Keeping it simple – The lost art?

Throughout all the plethora of changes imposed on the NHS by successive governments, the increasing complexity of virtually everything is one of the most striking features. We meet it everywhere in the use, or abuse, of language. Those of us obliged by the nature of our jobs or involvement in local campaigns to attend meetings addressed by management representatives have to read and print off reams of paper inflated by “management-speak”.

Labelled ambulance

The art of succinct and meaningful expression has been lost in a plethora of “visions”, “going forward”, being “vibrant”, “exciting” or “overarching”. Even once meaningful phrases like “patient centred” and “clinically led” have been overused to the point of becoming mere clichés.

This is bad enough, wasting professional time (and trees) but is multiplied in its seriousness when its spreads, as it has done more and more, into complexity of structure.

This has now reached the point where even those working in the NHS have difficulty in finding their way around; and as for the longsuffering general public, they must be totally confused. In the beginning there were Community Health Councils. How many could list all the different patient representation bodies that have appeared and disappeared since then? Could this be part of the strategy, to make people lose interest and stop fighting the NHS cause?

The increasingly frequent structural changes to the NHS itself, as well as moving further and further from its original principles and down the road of privatisation bear much responsibility for the current financial crisis.

What they have also done, particularly in the competitive market based elements, is to waste vast amounts of scarce public money so that all sections of the service and the staff who work in them are under great pressure.

Added to all its obvious benefits for the NHS, the NHS Bill if enacted would by simplifying the structure save a great deal of money.   Surely that must resonate with politicians of all stripes, even those or perhaps particularly those, who are obsessed with the deficit?

May I suggest they adopt as a working principle “Keep it simple” – it’s cheaper that way?

Dr Peter Fisher

President, DFNHS

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