Dr Phil Hammond, broadcaster and sessional GP in Bristol

Good communication is a must for medical teams

What can we learn from England’s latest footballing failure? Let’s pretend Fabio was leading a crack surgical team in a race to perform the world’s first brain transplant. It might be stretching it to imagine John Terry holding a scalpel, at least in a surgical context, but bear with me. Other teams are competing to be the first, and by the time England has got the patient on the trolley, the Germans have already performed two brain transplants and are pushing for a third. Where did it all go so wrong?

Let’s start with the theatre manager—I have enormous respect for Fabio Capello, at least I would do if I could understand him. Even when he’s speaking through an interpreter, I struggle to make sense of him, so what 22 overpaid numpties make of it all is anybody’s guess. The more people fail to understand him, the angrier he gets, like Postman Pat’s psychotic Italian half-brother. You don’t want to upset him, for fear of finding a horse’s head in your bed, but you can’t help yourself because you don’t know what he wants.

Spanish TV rather unkindly hired someone to translate what Fabio shouts pitchside, and aside from a lot of earthy abuse, there was an almost forlorn repetition of ‘Wayne? Wayne? Wayne?’ Much of the dugout discussion with assistant manager, Stuart ‘Psycho’ Pearce, was an argument about whether Psycho should stand up and shout before Fabio, or whether Fabio should always be the first to stand up and shout.

If Fabio was in charge of an operating theatre, there’d be carnage. We know that good communication is crucial to performance and after the disastrous case of German doctor Daniel Ubani who killed a pensioner with an overdose of analgesia after confusing the drug names, there have been calls to ensure overseas doctors have a proper command of English before being allowed to work in the UK. Football per se may not kill anyone, but there’s an ugly association between England losing and domestic violence. But European law currently prevents us enforcing language tests on European employees, even though testing is compulsory for doctors and nurses from Australia and America where English is the first language.

Fabio can’t be blamed entirely for his team defending like the Keystone Kops on gripe water. Granted, we saw off the mighty Slovenia, a nation that boasts more brown bears than professional footballers—and probably brown beers. It was the surgical equivalent of a routine hernia repair in preparation for the biggest and most complex operation ever. Germans succeed in football because they work as a team, and the same is true of surgery. In a good surgical team, there is no hierarchy. Everyone knows what they’re doing, anyone can raise a concern, and checklists are used to ensure absolutely no stone is left unturned (or swab undiscovered). England operated like a bunch of prima donna locums who have barely met, didn’t know what they were supposed to be doing, and didn’t much care because they earned a much better living over the road at the BUPA Premier League hospital.

You could tell all was not well with England when John Terry tried to blow the whistle on team disharmony. I’m not sure whether the Public Interest Disclosure Act covers professional footballers, but it soon emerged that Terry hadn’t exhausted all the correct internal channels before taking his concerns to the media. Fabio’s door may always have been open, but the last time Terry knocked on it, he was sacked for copping off with his registrar’s girlfriend, so you can understand his preference for public revenge.

Dysfunctional teams never deliver. Life is complex and to err is human, but if we don’t learn from our errors, we keep repeating them. It requires difficult conversations between skilled communicators to get out of a really big hole, and Fabio’s English simply wasn’t up to the task. Whether the FA is right to give him a second bite is anybody’s guess. But I wouldn’t let him anywhere near my brain.G

View Dr Phil’s tour dates, books, DVDs, and Private Eye columns at: www.drphilhammond.com

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