Book Review – Catastrophe and Systemic Change

The Grenfell Tower tragedy was the worst residential fire in London since the Second World War. It killed 72 people in the richest borough of one of the wealthiest countries in the world. Like other catastrophic events before it and since, it has the power to bring about lasting change. But will it? The historical evidence is weighed against ‘lessons being learned’ in a meaningful or enduring way.

In an attempt to understand why, despite enormous efforts, we persistently fail to learn from catastrophic events, this book uses the details of the Grenfell fire as a case study to consider two questions:

Why don’t we learn?
What would it take to enable real systemic change?

The book explores the myths, the key challenges and the conditions that inhibit learning, and it identifies opportunities to positively disrupt the status quo. It offers an accessible model for systemic change, not as a definitive solution but rather as a framework to evoke reflection, enquiry and proper debate. Catastrophe and Systemic Change is a must-read book for a wide range of readers including those interested in change management, leadership, policy-making, law, housing, construction and public safety.

About the author

Gill Kernick is an internationally experienced strategic consultant specialising in safety, culture and leadership. She lived on the 21st floor of Grenfell Tower from 2011 to 2014.

Advance praise for Catastrophe and Systemic Change

‘This powerful book lays out starkly the many failings that led to the huge tragedy of Grenfell. In the immediate aftermath, Grenfell was expected to prompt significant change. Yet four years later even the cladding issue is not resolved. Kernick describes why effective learning and systemic change do not happen – even in the face of events that make us weep with fury. I will respond to the book’s ask to take small steps toward change by challenging organisations to practise two things: error wisdom and chronic unease.’ – Dame Kate Barker, Trustee Chair, USS, and former member of the Bank of England’s Monetary Policy Committee

‘Reading this powerful story of the Grenfell Tower fire and the testimonies to the still ongoing public inquiry, it becomes difficult to avoid the conclusion that the disaster was mostly the result of a multitude of market and regulatory failures. Gill Kernick shows that lessons had not been – and are still not being – learned. Ignoring “low-probability, high-consequence risk” to cut costs comes at a heavy human and economic price, as we are also discovering with the Covid pandemic. A very sobering verdict.’ — Vicky Pryce, former Joint Head of the Government Economic Service

‘Learning from catastrophic events to drive necessary change should happen in every area where public safety is a fundamental requirement – as, for example, in the provision of housing. It is scandalous that there is widespread and fundamental failure to apply any lessons learned. Read this book to understand the interplay between those at the top and those at the bottom of the power ladder, and understand how we all can, and should, influence decision and policy makers to facilitate and achieve the changes which are so needed.’ – Her Honour Frances Kirkham CBE (coroner in the Lakanal House inquests)

‘After every tragedy and subsequent investigation, we are told systemic change is needed and lessons will be learned. Gill Kernick’s new book grapples with the barriers that, with equal predictability, seem to stop that happening – really important questions four years after Grenfell, and as we continue to battle with the pandemic.’ – Jill Rutter (Senior Research Fellow, UK in a Changing Europe)

‘Firefighters across the world watched as the Grenfell Tower burned and knew the courage and bravery being demonstrated by members of the London Fire Brigade who battled heroically to save lives and fight the flames. They came under intense scrutiny for their actions on that night and now it’s time for the talking to stop and the lessons learnt to be put into action. I spent thirty years as a firefighter and witnessed many catastrophic events which resulted in talk and no action. This book should be compulsory reading for everyone who has any part to play in implementing the lessons learnt.’ – Duncan J White – Group Editor, International Fire Fighter magazine

About the book