what you get here

This is not a blog which expresses instant opinions on current events. It rather uses incidents, books (old and new), links and papers as jumping-off points for some reflections about our social endeavours.
So old posts are as good as new! And lots of useful links!

Friday, March 4, 2011

wooden language of reform


„Various types of interorganizational arrangements, many of which are referred to as partnerships, alliances, or multiple stakeholder groups, are emerging in numerous contexts as a method of negotiating diverse interests, goals, resources, and knowledge in decision- and policy-making processes. Such organizational relationships do not rely primarily on market or hierarchical forms of authority or control but rather on a commitment to realizing and negotiating innovative solutions to complex social problems collectively”.
How on earth can people write this way? The language of reform is so awful – I tried to explore why this should be so in Just Words? Of course there are some for whom it is deliberate obfuscation but, for the most part, it’s the old adage „those who can, do; those who can’t, write (or advise)”. The academics and think-tankers producing the material, for example, on health reform have rarely had the experience of managing things – for the most part they have absorbed theories and the words they use relate back to those theories rather than the real world in which doctors and patients interact.
A recent review in London Review of Books drew attention to the meaningless language which the British coalition government is using for its brutal restructuring of the health service and contrasts it with the clarity of the langauge when the health service was introduced all of 60 plus years ago by Bevan the left-wing Labour Minister.
Aneurin Bevan argued like someone willing to go to the wall for what he was saying. He spoke belligerently. He spoke as though to oppose what he was saying would be to offend against common decency. British politicians don’t talk that way any more, even when it matters. Take Andrew Lansley, the secretary of state for health. Like so many of his cabinet colleagues, and so many of those student politicians in the shadow cabinet, he appears to grasp the bullet points of an argument without ever grasping the argument. There’s a little moral seasoning to his dinner party rhetoric, a little dead-eyed flutter of words like ‘innovation’ and ‘commitment’, but Lansley has no feeling for the needs and fears of people who go to the doctor. He has no idea, but plenty to say.
Lansley’s Health and Social Care Bill will summarily abolish 152 primary care trusts in England, and GPs themselves will have to choose where to buy services from. The NHS thereby becomes a stimulus to energetic competition in the private sector, and the notion of universality goes out the window. Even GPs, who are not known for hating power, don’t want power this way: turning them into commissioners is a category error. Lansley’s proposals borrow the sound of freedom in order to usher them into a financial prison. It won’t work, and GPs know it. Yet Lansley’s department continues to show a peaky disregard for sound paragraphs. ‘Liberating the NHS’ – see what I mean? – is said to be the result of the consultation process. Here’s a typical block of text:
To further incentivise improved outcomes and financial performance, consortia will receive a ‘quality premium’ based on the outcomes achieved for patients and their financial performance. Some of the outcomes from the Commissioning Outcomes Framework will inform the premium – but not necessarily all, since some may not be suitable for translation into financial incentives. The Bill introduces the powers necessary for the quality premium, and we will discuss further with the British Medical Association and the wider profession on how to shape it.
By way of contrast, let’s look at Bevan’s speech to the House of Commons on 30 April 1946, on the occasion of the second reading of the National Health Service Bill. ‘In the last two years,’ he said, there has been such a clamour from sectional interests in the field of national health that we are in danger of forgetting why these proposals are brought forward at all … Many of those who have drawn up paper plans for the health services appear to have followed the dictates of abstract principles, and not the concrete requirements of the actual situation as it exists.So far, so clear. Today’s conjurors with ‘paper plans’ might hang their heads. Then, this: It is cardinal to a proper health organisation that a person ought not to be financially deterred from seeking medical assistance at the earliest possible stage … The first evil that we must deal with is that which exists as a consequence of the fact that the whole thing is the wrong way round. A person ought to be able to receive medical and hospital help without being involved in financial anxiety … If it be our contract with the British people, if it be our intention that we should universalise the best, that we shall promise every citizen in this country the same standard of service … the nation itself will have to carry the expenditure, and cannot put it upon the shoulders of any other authority.
You can hear the putter of hope and the crank of disgust in that very plain speech. Orwell would have liked it – its lilt, its flow and its moral transparency. But it is the quantity of solid civic ambition that resounds now.

The phrase "wooden language" is aa bit of an insult to a beautiful thing - trees and wood - hence my photo (a Targoviste verandah from Mandache's collection)

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