“The doctor didn’t listen to me and so he misdiagnosed my cancer.” My friend was understandably annoyed. To avoid repeat situations hospitals today have embraced an ethos of patient-centred care. The views of the patients and their carers are listened to more than they were in the past.
Challenged by this claim of a new direction in hospital care, I asked whether it meant that previous hospital care was not patient-centred, and if so, who actually occupied the centre of the care program. The answers surprised me, both by their scope and their vehemence.
In quick succession I heard about doctors whose cursory inspections led them to make a poor diagnosis, but no-one was willing to contradict them. This was doctor-centred care. Then there were tales of senior hospital staff who so intimidated junior nurses that the latter were reluctant to report symptoms that went against the views of their seniors. Given that the junior nurses were more likely to hear what a patient (or a patient’s family) was thinking, their warnings should have been valued. This situation might be called matron-centred care (although the title of matron is rarely used today).
I heard about medical decisions being over-ruled by domineering parents or by legacy-hungry off-spring, and about medical errors being made by exhausted clinicians or careless support staff. The litany pointed to a situation where all too often, the central concern of the treatment was definitely not the patient.
While I was thinking about this, I started to reflect on education today, and I realised that the equivalent to patient-centred care would be child-centred education. I also realised that both catch-phrases had a familiar ring to them – but that neither health care nor school necessarily lived up to the promises of these two labels. I then started to reflect on some of the actual situations in our schools, starting with the central education offices.

Bureaucracy-centred education
When the rules of Head Office override the needs of the children we have bureaucracy-centred education. This happens more often than people realise and therein lies its true threat. We see this form so often that we shrug it off with some mild retort such as “He who pays the piper picks the tune”. In other words, we assume that since our wages are paid by this central office, we have to obey whatever they tell us. This is nonsense.
If a Government Minister told me to shoot my child, I would (at least on most days) refuse his request, pointing out that the life of my child is more important to me than the dictates of a desk-bound politician.  However, when the Minister tells schools that their poor rating in certain international tests means we must become more like our highly placed competitors, we accept this. Too few people stand up to the politicians and think-tank leaders and point out that Asian students, for example, perform better than us in certain areas because of a different approach to education in Asia. The people who best know the world of education, the teachers, allow bureaucrats to foist poor policies on them, regardless of the impact on the students. We often complain about politicians setting the agenda in education, but we are loathe to object.  
Perhaps in our naiveté we think that the Education Minister’s office is peopled with educational experts, but that is rarely the case. While the impact of some very senior and very experienced educators might be felt in educational decisions, their views are also easily enough ignored or over-ridden. Perhaps I have been watching too many episodes of Utopia, or maybe I have visited too many ministerial offices.

Union-centred education
Over the years, I have had varied relationships with unions, sometimes admiring them, sometimes attacking them. At no stage, however, did I ever seriously think that we should abolish them. I recognised their important role in the complex mix of education and for most of my professional life I was proud to be a member of the union. However, this does not mean that, in my view, unions don’t make some unfortunate decisions.
Today union membership seems to be declining, but education unions are one of the few exceptions to this trend. What that says about the unions or the teachers is anyone’s guess, but I suggest it indicates our high level of satisfaction about the work the unions perform. However, this is not always a seamless record.
Education unions have gained improved conditions for schools – and indirectly for the pupils – through many of their campaigns, such as when they pushed for greater support for teachers to improve their qualifications. I also believe that their influence (and here I am talking especially of government school unions) has indirectly helped other unions, including nurses and emergency services, to gain better conditions. However, there are a couple of instances where I would argue that education unions have put their own needs before those of the pupils.
The first of these relates to the divide between government and non-government schools. Instead of seeking to join forces with fellow educators, there has been a needlessly divisive policy of non-cooperation, and I believe that education as a whole has suffered from this attitude. Fortunately, principals’ associations have often been far more open to sharing and this has drawn on the strengths of all schools, not just one group.
The second place where pupil needs have been ignored by educational unions is in the silly and quite needless defence of poor performance of some teachers. Whatever might be said of the justice of such an approach – and I admit that the debate is not one-sided – the main effect of such defensiveness has been to lower the esteem of the profession in the eyes of the general populace. I am sure that some people, including parents who should know better, believe that our schools are filled with hopeless teachers who couldn’t teach a dog to chew a bone. This silly misconception is as mindless as the view that all farmers live a life of luxury because of farm subsidies or that all police officers are bullies. The consequence of the low esteem for teachers is that parents allow their (poor performing) children to excuse their own behaviour by blaming the teachers. No-one wins here.

Principal-centred education
When it comes to principals mucking up the system, the gold and silver medals go to those who think their role is to echo whatever the central office says, and to those who allow themselves to be blackmailed by parents. I am all in favour of strong, even forceful leadership by system administrators, and many of the decisions that come from the bureaucracy have merit. However, on those occasions when the words from above are suspect, no-one has a better chance than a principal to overturn these dictates. Such rebellion will be risky, of course, because future promotions are determined by Head Office, but only the most autocratic of directors will refuse to listen to the on-the-ground leaders of schools, the principals. Regrettably, too few principals seem willing to disagree with their nominal superiors. The later therefore falsely assume that their dictates have popular support.
The second group who intimidate our principals – at great cost to staff as well as pupils – are noisy parents. Now don’t get me wrong: I am not talking about nasty parents or misguided parents, or even negative parents. These are more or less easy to identify and most principals seem to be able to cope with these without losing too much sleep. No, the ones I am referring to here are the ones who are often seen by others as the star supporters of the school, the ones who attend every meeting and who sell tickets for every fund-raiser. In fact, their only real fault is that they think that they – and they alone – are the font of all knowledge and the repository of all wisdom. They think their views must be adopted and anyone who disagrees with them is a left-leaning terrorist or a child-spoiling post-modernist. Let me give some examples.
At a parent meeting, someone advocates a healthier diet for the school canteen, and backs up the arguments with relevant data on the increase in obesity in our communities. The meeting seem to go along with the idea until suddenly someone stands up and reminds people that this idea has been tried – dismally – in the past and it was a major blow to the budget. No-one seems keen to seek further details because this voice seems so authoritative, and the idea dies. This is the time, for the benefit of the children, when the principal should get up and remind people that the situation eight or nine years ago was very different, and the options available were far less impressive, but the principal simply wilts in the background and the hope of today’s children for a healthier canteen are fully dashed.
The arguments raised, the reasons offered, the decisions made will vary from school to school, year to year, but every school seems to have a handful of these vociferous parents and all too often the staff seemed bluffed by this person – with the needs of the students being over-ridden.

Teacher-centred education.
Having had a swipe at systems, unions, principals and parents, it is probably not surprising that I would also make some comments about teachers. However, just as I think that education offices are sound, unions committed, principals dedicated, and parents on-side with education, so I want to make it clear that I have a very high opinion of almost all of the teachers with whom I have worked in the past 50 years. On the other hand, I did use the phrase “almost all” and so there have been some teachers whose habits struck me as child-unfriendly.
The worst offenders are those who played favourites and the next worse are those who lack consistency.
It is easy to understand why teachers like some children more than others – some children are more likeable than others! However, this does not justify the situation where some teachers actually favour particular – in order words, they play favourites. Ironically, the process actually backfires, and that is my major reason for criticising it. As soon as a teacher singles out a student for special attention and care, that student becomes rejected by many of the others in the class. It is not always immediately obvious, but you only have to listen carefully while you are on playground supervision to find how often it happens. The favoured student might not mind, reasoning that having a powerful friend in the teacher is more important than losing some friends among one’s classmates – but the usual pattern is that the favouring teacher is not in the class next year, whereas the bulk of the classmates are. The ‘favoured state’ position can be perilously shaky, and putting a child in that position is not exactly a positive child-centred relationship.  
The second group under fire here are those who wax and wane according to the mood they are in, so that their students never really know how to take them. One day they are fun people, sharing a joke and making a class feel safe; the next day, they are grouches who snarl at everyone and everything, making it impossible for their students to know what is wrong. This sort of emotional hurdy-gurdy is deeply confusing to children and young people. Their right to have mature role models is destroyed and instead they spend their time trying to second guess these adults. No wonder so many people leave school confused and insecure.
Take any of the examples I have given, and you may be able to think of other offenders to outmatch them. The aim is not to multiply the number of offences committed against our students; instead, it is to remind us that if schools are really doing what they should be doing, it is the needs of the children that should dictate the actions of all those who allegedly support education. If we can remember this, and ensure that education truly is student-centred, the day may come when we all agree that school days are indeed the best days of our lives.