[00:00:00] Dan: Hello, and welcome back to We Not Me, the podcast where we explore, how humans connect to get stuff done together. I'm Dan Hammond.

[00:00:14] Pia: And I am Pia Lee. Dan, you have been quite a central figure in some very exciting musical festival that is happening in Ilkley. So Ilkley is a little village in Yorkshire, but like, you know, all good English series, Ilkley's got a lot of character and a lot of interesting things happen.

[00:00:38] Dan: A lot of character and a lot of characters that's for sure. And we're, we're in a little bit of an Ilkley season at the moment here on We Not Me having seen Andy last week, our guest this week as well, which we'll get onto, but yes, Ilkley Live came out of COVID actually, because we weren't allowed to, there was a time when one of the lockdowns was, you could only see one person outside and be distanced by two meters. I can't remember what the exact rules were, but anyway, I ended up doing my band practice with my friend uh, the bass player, Greg, and we would. Play in my garden. And we had a few people sort of standing around the gate and having a peer in and have a listen. Which was what they, I suspect they didn't have very good musical taste to be honest, 

[00:01:19] Pia: They're very 

[00:01:20] Dan: and yeah, exactly. It was COVID. Woo. 

[00:01:22] Something's 

[00:01:23] Pia: of isolation. Whew.

[00:01:25] Dan: But anyway, so, so out of that, Ilkley Live was born. It's a It's a community music festival, basically that anyone can play in their own garden. And anyone then the audience we publish the we publish the program and you can walk from one to another and watch different, different music acts. And we had about nine, I think last year we had 20 this year. So in the second year it's getting quite big. So it was quite a decent number of, of performers. It was absolutely wonderful. And the sun Sean on us and all was well. 

[00:01:56] Pia: It's such a democratizing of sort of, of music and that spirit, you know, it's, you're not having to pay for it. It's bringing out everyone's talent and, you know, Iley is a rich community, so that, so there would be a lot of folks there that are great artists.

[00:02:10] Dan: And actually I'm, it's lovely because actually just with that, the idea is to be very about, much about the community. It's the community's thing. And that my, one of my favorite moments this year was I saw the day before someone posted one of the bands posted, they were gonna play in their garden and they were actually gonna allow, they had other bands playing after them, so they were hosting some other acts .And they built a stage. They actually built. It was sort of okay then. And it was incredible. Absolutely incredible. So, you know, that's just something that just happened and people took the initiative to do it so good on them. And the band, the finishers were amazing.

[00:02:44] Pia: And that word initiative, that's my experience of Ilkley. The other I is that there's a lot of people there that do take that initiative. And that's that's Becky who is our guest today. Tell us a little bit about her and how you know her.

[00:02:58] Dan: So I came across Becky, when, as part of her clean bathing water status campaign um, for the river, she'll tell us all about it. She has a lot to say about how she achieved this in Britain, you know, a UK first of achieving bathing water status. But she also has her professional career, both of which really play into this we not me thinking, which is how do you get groups of people to achieve something different. So really looking forward to hearing Becky let's go over there now.

[00:03:28] Becky, it's an absolute delight to have you on the show. Thank you so much for joining us.

[00:03:38] Becky: Ooh, you're a love to invite me. 

[00:03:41] Dan: Um, 

[00:03:41] Becky, let's get stuck in. How, um, Talk to us about you a little bit. How did you get today? 

[00:03:47] Becky: Well, Dan, I mean, no one says no to dance. that's how got here. but, uh, I've uh, I'm an old lady, Dan, I'm sort of grumpy of Ilkley, the world. Um, so I am mostly frustrated, agitated, and generally hacked off. And that's mostly around things that are about social justice. Really. So I'm a professor in health systems innovation, but that's because nobody could bear me to be in a real job in the NHS. So I sit alongside it, um, poking and prodding and nurturing and supporting and being a good friend, but also a bit of a challenger. And, um, I do a bit of the same Ilkley to be honest, where we live. So I'm a lover of all things that are about, um, the resilience, the, the innate talent, the interests, the effort that people and communities could put into spaces. And, um, how do we stop the old world, the feudal hierarchical, you know, how do we stop that biting back and stamping them out really? 

[00:04:51] Dan: What a strong start.

[00:04:52] Pia: I've now realizing why you two get on so well.

[00:04:56] Dan: What a strong start. That's amazing. I must say Becky I've seen a film of you addressing a conference and not giving the audience any, any slack, which I, yeah, I could see all your introduction definitely paid off there. I could see it. So, wonderful to have you on the show and I can see in what you're saying? Absolutely, right in the heart of we, not me. How do we help humans connect to get stuff done? So we'll talk a bit more about that in a minute, but before that, we're gonna torture you with the conversation starter card game. So I'm going to choose a starter card at random. And I'll ask it one of one I found I'm just having a bit of a shuffle here. Oh, here we go. My first paid job was.

[00:05:34] Becky: Oh first pay job was, um, actually I, I was thinking I was, was I actually working? I think I had two jobs at once. I was a student nurse, but never, never had any money to being a student nurse. So I, um, was also strawberry picking sort of piece work in the fields. And I was incredibly motivated by how much money I could make from picking strawberries at a vast rate of knots. I would not talk to anybody. I was just. Pounding through for hours on, in the sun to earn my little bit of money. So I could live off something a bit more than Bran following. 

[00:06:08] Dan: I bet this strawberry growers are still talking about the Mabe years. those are great

[00:06:14] Pia: The ma 

[00:06:15] Dan: done in exactly. Exactly. Exactly fantastic. Fantastic. So, well, okay, that takes us right back to the very start, but let's let's come back to the present. Becky. Tell us about what a little bit you touched on these things. Take us into your world a little bit. Why don't we get, I think there's a lot here to unpack. So why don't we, why don't we start with your. Health systems work. What do, what does that actually look like? And this relationship you have with the, with health, fraternity, and uh, sorority?

[00:06:45] Becky: So I'm um, there's a few things that I think really matter to people and really work when you're trying to do change work, but they're not things that those who've got historical positional power tend to like really. but if you believe that the system, whatever the system is doing exactly what it's designed to do, then, when you are trying to get a GP appointment and you can't that isn't by accident and, you know, hold your hands up and go, oh, it's all a bit difficult. And we can't do anything about it. You actually can.

[00:07:19] So my job, I guess, is to sit alongside the NHS and help it understand why what's happening. Isn't is really in its own hands. And I absolutely love general practice front door of the NHS. If you can't get that right. Heaven all. And they're fabulous people running, you know, little businesses, you know, completely happy talking about fungal toenails or major heart attacks. God bless them. It's brilliant that they will do that day in day out. And we don't give them anywhere near enough credit for what they sit through every day. And so what they'll say is what they're being rewarded for and paid to do is to offer appointments. The thing about an appointment system is whoever shouts loudest can get an appointment, but there's a load of people that can't, or don't know how to, or don't have the capacity to.

[00:08:09] And so it generates a level of unfairness. And because if you open a door and say we've got slots, then people will all sign up as fast as they can. And particularly if there are a minimum amount of slots, Because you'll be worried. You won't get a slot tomorrow. So I'll bag my slot today, even if I'm not too worried about if I'm not too sure it is because it might, I might not get a slot tomorrow.

[00:08:30] So it creates demand. Actually, some of you'll know this from any work you've ever done on quality. So where we show GPS, you know, do you know who's coming through your door? Well, people that need us, I said, okay. So are those people, people with long COVID yep, definitely. those are there people on waiting lists who can't get, you know, who are de oh, it's definitely those people long term, oh, it's definitely those. Is it young kids, you know, who suffered during the pandemic and mental health? Yeah, definitely those. So at the moment we're offering 20% more appointments that we are offering pre pandemic, but it's still not enough. But actually nobody knows what we're offering them for, because it's definitely all those things I say, well, how much don't know. Really? Okay. You don't know. Why don't you know? 

[00:09:19] So the NHS is desperately underinvested in general practice understanding. What's going on in general practice and in the good old days. And the appointment system worked, cuz it wasn't demand. Wasn't quite as bad as it is now. And there were more GPS and uh, and there's sort of, there was, it was clearer what general practice was for.

[00:09:41] So when we show GPS who's coming through the door, I nobody between the age of seven and 24. Um, and they go, oh. We thought We were seeing lots of young people. I said, well, it turns out you're not seeing any of them. So have they not got any health needs? No, they've got lots. Well, where do you think they're going? No idea. and then they're horrified. Bless them. They're absolutely horrified cuz they have no idea. And then you say, so is your job to provide primary care or to provide an appointment system? 

[00:10:08] So that's how we work, which is we, we help people see what's really going on, not the fantasy what's going on. We bring us all evidence based to it. We challenge folks and then say, so how you've designed the system is giving some people and it's primarily older people a lot of chances to turn up at your practice. But if they're having to turn up so much, does that mean that you're not actually meeting their needs? Cause how many times do we have to be seen? 

[00:10:36] So it, it starts whole lots of conversations and we're not judging and we're not blaming and we're not shaming. We're just saying, why is it like this? And is this what you came in to do as a GP or a nurse in primary care? What is it you wanted to do? Because what you're doing now, isn't fair. And that usually gets people to think. And it's hard work, isn't it? But it helps 'em think about how do you do it better.

[00:11:01] Pia: And what's the response Becky from GPs? Are they, are they generally. Did they have the head space to be able to think above their business as well as in their business, as such.

[00:11:11] Becky: Well, they do, they don't, but um, if they carry on doing this, they'll be, they're so exhausted. Honestly, they're so exhausted. So, you know, it's not uncommon to have GPS in tears when we go through this stuff because they've come in to do something. It's not, they're not doing it, but they're also not nothing's working for anybody including, including them.

[00:11:31] And actually there is also, there's very little background support to general practice. So, you know, most corporates in this country run 9% of their costs of management costs and hospitals, it's like 4% in general practice. It's under 1%. So they're also doing a load of staff that is not what GPS and nurses and receptionist should be doing. So we do help them say no to some stuff you say, do you really, you know, you let's just not do that for a bit. Give me an hour, just an hour of your time. And let's have a bit of a think. And of course, with an hour, looking at young people and mental health, they can probably think about reaching out to schools to find out what they want. And then of course they don't have to convene everything. There's lots of other people in the system interested in young people's mental health. So, well, let's get 'em together and say, well, whose job is what, what can we do together? And you're better off doing it together? A bit like this theme of what we're talking about. Dan, you're better off doing it together and do it all on your own. You can't fix this on your own as a GP, but you can do it together with schools and mental health services and families and your social prescribers. So find better solutions together is, um, is what we're trying to do. 

[00:12:45] Dan: And so where does that, that human connection, the sort of, yeah. Bringing people together to solve this problem. Where does that work well and where and equally where, where do you see the human factor, the connection factor, failing?

[00:12:58] Becky: Certainly in primary care you get paid for numbers of people. You see. And that does not fit this model. So if you're trying back to our young folks, you know, they don't really want to come into GP appointments. They might want to do something very different, but that wouldn't count in the same ways, then you don't get paid in the same way. So the, the desire, the payment system for a lot of NHS work is activity, which is not relational. So it's getting people through things. And that means, you know, we might over treat some things. We might be offering too many operations to older people. Probably not great for them, um, certainly for their long term health.

[00:13:40] So overall we're in a sort of, you might know this sort of tailors model of mechanistic machine model of design. The treasury is in that mode completely. I would say the health department is not in that mode, but the treasury is absolutely in that mode. You know, they're all idiots tell 'em what to do, make 'em do it. Um, tell 'em off. If they don't do it was wall payments said they don't do it and we know better. And it, they really don't, you know.

[00:14:08] So it doesn't support collaborative, innovative models, and most people on the frontline working in primary care, you know, back to what you're seeing on a daily basis, which is, you know, people in pain and people suffering, but also people with sore throats and kids that been bullied at school and fungal toenails. You're not necessarily an innovator in that space because your day job is to do this really lovely, intimate work with folks. And it isn't to come up with wacky new solutions to how we organize that work. 

[00:14:42] Pia: And is that any impact on like the number of GPS coming into the system. I mean, our GPS being turned off by the prospect of this at times?

[00:14:52] Becky: Yeah. So, um, I think the rele at the moment, you, it's very hard for primary care cause we haven't got anywhere else. So you, you sort of choice front door of the NHSS primary care or A and E. You call an ambulance. The ambulance has only got that choice. The ambulances have been absolutely brilliant, because they are managing to help people stay at home more than they ever were. So you're sort of seeing in Yorkshire here about before the pandemic, about 10% of people, the ambulance saw, they managed to keep at home, you know, they do fantastic stuff, paramedics, don't they? Now it's 30%. It's brilliant, but we've still got ambulances wrapped up outside hospitals with old ladies waiting to have a we and a drink, and it's just outrageous, really.

[00:15:35] So we've got a real problem about where do people go? We don't have urgent care centers anymore. We don't have some of the background stuff that would help the bullying kids Sure Starts, et cetera. So a lot of that's been stripped out. So the front door's very small. Um, and, uh, and certainly in primary care, the demand is post pandemic, during pandemic through the roof. And we've got a lot of COVID sickness again. So you've got repeated bouts of sickness in your staff, which means that people really, really, whilst they also go to work with COVID you can't, if you're working with vulnerable people, you just can't.

[00:16:11] So we're asset stripped. Anyway, we were, we've got a workforce crisis that we don't have enough people coming through. And a lot of people retiring. We, we can't hang on to people because they've changed the pension rules. So it's of no benefit to you to stay in the job as a GP, you need to retire as early as you can, because your pension, it really affects your pension payments. And we haven't got governments prepared to address that. So the it's an absolute storm at the moment. 

[00:16:38] Pia: And it, and I'm wondering, I'm wondering, I mean, you know, for some of our listeners will be listening from across the world. So some will be in the us, some will be in Australia. Is this something that you're seeing across as a global phenomenon or is this something just happening in England alone?

[00:16:56] Becky: it's a mixture. So obviously other people have got different COVID responses, which help in other places. Um, so we, we are very lax compared to other countries. Um, but, uh, there's been better workforce planning. And you know, the amount of money we spent per head in this country is, you know, we are way down compared to many other countries. So we are we're tipping into third world levels of, of payments and provisions. So whilst I keep saying they're putting more money in the NHS, it's difficult. Um, I wouldn't say so. So there's lots of, there's lots of things that don't help, but I, you know, you look at our childhood poverty levels. So if you, it is not just the workforce of the NHS, it's a fundamental underlying levels of poverty in this country, which are shocking and that's driving up a demand that is there's nowhere else for people to go. There's not social care. So that's our biggest issue. So I think, are we seeing the same levels of inequalities in poverty in other countries or the first world countries you we do in the states? Not so much in Australia. So depends how depends, how you

[00:18:00] Pia: it sounds like a creaking creaking system. Doesn't it? When you layer it up like that, you're seeing, you know, the, you started this conversation looking at appointments but you very quickly dial it back. It's a, It's a systemic challenge on multiple fronts. 

[00:18:15] Becky: but it's not IM, so I, I don't want to think it's impossible. It's not impossible. Um, we could do with, I guess you some slightly less judgemental models. You know, we've got, we've got the most centralized democracy in the world, you know, it's feudal almost. And so local solutions for local people is very hard to enact in this country, but where we do and actually where, where, where primary care, where general practice works collaboratively, the other parts of the system, and ask for help from local communities, you know, it can really radically change this. So we can liberate phenomenal resources within general practice, by going through their appointment system and helping them design it proactively based on need rather than reactive. The problem is it doesn't get them the money. So, and most GPS will take the hit. Honestly, they'll take the hit because they, they're not, you know, they're not all out for the dollar that people think they are. So I find that, you know, clinical professionals and people at work in health service. Are there because they really, really care about people and health. And so they will at a local level do the right thing.

[00:19:28] Dan: It's a picture of such pressure. I mean, even not working in G in a primary care practice, I'm feeling a slight sense of a sense of that myself. Now just hearing it through, but it sounds like there are some, just some ways through, but I'm just going to. Change gears a little bit, Becky, and I'm trying to do a nifty little segue now that are very hard days, work in a GPS practice, I'm sure people like to go for a little swim in a river, and I'm going to just segue into your other life if that's okay. Just if we talk about some other challenges. So talk to me about your work with bathing water status, which is certainly where I came across you first. 

[00:20:04] Becky: So it sort of started with um, a friend of mine saying we are reporting, you know, raw sewage being dumped in the river on a regular basis and no one's doing anything, and I went you, what? What do you mean? I said, we all pay for our sewage to be, you what? I mean? All those kids, local kids they'll paddle play, swim down there. We had no idea. And it turned out that our local water company is throwing raw sew into river third of the year. And no one knew everyone's paying their bills. So, that was the outrage, which was what are we people be taking for a ride here? You know, I, I do my bit as a little citizen here. I pay my bills, honorably. I don't not pay because you're not doing it. I pay my bills. And then you take the money and what you do with it. It turns out you give it to your shareholders. Thanks. I can't, you know, so you've got a nice job in Canne and I live in a little terrace in Ilkley, and that doesn't feel right to me.

[00:20:56] And we followed similar to the other to the, to say with the GP stuff, which is, you know, the phrase is you can't get there from not here. Living in a fantasy about what's really going on, doesn't help you work out what you should do. So we're always trying to find out. With all the, I'm always trying to find out with all these processes what's really going on around here. And you could, you know, if you're into the theories, you could look at bit of the Otto Scharmer, Leading from the Emerging Future. Or you could look at high fixes, you know, adaptive leadership, similar. They all do the similar thing, which is what's really going on around here? Who cares about it? How do you connect people to it? And then how do you with H how do you turn the heat? 

[00:21:34] I was telling you about GP practices and just showing them the data often that's enough to say, did you know what's going on? And they go, woo. And so we thought of, we shoulda thought the same, what happened with the river. But it turns out with very big corporates. They have broad shoulders and thick skins. They're not at all horrified by what they're doing. Oh, lovely gPS are really horrified corporates, not at all horrified known, not by any means of the matter.

[00:21:58] So what we did was similar, which is that we looked at the data about how polluted the river was being by the water company, and then it turns out that the regulatory body said, no, the water's very good quality. I would swim in it and drink it. I said, would you really, that's fascinating. Why do you think that? Because we measure these few things. I said, they're not all the things you should measure, are they? There are all the things that we measure. That's different answer. Why don't we measure some things? And the nice thing about living in Ilkley as Dan will tell you, is that there's a lot of talented people here. And it turns out there a professor of something called diatoms, something that's in rivers and et cetera. So we had quite an interesting gang. We manage to get together are very diverse people who care about the community and the quality of the water, whether it's people who walk dogs, swim, people who like environmental stuff, fisher folk, the whole works. So we have a very diverse gang. And we argue a lot, which is always good. But what we did was set up a citizen science project to test the water in the river and lower behold, it is full of crap. And that is what anybody. And certainly Mr. Environment agent. So you should not be swallowing it as you swim, because if you did, you'd be really poorly. And so obviously he was lying

[00:23:26] Dan: As people are. Yeah. 

[00:23:28] Becky: So we made that very public and thank goodness for our national media, because we wouldn't be anywhere without it. So we tried doing the rational nice thing, which. Turning the heat up by showing them the data privately. And they went, oh yeah, but we couldn't afford a solution really? Okay. I mean, why not think, do you not own a lot of money? And then we tried holding town meetings. 200 odd people in Ilkley coming together with the agencies. We do, we run it a bit like a Quaker meeting, sit in circle. Don't let them sit at the top of their power points, that would be disaster sit in the middle because they're accountable to us. So demonstrate their accountability, demonstrate us as consumers, hard in a monopoly, cuz you can't take your money anywhere else. And then just to make it okay. In that we wanted it to be properly accountable invite Look North, which is our local radio TV station. So they film these people. 

[00:24:20] And so we did that because then it's always on record. And then we have records of what everybody says. And that works for a while, so that got 'em going because their shareholders don't like that sort of publicity. And then they get a bit immune to it and you have to think of something else. So this one has been harder in many, much harder than the NHS of anyways harder because it, the willingness to engage with the issues for the benefit of consumers is nowhere near as strong as the needs to meet shareholder value. And that's, it's overwhelming, you know, so our water company is owned by the bank of Singapore Deutsche bank, Australian pension fund. And of course the idea of a private company is they put money in on a much longer, they could borrow for a much longer term and they obviously have to pay interest on their borrowings, but it's a lower interest rate to put in the infrastructure. But what we've found over the course of our investigating what's really happening around here is not only as lows of pollution in the river directly related to sewage, which is horrific and kids don't know that, and profoundly, still don't know that Ilkley as they paddle and play, Cause no one will put signs up to say, cuz they won't own the problem. But not only that, but the investment, the money to the money they borrowed, which was huge. Was not going into infrastructure. So they were borrowing money to pay dividends.

[00:25:42] And that became no. So we're beginning to surface something huge here. So suddenly little Ilkley. Hello. We thought we were just doing this turns out we're taking on all the water companies in the country, along with 

[00:25:56] others. 

[00:25:57] Pia: poo really did hit the fan. I think at that point,

[00:26:00] Becky: We've got absolute. Yeah, we've got a legal team, a comms , . We're supporting 50 other campaign groups. But we have got, we have now got, I suppose, a whole national program to reduce the pollution by water companies. I think it'll take, well, I'll be dead. You know, it's gonna take 30 to 50 years, but there, there is, there are plans going in to do that now.

[00:26:22] Pia: But this is So the business, they call this in. I dunno, it's the same England, but they call it a rot, the whole thing's a rot. So what,

[00:26:30] Dan: very Australian that 

[00:26:31] I love it. 

[00:26:32] Pia: yeah, it's not a root, it's a rot. And what and so what it looks like on the front of it is not really where the money's going. You gotta follow the money, which is exactly what you did in that. So again, of quite an adaptive, but quite dangerous, cuz you would've literally gotten to some deep and dirty water, you know, doing that. And when people are protecting their profits, 

[00:26:54] Becky: Yeah. 

[00:26:55] Pia: you know, that could become pretty murky and pretty 

[00:26:57] Becky: I think

[00:26:58] certainly for some of the folks that we, so we work with the Financial times. They do all the work on the dividend, you know, they, cause we haven't got the expertise, this, so you've gotta find partners and collaborators or people that are interested. And then you've gotta find people that are in for the long haul. So the lovely surface against your whole campaign group, they've got they're in it for the local. You've gotta find. I think but then it gives you lovely moments, like, you know, having a few drinks of Fergal Sharky, then if you remember, cause he's a river campaign, it turns out. 

[00:27:29] So the, it has hilarious moments to it. And it's, and there are moments also of course, where the best things to do is to collaborate. You're not always being adversarial, so our getting bathing status for Ilkley actually, you know, our local Walker company supported that because it meant that they could then bid for investments, they could get support. So sometimes you're turning the heat up and sometimes you'd be adversarial, and sometimes in helping people, you know what some people say, I think delivering their account, their duty to them delivering their duty to them, cuz that is what their job is. Sometimes you're doing that and sometimes you are helping solve problems together and we're doing a bit of that this afternoon. So we're sometimes in the collaborative space and sometimes in the other space.

[00:28:12] Dan: Yes. And I've seen, I've seen both of those actually, Becky. And just thinking about that strange group of that strange coalition, you pulled together, multiple interest there. And even though what you're doing, I mean, I have to say being a resident of the town, I was stunned that people were literally at the council meeting, voting to have poo in the river. There are, there were, are people out there, so it's not a com amazing. It's not a completely uniform belief that it should be a clean river, but most people are onsite. And even when you've got that. Strong purpose behind you. It's not always easy to unite those groups. Is it? How do you find that common ground to move forward and not just end up bickering on the edges?

[00:28:51] Becky: You know, you can only go at the pace that people are willing to go at. So even though we might want to go faster on some things, you just can't. So we have quite regular town meetings and we, and people are persistently surprised. There's always somebody new there who had no idea or um, or somebody emailed me yesterday, cause we're trying to get people to stop paying their water bills, potentially their water bills in September that relates to the bit of way you supposed to every sewage treated. So I pay in my whole water bill I pay 150 pounds last year for the sewage treatment bit and they dumped it in the river a third of the year. That's 50. That's just one month a bill. So I'll just not pay it for a month because they didn't deliver it.

[00:29:31] But the pushback is you haven't got that, right. That can't be right. That they're doing that for a third of the, that can't be right. I said, it's their data. It's the water company's data. And they agree with us. They just don't put it all over their website. This is not, that is not contested. And people can't believe it. They said you must be wrong. So the, you know, you, you've just got to persistently tell the story. Persistently, find ways of getting people's attention and storytelling is the best way we've had some local kids, very sick they're in the local hospital on drips from being in the river and missed their GCSEs. So we've got that in the front page of the Gazette just before this story. 

[00:30:09] So you find you've got to persistently help people understand the problem. And of course they don't all agree. And of course they don't need to. And some people think the best way is to persistently be reporting, and that's what they'd rather do or. Everyone's got their own. Everyone's got their own route. You can't be everything to everybody, but you do need to take the wealth of people with you. So we make sure that our MPs are alongside pretty much all the time. And when they're not, you know, we try and meet to discuss our disagreements our local counselors, our town council. So our representatives are briefed all the time. And we brief all the MPS in the country. Every time, there's anything environmentally, we project it. So we, you know, you are always watching national local all the time, so you've gotta, and just be completely open and willing to go to be challenged and to have the discussions and to go with as much as people will or won't do.

[00:31:03] Pia: Which I think is, is a, it's a real it's a real balance between forging ahead for, you know, for to get some kind of resolution, but not pushing too hard.

[00:31:12] Becky: Well, you could be, you could be marginalized. The problem is if we became a little sort of weirdy pressure group we are regularly positioned like that, but we try and think who's going to speak on our behalf? We try and change the mix of the group. We try and have younger as well as older. So it's not always me and Karen. And so you persistently Jing up, who's there. Different people turn up to meetings that they don't see the same people all the time. You've got to really think about that because you can become sort of fixated sewage group. My kids are always horrified. My tombstone will say, you she stopped shit in the river and really, they're more proud of what I've done in the NHS. They say, well, can't believe you're gonna go to your grave and that's what everyone's gonna remember you for. It's horrendous.

[00:31:58] Pia: And did you think Becky, when you look back over your life, is this like a theme that runs all the way through? Have you chosen adaptive, challenges and you've really wanted to kind of, you know, get cranky enough about it to find a solution?

[00:32:12] Becky: Yeah, I think so. Yeah. And that some of that's how you brought up, isn't it. And my dad was a, he won't remember this. He doesn't even remember taking me into the factory, but he built and ran a paper factory. Paper making factory. And so when I was a kid, you know, if anything went wrong, even at weekends, he'd go in. And when he went into, well, I'd go invite, you know, no one knew what to do with me. I'd go in with him on holiday days. And you know, he'd first thing he'd do is he got in in the morning was he'd go down to the paper mill and he'd sit with the ladies who were doing the, who on the sort, the paper making line, and he'd look at the telemetrics, but he said, I so tell me how it feels, and of course not, this is what the telemetric say, but I want to how it feels. And they would sit and talk to him about what adjustments they thought needed making et cetera. And that's where he'd start. And because it was about water and paper, he had a fishing club, he was very worried about what was going into the river, he was thinking about the environment in which the factory was working. So I think that you, you see things differently, don't you, when it's like that you see what it's liked. And he never, ever saw himself as being special. You know, he was always one of part. And I was so proud of the thing he designed and built and celebrated it and, you know, so I think that was a very interesting, he was quite a, a loner in many ways, but at work he was a very communal person. So I think, you know, you see something like that and you see what's possible actually, which is what everybody sort of. Feels it's their business and cares about it, you know, magic happens. I think that's what it taught me. So every time anybody's told me, it's not my business, I think 

[00:33:49] who says?

[00:33:49] Dan: don't. It absolutely is. Um, Becky I'd love to just dive you've mentioned our, you know, Ron Heifetz and adaptive leadership, adaptive challenges. Could you, I feel that's, that connects this, your worlds as Pia just mentioned. Could you just dive in a little bit, just for our listener to talk about that you clearly had some knowledge, but also deep experience on dealing with this. What is an adaptive challenge?

[00:34:15] Becky: So, you think the predictable world is if I do X, Y always happens, you know? So you hope if you went to have your leg chopped off, down in the hospital, that they would do it to the right leg. And so there are 

[00:34:26] some things that are absolutely step by step. Getting a man on the moon is step by step. Digging the channel tunnel step by step, very complicated Yorkshire water, and our sewage works. I hate to say it. It is step by step. It's a predictable challenge. They keep telling me how very complex it is. No, it's not. It's complicated. You just have to open your purse and pay for it. That's the bit you're struggling with. So it's understanding things that are um, at tame, linear, deterministic, things that are complicated, but still are amenable to predictive interventions and things where you have no idea what will happen.

[00:35:01] So, you know, like looking after someone with who, who's living with dementia, How do you do that? So what are the solutions to that? No one really knows. And you can't do it without the person that's got dementia either. So, you know, sometimes people will say, I've, they'll be very why they're quite fat. It's because they forgotten they've eaten. So what do you need to do? You need to put sticking things on, you need things on the telly, you need phone, you need all sorts of things. So the response is that it's a water bed world, that if you do X, Y might happen, but A, B, Z will also possibly happen. So you are always thinking about the intended and the unintended consequences, and you're looking for those. So you are always intervening checking are we guess where we want to be.

[00:35:45] So the adaptive challenge with the water is not the solution, which is not an adaptive challenge. The adaptive challenge is the collaborative sets of relationships that have been set up that mean it's very hard for anybody to do what they're supposed to do. So, you know, there's this conflicting legislation, which means sometimes what the is doing is legal. And sometimes it's not legal depending on which one you look at. Those sorts of things. The environment's a bit more complex. So getting the relationships right's complex.

[00:36:13] Dan: I think we are, we're often in danger aren't we have seeing adaptive challenges and. And applying simple solutions to them that just that, and then they're set and forget as well, but they're just not going to work. And it sounded like there's some of that in your healthcare work as well.

[00:36:29] Becky: So, of course people like certainty. We're not very good as human beings with too much uncertainty. You saw that in the pandemic where the whole world was uncertain and we, we lost the plot on most of us on a regular basis. So people like certainty and they think certainty is good and actually having something. And you're right, you do have to start, you can't sit there and look at it forever, you know? Oh my God, that's very difficult. So you do have to step into. But you need to step into open, to change and to adapt rather than set into it with a project plan that you're not gonna move from no matter what, because actually that will make things worse.

[00:37:05] So it's knowing that the certainty is not generated from your project plan. The certainty is generated from the sets of relationships, which means that you'll work at the problem together. And that's the thing that people forget, I think.

[00:37:18] Dan: I dunno about up here, but I think we couldn't end on a better note than that. That's absolutely the we not me answer to things. It's been wonderful to hear your thinking, Becky and I love the outrage that you that you have that drives you as well. It's inspiring. I have to say so thank you so much for joining us. It's been absolute delight. It's been wonderful.

[00:37:39] Becky: Thank you 

[00:37:40] for listening. That's all sweet of you. 

[00:37:46] Pia: I loved how Becky illustrated both the challenges in the health system and the clean water challenges and the link around this adaptive leadership. You know, I think this is something we can all learn from because if you approach a complex. Problem looking for a simple answer or even approach it with a methodical technical answer, you might even end up making the situation worse. And yet it, it requires a combination of sort of tenacity, an enormous amounts of patience at the same time. And you could really hear that through a story. I think. 

[00:38:29] Dan: And real, just deep connection with other humans in the system, that, that, that really comes to it. Doesn't it. And it's amazing. Is it the, we mistake. Problems for being simp as technical problems. And we, we just love a simple answer, you know, I dunno how many times we hear or we've even said they should just do X. Very rarely can anyone just do anything in this world? And it's going to solve the problem there aren't, you know, the technical problems that are easily solvable, but solvable, but the yeah, these are mostly we're facing these adaptive problems. It was great to hear Becky talk about both of those too.

[00:39:06] Pia: And I think that she highlighted some to be Frank, some worrying trends in the UK, things that are really going to require humans to come together in a different way to solve them. And I don't, and the UK is not on its own. It's. I mean, we've got this problem all over the place. So I don't think it's just, it was just a way to illustrate it. But if you pretend that it's not happening or you try and find a quick fix, that's probably going to exacerbate the situation. we, I think we only looked at the health system through the lens of the GP. There was, There was a lot of other aspects to that, that, that, that adds to the complexity.

[00:39:47] Dan: Hugely. It's really complex as you're saying the yeah, I think what she said about um, you know, we pay our bills and that money goes to the shareholders. I, I, I, you know, without going on about it too much, I honestly see that everywhere now. And, And I think this crisis we're in, the cost of living crisis it's caused by that same syndrome. Um, and I think you're right. Humans are gonna have to connect differently if we're going to solve this. And I'm sure we're, we're in for a big reset, I think how we run things. Here's hoping, but it's, I was just thinking about also ability to, in that system, if you view it as an adaptive challenge, how you connect with people and the skills are required, then I'll, I'll tell a couple of quick stories about Becky.

[00:40:29] The first time I saw Becky, I was in that circle, the Quaker meeting group, and I was sitting behind the person from Yorkshire water and opposite Becky, and she was holding him to account on some of the facts he was using and on my word. I was just so grateful I wasn't him because I, her, the laser eyes were on him and it was just burning. So she really held into account. 

[00:40:52] Fast forward about two years. We had a meeting, a town meeting with with the leadership team of Yorkshire Water and on Zoom. With good people of Ilkley who were basically brandishing in a Zoom sense, torches and pitchforks, and oh, my word, they were marching on, you 

[00:41:10] Pia: They were mad. They were very uh,

[00:41:12] Dan: was. she, exactly. But she managed to create this space where she said, look, we need to be polite with everyone. We We're in this together, we're trying to solve this problem. She created this space where actually Yorkshire Water were able to speak. We could understand their side of things, which was very surprising. My mind was changed during that meeting about what position they were in.

[00:41:32] That adaptive challenge requires adaptive leadership. You have to be able to flex on all kinds of ways. So I think these are things that we can all learn for our own tasks. But also if we're going to sort the problems of the world out, which are adaptive and require higher levels of connection that we're actually than we're showing at the moment.

[00:41:51] Pia: Absolutely a hundred percent agree. And I think and I think we should include this in the show notes. There's some great work being written by Otto Sharman. So for those people that are listening to this and thinking, oh, I've got some complexity that's sitting in where I'm working. Then I think this is a great read. I'd highly recommend it because it just opens your eyes to a different way of being able to harness collective thinking, but it's a, it's a magical mix between patience and tenacity

[00:42:19] Dan: Yeah, that's a great way of putting it.

[00:42:21] Pia: you know, it's not easy, but some great things have been achieved as a result of it.

[00:42:25] Dan: And it's, it is actually, I was using that um, with a group not long ago and the Otto Scharmer thinking and levels of listening and so on. It's very pragmatic, actually really pragmatic and really just. Immediately useful. So yeah, we'll put some of the show notes about about that work as well.

[00:42:41] But uh, that is it. For this episode, you can find show notes and resources at squadify.net. Just click on the We Not Me podcast link. If you've enjoyed the show, please do share the love and recommend it to your friends. Also, please give us a rating on your favorite podcast platform. You can also contribute to the show by leaving us a voice note with a question or a comment. Just find the link in the show notes. We Not Me is produced by Mark Steadman of origin. Thank you so much for listening. It's goodbye for me.

[00:43:10] Pia: And it's goodbye from me.