andre Weil, humanity is divided into first, second and third-class minds. Crucially, this division isn't by IQ but by originality and openness.

The GP Record, by Fran Orford
The GP Record, by Fran Orford

Those with first-class minds are freethinkers, untrammelled by others' opinions and not bound to the past. They recognise their own limitations, seek advice when out of their depth and willingly change their mind if new evidence appears.

Second-class minds are not particularly inventive and certainly not as thoughtful. They don't like to be outshone; they will stubbornly defend their existing opinions; they envy those with first-class minds and go to great lengths to silence or sideline them.

Third-class minds don't think at all: they go with the majority - which usually means what the second-class minds are thinking.

You can see where this is going, can't you? How many NHS committees are run by second-class minds, there because they enjoy the power? Unfortunately they can also ensure that the original thinkers in their team are marginalised and outvoted.

This is a crucial problem for the new clinical commissioning groups (CCGs): colleagues have remarked on how frequently new posts are being taken up by the same old faces making the same ineffectual decisions.

The new NHS needs first-class thinkers to run it and a fresh look at the way it operates. CCG leaders don't need to be particularly inventive themselves - but they do need to be open to suggestions, ready to admit mistakes and, above all, willing to try new approaches without preconception or bias.

The difference between a first-class and a second-class mind isn't about IQ. It's about open-mindedness, a readiness to take advice from others and a refusal simply to go with the flow. Anyone with a second-class mind can become a first-class mind just by changing their attitude - usually by becoming more humble.

How can you tell what sort of mind you have? It's easy. Third-class minds don't think at all: they follow the herd. Second-class minds tend to surround themselves with third-class minds, whom they can outshine and dominate. But first-class minds want to associate with other first-class minds - or even better, if only they could find them.

So which one are you? And what about those seeking to run your CCG?

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