The origins of a disrupter

This is the start of my diary to help fellow disrupters by sharing my story.

Disruption wasn’t intended I assure you. Let’s look at the aetiology:

Age 4, My parents sent me to elocution lessons so I didn’t grow up with what they saw as the disadvantage of a Lancastrian accent (discuss). Weeks later I’m at Horwich Festival; shoved on stage to recite poetry; Bravado, by Carol Brahms, at the first of many speech and drama competitions. I won many times, until I turned 18 and could choose for myself what I did.

I learnt that standing on stage spouting stuff is no biggie.

Class 2 parents’ evening at High Lawn County Primary School, Bolton: the teacher told Mr and Mrs Fisher that I had no imagination and that I couldn’t picture waves crashing on a beach. Worse, my mum and dad told me this. I was indignant, even at 6. I’ll show her, I thought.

Bolton School: where girls were taught to aim high and achieve. By this time I was writing subversive and inventive stories about characters at school, scribbled on pages pulled out of my General Classwork Book, passing those stories around my friends and making them laugh. There was a live sponge that lived behind the lockers and a hand dryer in the girls cloakroom that attacked people for no reason. Teachers Miss Mott and Mr Blissett were conducting an illicit and unlikely love affair. I learnt that I had a very fertile imagination thank you. When asked at 11 what I wanted to be when I grew up, I replied ‘an authoress’ (no laughing at my the quaint language).

Then there was my dad, Geoff Fisher, larger-than-life super-salesman. He could cajole, charm, and work-the-system like no other. He broke rules and didn’t care. He was at war with those who thwarted him. I watched this-the nervous, asthmatic, myopic child that I was. I found it excruciating and fascinating in equal parts.

Mum Hilda on the other hand was disruptive in another way. After munitions work during the Second World War she left secretarial work to retrain as a hairdresser, setting up her business in the upstairs room of her parents' house. She gave it up to get married and have two children, my elder sister Christine and me. But when I turned 11 she defied her husband, who wanted her at home washing his socks and making coconut cakes and set up a second hairdressing salon on Mayfield Precinct, Darwen. Christine had just finished her hairdressing indentures with a nearby salon and mum took on both Christine and another hair stylist. She learned to drive (more arguments), bought a tiny Fiat 500 and drove herself and Chris over the moors from Bolton to Darwen every day. My dad was incandescent because mum was no longer dependent upon him. She could earn her own money and make her own decisions. I spent my school holidays manning the till, sweeping hair or drowning clients at the wash basin. I saw entrepreneurship at very close quarters.

Dad was a strict disciplinarian, which could lead to only one thing: teenage rebellion. I turned from a meek, dependent child to a fun-seeking liar. One evening I told my dad that I was off up Daubhill ('Dobble') to see Diane and we would be at home looking through some photographs and I would sleep over. Two hours later I was in a taxi and off to The Bees Knees nightclub. When the taxi dropped us back at Diane's, the first thing I saw was a white Ford Escort with my dad at the wheel, light on, reading the paper. He wound the window down and just growled 'get your toothbrush'.

Let's skip through terrible A level results ( two weeks at a time off school with asthma huh?) and my plans to do a degree in speech therapy morphed into entry into nurse training at Manchester Royal Infirmary. I was paid a pittance - but at least I was paid - to learn and I got subsidised food and accommodation. The hospital's school of nursing taught me - nursing degree courses were rare back then. I chose nursing because it offered an 18 year old, anxious girl like me with a room in the nurses' home, structure and a career for life.

So I’m in the bar at the MRI Social Club (they had such things in those days. It’s a suite of offices now). The staff nurse from my second ward allocation leans over and says ‘The trouble with you, Heather, is that you’re too Bolshi‘. Following bed-bath practice on the vascular ward, Sister Melia spits in her heavy French accent ‘Student Nurse Fisher, you are running before you can walk!’ Honesty dear reader, I didn't understand at the time what prompted these comments. I was just being what Bolton School had taught me to be: nosey and questioning.

After several years of staffing in cardiothoracics at Wythenshawe Hospital, working through my own respiratory issues, I ended up on ward B6, where I was on first name terms with the revolving-door chest patients. I remember thinking ‘I know, I’ll work in general practice and stop all these patients getting readmitted’. This was the start of me thinking that I could change the world.

I left the NHS (at that time being a general practice nurse or GPN was considered outside the system, discuss) and went to work in Longsight, inner city Manchester. Ducks and water come to mind: the GPs had never employed a nurse before, so didn’t know what limits there should be - and neither did I. Bingo. I told the GPs early on that my intention was to be a partner in the practice (yikes!). It's a wonder that they didn't chuck me out there and then. They told me politely that they would consider it, in time. By the early 1990s I had been elected vice chair of the local practice nurse group. I started arguing with the university that I should have a student nurse allocated to me so that they could understand primary care and aspire to be a GPN. It took another 25 years or so for that to catch on.

I met a ‘primary care facilitator’ who helped me develop my practice nursing service. Judith she was called. Wow, I thought: Helping people develop and change things. I must do that. And so I applied for a job at Salford Family Health Service Authority to do practice nurse development. The role was two grades higher mark you, which didn't make me any nursing friends at the health centre where I worked, who considered me both an outsider and an upstart.

Like the GPs before them, the FHSA had never employed a nurse before so didn't know what to expect. I had a great manager who guided me through what I thought needed doing. I used both carrot and stick with GPs-paying them extra in the first few weeks to take a nurse on and give them a proper induction programme. I kicked a lot of GP ankles under the table when interviewing with them, when they asked 'so, nurse, do you plan to start a family?’ I set up 3 GPN training practices for those transitioning to work in primary care in Salford. Yep, that took another 25 years to catch on.

I progressed from the FHSA to service redesign, acting head of nursing and then director roles in primary care trusts. I turned to the Open University Business School, my go-to place for management training, where I had done my certificate in management. I started my masters in business administration - a general MBA- because I wanted to study alongside people outside the NHS and learn from them. This threatened my line manager who either ignored or belittled my MBA assignment work. No-one could stop me from doing it, because I paid for it myself using 0% interest on the credit card. By contrast, the nurse managers were absolutely fascinated by some of the initiatives prompted by my MBA, such as bringing in managers pro bono from Kellogg's to help us to consider how our PCT provider unit (community services) could be more market-led. Day school and residentials were exactly like the film 'Educating Rita'. My mind kept opening and I met loads of fascinating people whose knowledge and contacts I still draw upon even now.

As I started to get more senior in management and things got scary, I just pretended to be super salesman Geoff Fisher. One day, in my Geoff persona, I was facilitating a diabetic network when the lass from the regional health authority told me that in her opinion I was a budding chief executive. Alas, even though my CEO spotted this too and sent me on the King's Fund Top Manager Programme (TMP) to make that happen (a career-changing experience that I shall relate later), I realised that I wasn’t a big-organisation-statutory-system-leader kinda gal. I knew then that I was a square peg in a round hole, but didn't know how to escape.

Reflecting on everything that I have just written makes me think that what is at the heart of my disruptive spirit are parental and educational influences. Seeing how things could be better and just getting on with it won me support and grief in equal parts. I didn't know how to control myself, understand others and win their help - that was my trouble. When I did the TMP programme, which focused on how to use your emotional intelligence, the scales dropped away from my eyes. I became aware of not only how I was feeling but the feelings and reactions of others. But it takes a while to change your ways and I continued to get into trouble for some time to come.

Next time, I’ll tell you how the system kicked me out and why it was the best thing for both of us.