I particularly like it when blogging is being done, or is about to be done, by people whom I know quite well. And my friend Helen Evans has just this very day started a blog about nursing, called the Nurses For Reform blog.
That said, the prose style so far is rather corporate and armour-plated for my taste. However, despite the rather baffling word “contestability” – which is presumably some kind of Blairite code-word, for something or other – I think it is reasonably clear what is intended by the following:
NFR rejects bland egalitarianism in favour of contestability. Above all else we believe that greater partnership with the private sector is to be actively welcomed and that this sector’s contributions are good news for patients and healthcare professionals alike.
That suggests to me something quite like free market medicine, and of course I am totally for that. This next bit is definitely about free market medicine:
NFR believes in fundamental change. It believes that only by putting patients and consumers interests first will healthcare improve. It is only when healthcare is opened up to real consumers and trusted brands that nurses will find themselves working in a sustainable environment and with the incentives, resources and encouragement to deliver a responsive, popular and truly high quality service.
This says stuff I agree with, but in the manner of a corporate mission statement, and I loath and detest nearly every corporate mission statement that I have ever encountered.
Wouldn’t it be fun one day to read one of these things starting with something like: “We believe only in superficial change. Fundamentally, things should stay pretty much as they are.” And how about someone just occasionally admitting that he aims to supply an “unresponsive, unpopular” product or service? Many splendid tradespersons do just that and are richly rewarded.
However, since this is a corporate mission statement, I really ought not to carp. And since this is medicine and nursing care in Britain that is being talked about, well, I admit it, I do believe in “fundamental change”. Nor can I reasonably object to the ambition that nurses should work, if at all possible, in a “sustainable environment”, nor to them delivering a “responsive, popular and truly high quality service”.
To be more serious, I have quite often heard Helen Evans say, in the plainest of English, that one of the many problems of Britain’s National Health Service is that its nurses do not now have a proper career path in front of them. As soon as they get really good at their job, they tend to leave. The NHS has lost many of what would now be its NCOs, so to speak, good and experienced senior nurses being to hospitals what good and experienced sergeants are to armies. And where have they all gone? To get married, or to the private sector.
When the postings at this new blog get more specific and personal, as I am sure many of them will, I will surely read them with interest and pleasure. There will be more links from here to there in the future, I promise you.
But, for the ongoing inside story of NHS disasters, including “Consultant Nurses” try:
http://nhsblogdoc.blogspot.com
Then get ready to sign up for private medical insurance.
Don’t want to rain on your parade, Brian, but I don’t find NFR’s comments induce the slightest optimism in me about free market medicine any time soon.
This all sounds remarkably like Blair model #1 when he is in pro-consumer mode (as distinct from Blair model #2, when he says the opposite, by stressing the importance of communitarian values). A couple of years ago Blair said that public services needed to be reformed “to deliver in a modern, consumer-focused fashion”. By now, most people would realise that is vacuous PR coming from him, but everyone plays the style-over-substance game these days – a symptom of mediocracy.
It may be that life for nurses has become so difficult under our dear system of monopolised state medicine (gradually creeping closer to the Romanian model, methinks) that they are starting to admit openly the defects of insisting on egalitarianism in health care. I seriously doubt, however, whether the results of NFR’s actions will prove more than cosmetic at best.
‘contestability’ strikes me as a Blairite alternative to ‘competition’ – a word all true socialists (even the ‘Nu’ ones) deeply loathe since it implies both choice and freedom of choice.
With the seemingly desperation of publishing houses to sign up bloggers for their ‘story’ (policeman’s blog, paramedic’s blog etc.) I am very wary now of reading any of this type of blog at its inception for fear that I am reading Bloomsbury’s latest signing’s press release rather than genuine expression and comment.
Julian Taylor,
I think it’s more than word choice. I think there is meaning under it.
Contestability can be validly used in a go/no-go situation, as in to contest a will or a divorce. It can be used when the ‘choice’ is ‘our way or the highway’.
Competition, on the other hand, means rivalry, as in for a prize or a customer.
In short: use plain English.
I don’t know whether I’d like free market health care or not. I’ve never seen it.
In Mexico, one is free to buy the medicine he wants at the drug store. In America, the government health care demands we pay a doctor to prescribe.
There is no free market system in America, so I don’t know what all the free marketers think they are trying to protect!