Bumper June Crop of MAC Musings

“Text cloud” for this post below, created by www.wordle.net

Ruminant Rumblings

It has been a bumper month for the public engagement debate across a wide range of participatory and management issues. We have sought inspiration for better management practice from an annual ritual in the Swiss Alps where cows battle out issues of hierarchy and succession in what we might call a ritualised ruminant rumble (to borrow the rather ancient gang fight vocab of West Side Story) complete with combat footage video. This piece brought out the worst in partner-originated puns.

Participation by Invitation Only – a discredited approach

Management issues were at the heart of Caroline’s accusation that parent power was nothing more than a piece of populist spin. The model of ‘trouble-shooting’ management embodied in an Interim Executive Board does not seek to engage parents. Instead they seem to favour the traditional ‘expert’ management style – taking the hard decisions quickly unencumbered by the burdensome baggage of external consultation. This executive pays little heed to the necessity of communicating what it is doing to parents and even as it moves to appoint a new governing body, the Board deploys the discredited practice of participation by invitation only whereby a small number chosen from the ranks of teachers and parents and a member from that most nebulous of concepts – the local community – are invited to take their place at top table. And invitations as we know can be withdrawn.

NHS Market Stimulation – new competencies needed

Andrew Craig has a different emphasis in his piece on market making in healthcare. This is a new competency for the NHS and unsurprisingly they are not yet very good at using their purchasing position within the economic framework of the NHS to get better value for patients. All are having to learn very quickly on the job as they look to managing their budgets in anticipation of them becoming subject to the new constraints on public expenditure. The debate on the positive contribution that markets may make is a theme of the current Reith lectures where Sandel tells us that there are instrinsic values in human activity where a purely economic approach does not work. The NHS will perhaps always be a battlefield between these two ideas in a context of political management.

Morality and Economics – a Reithian debate

I have touched in a previous newsletter about the deficiences in the consumerist model in those contexts where the citizen interest has to be invoked to make provision work for all sectors of societies. I wonder if this Reithian debate will form any part of Richard Thomas’s agenda as he becomes the Deputy Chairman of the Council of Management of Consumers’ Association. We marked Richard’s departure from the post of Information Commissioner and summarised the interesting debates we heard at a farewell conference in May 2009 – Jack Straw was moved to deny that the Government was using Orwell’s 1984 as a manual of statecraft. The mixture of the economic and the moral is particularly volatile in the arena of public privacy and data protection where a technology is evolving at light speed while the debate on public morality and efficiency and of course now national security and personal safety moves at its traditional pace as lots of people try and make up their minds about difficult topics.

Sarah’s Story and decency, fear and distress

An example of the controversy that can arise from sincerely held differences of opinion in the public arena came with an Advertising Standards Authority decision about five complaints received about the short film ‘Sarah’s Story’ made by the Motor Neurone Disease Association on the grounds that its violent images as Sarah is possessed by MND on the grounds that it offended against the Code clauses relating to decency, fear and distress. The ASA decided that the content was justified given the nature of the disease.

Please comment if any of the above resonates with you. We look forward in particular to hearing from Swiss dairy farmers.

We have caught our first LINks – the Wandsworth Care Alliance and the Partnership are chosen to be the LINks Host in Wandsworth

That Fabulous Beast
Loyal readers will remember from past blogs our somewhat over-extended metaphor of that fabulous beast the greater spotted LINks seen prowling the precincts of Westminster – was the beast to be set free and be seen all over England as the new embodiment of patient participation? Would it flourish and survive where so many other species of patient engagement have failed and died out?

Well in Wandsworth, we will be helping answer those questions. We will be establishing the best of habitats for this new animal working with the Wandsworth Care Alliance and Wandsworth Borough Council to set up the Wandsworth LINk – one of the first in the country.

We have been writing about LINks in our blog for a long time now – the first article was in July 2006 and with regular mentions since then. We are now about to discover the difference between being the commentator and taking the role of participant. The thread that unifies the two is being able to learn and draw some lessons from the work.

We are getting off to a very fast start since Wandsworth is an area that Val Moore and Andrew Craig know very well. They are already plugged into the local health economy in a number of ways – at the grassroots as members of the Balham Park Surgery Patients Liaison Group and then at an institutional level, Andrew Craig as the Lay Member on the PEC and Val Moore as a non-exec at St Georges Hospital.

All the partners will be working on the project and we look forward to doing a good job assisting the Wandsworth Care Alliance as it builds a new structure for the users of health and social care services in Wandsworth.

Business as Usual
In the meantime, we will be continuing the blog with our usual eclectic mix of articles – last month, we gave our views on the new proposal for a single door entry point for citizens who have a complaint and returned to the source with some musings about Beveridge’s original plans for the NHS. The last newsletter pointed out our propensity to value things like post offices only when they are threatened with extinction. This one has focused on new life for patient engagement in the form of the new LINks structures.

Eirlys Roberts – a personal tribute

So with these thoughts of death and renewal, it is the moment to pay my own tribute to Eirlys Roberts who died on 18 March aged 97. Maurice Healy one of her adjutants at Which? described her correctly in his Guardian obituary as “the mother of the modern British consumer movement“. Michael Young, later Lord Young of Dartington, is credited as the founder of Consumers’ Association, publishers of Which? Magazine. Founding was what Michael was good at – if what he set up survived, it was because he found/left in place people like Eirlys with the passion and skills needed to make sure the infant organisations survived and prospered to give a life time’s work to people like me.

The prose style Eirlys required all the Which? writers to observe, was in her words “to use concrete nouns, not abstract ones, the active not the passive voice, short sentences, short paragraphs and short Anglo-Saxon words“. Each piece destined for Which? was edited at least 4 times and pared back to the libel-free, truthful minimum. An Eirlys editorial session was a risky and exhausting encounter for those of us with a disdain for boring detail and a taste for wordy generalisations.

I joined Which? in 1969 just before the launch of Money Which? The Which? Guide to Contraception had been published shortly before. The Eirlys style was a fabulous formula for success – money and sex discussed in that clear, rational Which? style that helped the middle classes conquer their embarrassment at their materialistic and sexual urges and gave them permission to be interested in both subjects, discussing the relative qualities of their fridges at the dinner table, probably even in bed. (The quality and price of white goods in those less affluent days occupied the place in people’s conversations that entire houses and kitchens do now.) Reason reigned and consigned the vulgar emotions of envy and acquisitiveness conjured up by the adman to the bin (did we test those I wonder?).

I took those words of Eirlys’s from the Times obituary where as a classicist, she would have been amused to share the obituary page with Charlton Heston, the great charioteer of Ben Hur.

Vale Eirlys and thank you for that style and way of thinking – remnants of which I still cling to even now particularly when discussing patient engagement scenario situations at the cutting edge of positive citizen participation strategies rolling forward to the big picture event horizon of Local Involvement Networks. Clear enough?