Abstract
Love is a strong word, surely to be reserved for feelings of genuine passion. But it might become NHS jargon now that Prime Minister David Cameron has declared his love for the NHS. Cameron loves the NHS so much that he wishes to change it, although not quite in the way that he wished to initially when he was blinded by passion and wasn't listening to anybody but his health secretary, Andrew Lansley.
Indeed, the latest NHS jargon is the ‘listening exercise’ being conducted by Steve Field, erstwhile chair of the Royal College of General Practitioners (RCGP). Not that listening is bad. Certainly, anybody with the faintest of interest in NHS politics listened intently when Loughborough binman, Sean Donnelly aka MC Nxt Gen, rapped his YouTube hit about the health secretary and his reform plans. Apart from creating his own jargon term for disliking the reforms – ‘Lansley tosser’ – MC Nxt Gen stunned the world with a clearly communicated critique of the government's plans.
‘The Royal College of GPs even joined the attack,’ analysed MC Nxt Gen, ‘Looked closely at the proposals and said they were crap.’ But now that Field is involved, will the RCGP deliver the same verdict? Cameron's love of the NHS has inspired changes to the original reforms. Full institutional and managerial integration of the NHS and social care in England is the headline statement. In addition, hospital doctors and nurses will be more closely involved with GP-led consortiums. Competition in the NHS will not simply be for the sake of it, and private firms will not be able to cherry pick services.
At the end of all this, said Mr Cameron, the NHS will look reasonably similar, a statement that offers reassurance, threat or bafflement, depending on your perspective. Unfortunately, just prior to Mr Cameron's NHS love speech at Ealing Hospital, one of his ‘key advisors’, Mark Britnell, suggested that the NHS would be transformed into a provider of state health insurance and patients would be charged for using the NHS. Field, now chair of the NHS future forum, described these communications as wrong.
In simple speak, it still seems to me that the NHS requires, or is being required, to make savings of £15–20 billion over the next four years. Hence, to maintain and improve standards of care we need a more efficient health service and an increase in productivity. But we can't agree on two fundamental issues: how to do it, and why we are doing it in the first place.
Perhaps all the medical jargon and inscrutable communication are getting in the way? They are the resident evils in the NHS. Indeed, Conor Farrington argues in this issue that ridding our health service of these curses could deliver significant improvements in patient-centred care (JRSM 2011;