As we continue our series highlighting the work of our Board members, in this issue we speak with Mark Blake-Knox, Board member and member of the Audit and Risk Committee, and Fitness to Practise Committee (2011)
Could you tell our readers a bit about your background?
I am heading towards my 65th birthday. I am married to Ann for a long, long time…over 35 years. We have two sons and a granddaughter, Amber who is just one.
Professionally, I worked for 37 years for a relatively large, Section 39, not-for profit organisation that provided residential and respite services, and home support services for people with often very complex neurological conditions and physical disabilities. I was Chief Executive of the organisation for over 25 years. I loved the work, the people and the organisation. The organisation employed a small number of nurses, but always found it difficult to attract and recruit nurses who had knowledge and experience of supporting people with the complex clinical needs of the people it supported. Salary packages for nursing roles within HSE-run or Section 38 agencies were more attractive. One of the reasons I became interested in getting on the Board of NMBI was to learn if and how the organisation might recruit nurses with the skills it required.
When did you join the Board of NMBI?
I saw an advert for positions on the Board of the NMBI and applied to be the representative of the voluntary sector. My appointment was approved by the Minister for Health on the 5 December 2012, but as it was a new Board, established under the 2011 legislation, we did not meet until our induction training in April 2013. My 10-year tenure on the NMBI Board will end on 5 December 2022.
As a lay member of the Board, how important is it to have diversity in representation and what value do non-nurses/midwives add to the decision-making process?
I believe that the combination of nursing and midwifery together with lay people has been hugely valuable for the NMBI and, I am sure, for other regulators. While many of my nursing and midwifery colleagues have been senior managers, I, for instance have the experience of running and developing the strategic direction of a relatively large, complex organisation with a big budget. That knowledge and experience, I believe, has been helpful to the overall governance of the NMBI. Other lay colleagues also held senior management position in organisations like the HSE and had similar invaluable experience in governing organisations and knew the health and personal social system extremely well. Our nursing and midwifery colleagues educated us about clinical issues, the educational system that people have to go through to qualify as nurses and midwives, the standards expected by the nursing and midwifery professions of each member of the professions, the huge challenges being faced by nurses and midwives in wards and community settings across the country…before Covid, during Covid and during the cyber-attack on the HSE etc.
I am sure that most nurses and midwives do not often think about the regulator of their professions, except when they have to pay their annual renewal fee or for those few who have a complaint made against them. However, I am sure that one way or another they assume and hope that their regulator is well governed. For me, that mix of nurses/midwives and lay people, with different skills and experience, helps to ensure the regulator is well organised, well run and going in the right direction.
I think, like all organisations that want to be well governed, NMBI always needs to consider if the Board is appropriately diverse for the ever-changing population of nurses and midwives it regulates.
What have been your biggest achievements as a Board member?
I don’t know if, as a Board member you can see any achievements as individual ones, but you do try to influence thinking if you feel something can be improved or done better. I believe I challenge conventional and/or institutional thinking as sometimes I might have a very different view on some things.
I hope I have challenged perspectives in relation to complaints against nurses and midwives. While complaints are beneficial for improving organisations, services and us as individuals, for those against whom the complaint is made, the fact of the complaint, the process you must go through subsequently, especially if it goes to inquiry is long, complicated and hugely stressful. One of the things I with one or two others encouraged was a simple English guide to the complaints process for nurses and midwives, so that people can, at least, understand the process. The complaints process will be a key part of the NMBI’s strategy over the coming years.
What challenges have you faced during your time on the Board?
There have been many significant challenges at times…for the professions and NMBI (Covid being the latest), but they are all in the past. When I look at NMBI now, I see a well-run, well-led and managed regulator, with some brilliant staff at all levels of the organisation. That makes me very pleased, especially as I get close to the end of my time on the Board. While this probably never crosses the minds of the 80,000 nurses and midwives busily working throughout the health and personal social service system, it is important that the body that regulates its professions is well governed and well run.
You are also part of the Fitness to Practise Committee and the Audit and Risk Committee. Could you tell our readers what role these Committees play and how it affects them?
I am a member of the Audit and Risk Committee which has a very key role in making sure that the organisation is well governed from a financial and risk perspective. The Committee ensures that the financial and the operational processes are fit and appropriate, and always improving. It is very technical work that is essential to the governance of the organisation.
The work of the Fitness to Practice Committee relates to the processes that impact on a nurse or midwife once a complaint is made against them. Each year the NMBI can receive something like 100 complaints. While the number is very small when you consider that there are in excess of 80,000 nurses and midwives on the Register, it is really important, I believe, that every nurse and midwife know about the process. I chair and sit on panels that hear inquiries and I am sure that everyone who has gone through the inquiry process would say how stressful, terrifying and humiliating the process is. Inquiries are very formal and carried out often with two or three barristers in the room with lots of legal language being spoken. From my experience sitting on inquiry panels, it is critical that nurses and midwives remain professional in the workplace at all times, even when you might be going through some incredibly tough times in your personal life, or if the workload is immense, or even when you are dealing with difficult patients/service users. If you feel you are not fit to work on a particular day, think carefully before you make the decision to go to work or not. The standard of professionalism expected of nurses and midwives is huge and the vast majority remain unbelievably professional, even when circumstances are incredibly challenging.
In previous interviews with Board members, we spoke about how they find a balance between their work on the Board and Committees, their career and their home life? How do you find a balance?
I am very lucky in that I am retired and the only real pressure on my time is from our two dogs – one of whom likes at least three walks a day. The work for me is a pleasure. There is a huge amount of reading to be done by Board and Committee members for each meeting. I am in particular awe of Essene Cassidy, the current NMBI President, who has a very busy day job with lots of responsibilities, who must attend day and evening events as President, who seems to have a very busy family life, but is always brilliantly prepared for Board meetings and is always in good form.
Finally, what advice would you give someone who is interested in joining the NMBI Board or one of the NMBI Committees?
If anyone is interested in joining the Board of NMBI, I would say, if you can give it the time…”go for it”. While there have been many ups and downs in the nearly ten years, in particular, in the early years, I have loved every minute of it. I have met, learned from and enjoyed the company of so many extraordinary people, not just Board or Committee members but also the people who have worked/work for NMBI. You learn so much about two extraordinary professions that expect the highest standards of each other and, hopefully, you contribute to the further development of those professions and their regulator.
