Fiefdoms to obliviousness to organisational culture This exposure got me to thinking whether, several Director-Generals later, the existence of Ministry fiefdoms had changed. It seems not. But there is more to the fiasco than this. In todayâs world fiefdoms within such an important institution as the Health Ministry indicate a high level of obliviousness. This goes to the heart of undermining the overall trust and confidence in the Ministry of government, the wider health sector (including health professionals, district health boards and non-government organisations) and the public. Obliviousness has two different (not necessarily alternative) meanings. The first is lacking remembrance, memory, or mindful attention. This isnât the case in this instance. But the second, lacking active conscious knowledge or awareness (especially the latter) applies.