OPINION

'Don’t allow flippant politics to reduce the NHS to a flea market'

7 February, 2012 | By Mark Radcliffe

I don’t like arguing.

I used to. As a younger man, I enjoyed pointless debates about everything from the anachronism of royalty to how best to cope with a shark attack. As a teenager, I would argue about religion, the moral status of cows, the colour yellow, bread and the evil that is contemporary dance. It was exhausting but I was terribly earnest, debating the rights of cattle as if they were family members.

Later, we learn to shrug, don’t we? Not just about yellow but about god and meat, and even sometimes politics. Not because we don’t have beliefs but, perhaps because we are too busy to argue, we don’t always believe in the process or the parameters of the argument. Or the point of trying to alter opinions. Or even the people with whom we are expected to argue.

I think it probably counted as “good” politics when Andrew Lansley suggested that nurses may be opposing his health bill as a response to his government’s assault on their pensions rather than the fact that it was an unhelpful bill. It was a bit like turning up to work in a pair of ill-fitting hot pants and, when everyone pointed out that they really didn’t suit you, alleging that they were all just jealous.

But, as a piece of modern politics, one imagines Mr Lansley congratulated himself, because while it was offensive and crass and purposefully ignored the obvious fact that nobody likes it, it did manage to shift the debate away from the content and implications of the bill to the small-minded bitterness of staff.

Last week there was a summit meeting of 20 royal colleges. First, who knew there were that many royal colleges? Now that I know they are so common, I’m not sure I want one anymore. Second, do you think it was like a Jedi high council?

Third, isn’t it just a little bit of a shame that, instead of issuing a joint statement outlining collective concern over the health bill, the talk afterwards was of Mr Lansley’s comments?

While their repudiations were understandable, I suspect Mr Lansley was pleased to hear them. Because this government knows they don’t have to win arguments – they just need to make sure they get to choose what it is we argue about. Forcing people to defend themselves shifts the debate away from issues like equity in delivery, maintaining clinical standards and retaining consistent investment in service provision and on to how annoying staff can be. Control the parameters of exchange, and you control the politics.

It’s a bit like the argument about being attacked by a shark. Should I punch the shark on the nose? Stay perfectly still? Thrash about? Nope, it’s best to ensure if it attacks me it does so out of water, preferably on an escalator.

I look forward to the day when professional leaders stop feeling forced on to the defensive in the face of manipulative and flippant politicking and instead draw their own battle lines. Because what are we arguing about? Is it really as Mr Lansley suggests – that nurses are sulking (might it be their hormones, the little dears?) and cannot see reason when he offers it to them? Such nonsense is beneath us. Or is it that this Tory government – like all Tory governments – consider the NHS an anathema and won’t rest until it is reduced to a soulless one-dimensional and not-fit-for-purpose flea market?

Winning arguments is fine, defending people who are being attacked is an admirable instinct, but setting the agenda and controlling the ground upon which to argue is paramount now.

Mark Radcliffe is a senior lecturer and author of Gabriel’s Angel.

Readers' comments (20)

Anonymous | 8-Feb-2012 12:25 pm
Absoloutely, Mark.

Our professional leaders must show, well....leadership. A point you have made before. And based on their track record, therein lies the concern!

Like a Chairman of a football club talking about his manager, I just hope that Mr Cameron's recent confirmation of his total confidence in Mr Lansley means that it's signalling the end to the bill and Mr Lansley's reforms.
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Anonymous | 8-Feb-2012 12:43 pm
One of my problems, which may apply to many others too, is that I never learnt at a young enough age how to present a case and formulate rational arguments to defend it.

An MSc in my fifties has helped to understand the process and I am currently reading 'How to Win Every Argument. The Use and Abuse of Logic' by Madsen Pirie. Although there are some techniques I would not wish to use, and some I probably use already, I find this book gives a useful insight into examining the arguments of other people.

If only we all learnt these skills at an early age maybe we would have far firmer ground to stand on in defending our arguments against this healthcare bill.

Talking about flea-markets our modern local hospital comes to mind with bazaar like shops inside the front entrance and some rather cheap and scruffy looking clothing for sale hanging up high all around on pegs which brush against you as you walk into the open boutique. So much for hospital hygiene and providing an image of cleanliness and efficiency. One really wonders what sort of establishment one has entered - flea market or hospital?
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tinkerbell | 8-Feb-2012 1:07 pm
Anonymous | 8-Feb-2012 12:43 pm

One of my problems, which may apply to many others too, is that I never learnt at a young enough age how to present a case and formulate rational arguments to defend it.

Same here, maybe i still can't.

Maybe, for some of us, it's not until we are in our 50's that get a true perspective of what is vitally important and learn not to 'sweat the small stuff'. I guess it can go the other way like the 'old grumpies' who moan endlessly on about anything and everything. What would they do if they couldn't moan? They're not just set in their ways, they're set in concrete.
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tinkerbell | 8-Feb-2012 1:19 pm
so long as somebodys voice is listened to and hopefully that will be the doctors because they are usually more united and forceful, sorry nurses but that seems to be the case.

The big question is what kind of society do we want? Do we want a society where my life is more important that yours because i have the means to fund my healthcare and you don't?

Just cos' other countries don't have an NHS does that mean that we shouldn't either? How about selling one of your kidneys to fund your treatment? Apparently it happens on a daily basis in some countries where it is the norm. Have we been so pampered that we don't know what we've got until we lose it, so much taken for granted.

Wake up everybody and get real about the changes and how they will effect YOU.

Love me, hate me but don't remain neutral on this issue. Tme to stand up and be counted and united in our response. Stop moaning and take ACTION! If you've got some help and advice how to do this then offer it. Let's all share with each other how we can go about STOPPING this happening.

This is life and death we're talking about.
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tinkerbell | 9-Feb-2012 7:33 pm
http://www.youtube.com/watch?v=Dl1jPqqTdNo&feature=player_embedded

Don't watch this if you are easily offended by swearing.

Let's get the truth out there. Well done young uns
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Anonymous | 10-Feb-2012 8:24 pm
like Mark, I no longer have the capacity to argue or debate as I did in my youth.

Part of me wants the Bill to go through just so I can smugly say later on 'well, you get the NHS you vote for folks' - but I must concede that no one really voted for this lot anyway: it was voter apathy that gave this Gov power. Admittedly, Labour did not look a good bet for the NHS either - so I get the apathy thing.

Secondly, having lived through the last Tory Gov and their 'patients' charter' - that excrement was only proved useless by accepting it and rubbing the public's nose in it on the front line (pardon the mixed metaphors).

Thus, maybe we should let our NHS hospitals have 'private patients' and good luck to them - currently, we cannot find beds for any sick patients these days: private or NHS.

We might even get Tory party patients on our wards at long last - previously, NHS staff would not have been allowed to get anywhere near them - just think of what we could do with that sort of power.......I'd be back on the wards in flash for that sort of access to justice.
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DH Agent - as if ! | 12-Feb-2012 1:04 pm
'they just need to make sure they get to choose what it is we argue about.'

Quite - it is very important, to push the argument onto the right question !
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DH Agent - as if ! | 12-Feb-2012 1:06 pm
tinkerbell | 8-Feb-2012 1:07 pm

Anonymous | 8-Feb-2012 12:43 pm

I was never taught how to do that - but I have a science doctorate, and 'presenting the argument' is fundamental in science.

I wish more people could do it - it makes it easier to debate things !
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DH Agent - as if ! | 12-Feb-2012 1:18 pm
I am now 58, and I do find that I don't 'argue for fun' any more, but I am also tending to get grumpier as I get older.

So when I see something I consider is wrong and will cause real damage, especially if it strikes me that it is wrong largely because of 'one-sided back-covering', I really get stuck into arguing against it (by my own standards, of very little enthusiasm for anything since I was badly depressed 2 or 3 years ago).

But you do need to explain why you 'must be right' when presenting an argument (or, as an alternative, proving that there cannot be a single clearly-defined 'right' can also be handy) or else it is pointless - unless you are arguing with people such as politicians who can be swayed by 'mass opinion, however ill-formed'.

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Anonymous | 12-Feb-2012 1:42 pm
Why aren't Cam and Lan swayed by mass opinion?
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tinkerbell | 13-Feb-2012 8:26 pm
Because despite us living in a so called democracy and despite this government being unelected our opinion doesn't count. We are just plebs to the tory spivs who don't know what's best for us.
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tinkerbell | 13-Feb-2012 8:34 pm
rather i meant who think they know what's best for us or really don't give a damn about us, either way.
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tinkerbell | 16-Feb-2012 1:38 pm
http://www.goingtowork.org.uk/rally-to-save-our-nhs

Let's walk the walk!
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DH Agent - as if ! | 17-Feb-2012 10:35 am
Tinkerbell, are you keeping an eye on your blood pressure ? You are clearly as annoyed by this stuff, as I am by current EoL/CPR/VoD behaviours and beliefs !

I find the paradox with having ' a robust opinion you feel you must push on pro bono publico grounds' is that not making any progress, or making only snail-like progress, is frustrating, yet 'just dropping it' doesn't feel like an option.
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tinkerbell | 17-Feb-2012 9:35 pm
Michael i am like a dog with a bone on this. Like most nurses who have dedicated their lives to caring for others in OUR NHS we know there are many things wrong that can be put right if there is a will but we don't want OUR NHS destroyed in the process. Whatever is wrong with the NHS it has a HEART at its core to care for all and does not discriminate between the have's and the have nots.

I have been a whistleblower with much higher blood pressure being nearly hounded out of the NHS and near on antidepressants, so this is nothing for me. Whilst i am able i will fight with those who care to save OUR NHS.We will not be beaten all the time their is the will to provide free care for all.
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tinkerbell | 17-Feb-2012 10:25 pm
http://vimeo.com/22384946

This GP explains it much better than i can.
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DH Agent - as if ! | 18-Feb-2012 9:44 am
'Michael i am like a dog with a bone on this.'

Tink, that sums up me and my EoL/CPR/VoD approach - I've decided if nobody else will annoy the BMA, RCN, etc, enought to sort the problem out, then I'll have to do it myself !

I had noticed your determination !
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Anonymous | 18-Feb-2012 9:51 am
michael stone | 18-Feb-2012 9:44 am

could you do it somewhere else?
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DH Agent - as if ! | 19-Feb-2012 12:25 pm
tinkerbell | 17-Feb-2012 9:35 pm

'I have been a whistleblower with much higher blood pressure being nearly hounded out of the NHS and near on antidepressants, so this is nothing for me.'

Don't set me off on 'raising concerns with the NHS/PHSO' - that is another bone I can seriously chew on !

Anonymous | 18-Feb-2012 9:51 am

Not entirely sure what 'it' is in your question - but I suspect the answer is 'no'.
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Anonymous | 19-Feb-2012 12:33 pm
Michael Stone

"It" in your own words!

"if nobody else will annoy the BMA, RCN, etc, enought to sort the problem out, then I'll have to do it myself !"

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