Wednesday, 15 February 2012

Half term thoughts on the Health Bill

At lunch today with my wife, we were reading the papers, and got into an interesting conversation about the Health Bill, prompted by a lead article in the Independent, outlining that patient satisfaction with the NHS is the highest it has been in the last 10 years. This got us on to a conversation about the case for change, and what the Health Bill has been designed to do. I outlined to my wife the same case I outlined to you in September in this blog, and underlined the aspects that I have felt are key to uncovering what the bill is all about: namely the removal of the responsibility of the Health secretary to provide comprehensive healthcare for the people of the UK (dealt with to some extent by the last round of concessions), the change from PCTs serving a geographical area, to Clinical Commissioning Groups servicing the lists of patients of their constituent GP practices, and the removal of the limits to the amount of private work that hospitals can engage in. Rather than rehashing the same arguments, take a look at what I wrote before:

In having this conversation, what struck me the most was how long these issues have been apparent, and how long it has taken to percolate it's way through to the media. My views may not be right, and they may not even be very perceptive, but in the ongoing discussion no new evidence has emerged to make me refine them further: they are based on exactly the same evidence that was present 4 or 5 months ago. The delay in them reaching the popular agenda is not down to the availability of information on which to inform opinion, it is down to the much more diaphanous issue of how issues become important to the popular imagination.

I find it difficult to get excited about books that other people have excitedly recommended to me, and have to wait until I reach a point where I independently want to read a book before I am able to read it. This is partly driven by my deeply ingrained counter-suggestibility, but it is also partly driven by the problem of being told what to think and why. I don't want to have to like a book because someone I know and like loves it, and I do not want my reading of the book to be constantly influenced by reflecting on why my friend enjoyed it so much.

The same is true of big issues that are important to other people, for reasons of happen-chance, before they are important to you. It is hard to be effectively hectored into treating something with urgency and gravity, because no one wants their firmly held beliefs to be bullied into them. It is crucial that on significant matters, we all have the chance to find our own way there, that we are encouraged and supported to give the matter some air-time, but that we are not harried or cajoled into agreeing with others, because that is the popular belief.

So my brief point on this holiday blog, is that I am glad that the health bill is front page news, and I am glad that it is being discussed in newspapers and on news programmes, but I am no longer miffed that it has taken so long to make it on to the agenda. The time delay we have experienced was not wasted time, but time in which lots of people spent lots of time reflecting on what they thought and what they believed, and coming to well-reasoned conclusions, on both sides of the argument. We all need the time and space to work out what we think, and the key thing is that the bigger the issue, the more time and space we should have.

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