- Leandro Herrero - https://leandroherrero.com -

The Irish Health Service’s silent culture revolution was driven by ‘if-not-us-who?’ employees

Four years ago, starting in the Midwest of Ireland and replicating to other parts of the country, a bottom up social movement, ‘Values in Action [1]’, started to shape the culture of the Irish Health Service (HSE) . On top of their day jobs, employees joined in to create a system of peer-to-peer interactions and joint commitments to make nine behaviours live and multiply. They were conscious that behaviours create culture. No more words on paper, real behaviours in real life.

They trusted each other. They trusted our external help. The Leadership trusted everybody. Staff nominated the peers that they thought should lead the initial work as Champions. There were all hierarchical grades involved. These hierarchical differences, traditionally very strong in any health care system, did not count here. They all had in common, their love for the Service and the shaping of a collective future. They had a sense of higher purpose and grabbed the opportunity.

They did all this on top of long hours and the often, stressful situations of the day to day health care delivery. They beat the cynical and the defeatist. Some media were sceptical, even mocking (‘workshops on caring’) but nobody stopped. Some outsiders may have thought that culture was not a priority. These employees thought exactly the opposite. So did the leadership of the HSE.

Staff surprised managers and colleagues. They surprised themselves. They started to change their workplace and told their kids about it with pride. When, after two years, many initiatives in any large organizations are gone or fading, ‘Values in Action’ continued to show quantifiable advances that have changed the ethos of the place.

Our part in the process has now concluded but culture will never be ‘done’. The social movement continues. Nothing stopped these HSE employees from taking charge of the shaping of the culture for the future. They simply said ‘if not us, who?’ Agency at its best. Changes in structures and process may take place as any evolving public service may require, but this grassroots movement was determined to continue its often silent growth to ensure a behavioural fabric where anything good can grow.

As a lead on the small external team helping the movement, providing the Viral ChangeTM Mobilizing Platform, I followed the evolution with a sense of enormous privilege. One thing is for sure: I am not surprised in the slightest about its success. It’s hard to find any other place where employees were so committed to their work with a sense of purpose. They often see themselves on the front page of newspapers when something is wrong. They don’t often see themselves making the news when their 24/7 commitment changes or saves the lives of patients. They may not see their ‘Values in Action’ social movement as front-page-able. But no one will lose sleep about that. Their children, their families, their patient’s children, won’t thank them because of the front pages, but because of the collective place and space of pride, hope and service.

The leadership of the Service has often been in the media as a focus of criticism. Public servants know that this is part of the job. My experience of the local leaders involved who supported the ‘Values in Action’ grassroots is that they were exemplary. The top leadership of the Service, past and present, has made exceptional efforts to support the grassroots culture movement without dictating or interfering. Not a bit. Clear and simple, the past Director General made culture a priority and then trusted all of us. Many top leaders of local hospitals and community care have done the same.

In unsettling global times, the sight of people taking charge and shaping their destiny, is as good as it gets. After all, ‘if not them, who? If not now, when?’


For an understanding of Viral ChangeTM and how it can be applied read…

12 Rules to Manage the Covid-19 pandemic [2] with a behavioural counter-epidemic using Viral Change™ principles. An epidemic of the right behaviours, at scale, is needed.

Read Dr Leandro Herrero’s in-depth, thought provoking article which addresses the non-medical management of the pandemic through the lenses of large scale behavioural and cultural change principles, as practiced by the Viral Change™ Mobilizing Platform for the last 20 years, in the area of organizational change.

12 Rules For A Behavioural Counter-Epidemic To Deal With Covid-19   [2]

Now available in Spanish.



Dr Leandro Herrero is the CEO and Chief Organization Architect of The Chalfont Project [3], an international firm of organizational architects. He is the pioneer of Viral ChangeTM, a people Mobilizing Platform, a methodology that delivers large scale behavioural and cultural change in organizations, which creates lasting capacity for changeability.
Dr Herrero is also an Executive Fellow at the Centre for the Future of Organization, Drucker School of Management. An international speaker, Dr Herrero is available for virtual speaking engagements [4] and can be reached at: The Chalfont Project [5].
His latest book, The Flipping point – Deprogramming Management [6], is available at all major online bookstores.