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'When I grow up I want to make everyone agree with me'


I remember being asked when I was about 11 what I wanted to do when I grew up.

Of course I should have said: “I’m a boy I won’t ever grow up,” but I was 11 and awkward. So, instead I shrugged, mumbled something about being the first footballer who was also a spaceman and ran for the garden.

In truth, like many people who went into mental health nursing I had no idea what I wanted to do. I never really even had a clue about what I was doing. In fact I still don’t know what I want to do when I grow up - although I concede, reluctantly, that dodgy knees and middle age have drastically reduced, if not wholly eliminated, my chances of being a footballer. But not a spaceman.

I do enjoy other people’s expertise. I listened to a lecture on ancient Greece recently and was struck not only by the lecturer’s depth of knowledge but also by his overwhelming love of the subject. I think if you are going to be expert in something, you have to love it don’t you? And have deeply held convictions about it? Because, surely, when it comes down to it, few experts can be neutral when it comes to the subject in which they are an expert.

You may have heard that the health secretary Andrew Lansley - seemingly surprised by the fact that nobody likes his ideas for GP commissioning or how much it is going to cost - has decided to stage a “listening exercise” to gather the views of appropriate people. The problem is, of course, who will be doing the listening?

There are three ways to go here I think. The first is to randomly choose 50 people. A bit like jury service: if they don’t like the changes we stay as we are and spend the £3bn we save on health provision, or a big party, depending on your mood.

The second option would be to randomly select 50 “experts” - doctors, nurses, the odd strategist and, of course, some expert patients - and see what they think. If I were doing it, this is probably the way I would go although, I confess, I am drawn to the comedy of picking 50 people randomly and telling them to decide on the future of the health service.

And then there is the final and seemingly preferred option: you hand-pick 50 people who are likely to agree with you and ask them what they think. Quite unsurprisingly this is the route Mr Lansley has chosen, offering as it does both expertise and collaboration.

The government has announced a listening exercise and there will be 50 experts agreeing with it shortly. Somewhat telling is the fact that there is only one practising nurse on the panel, and five GPs - all of whom, according to last week’s Sunday Mirror, are in agreement with Mr Lansley before they have even done any listening. I’m not sure it really matters who the other 44 people are - managers, bureaucrats, members of Mr Lansley’s family… I’m hoping Lady Gaga is in there just to make it look less like a futile and manipulative exercise from the off but, unfortunately, I think I’m likely to be disappointed on that front.
I can’t say I am surprised but it seems a waste of time and money to pretend to engage expertise when really it is a dinner party. Why bother?

Maybe I am just being cynical but these proposals were not in any pre-election manifesto and they have been seemingly cobbled together with indecent haste and little thought. Will a listening exercise help it gather credibility? Perhaps. But for that to happen the panel will surely need more than just expertise - it will also need some political balance and then just a little bit of power.


Readers' comments (8)

  • brilliant! I'd like to be on the random jury please

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  • When I was 11 I wanted to be a cowboy, wish I'd stuck with that idea!

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  • Spot on, the whole thing looks to me like a whitewash.
    Their website is looking for suggestions as to how to tweak certain aspects of the bill rather than what people really think about some of the fundamental principles behind it.
    As an opponent of the unfettered free market, the requirement for Monitor to "enforce" competition and the timing of this amongst the stringent efficiency saving that are biting right now there seemed nowhere to put this down.
    I'm definitely feeling as disenfranchised as Mark is suggesting here.
    PS anyone with a LibDem MP I would suggest trying to apply some pressure there if you oppose the bill.

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  • When I was 11 I wanted to be on a listening jury. Can I join in on this one with Madonna as Lady Gaga is busy?

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  • When I joined nursing in 1994, the government gave funds to GPs for them to manage themselves. They were called GP fundholders. They soon banded together into Primary Care Groups to save costs and concentrate managerial expertise. These groups grew into Primary Care Trusts; much bigger organisations that came to have often controversial managerial 'expertise'. We had what came to be called a post code lottery because different trusts had different priorities. Sadly, it didn't work and these PCTs are being abolished. Can anyone tell me why the current move is not an incredibly expensive re-enactment of this big mistake?

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  • Chris you hit the nail on the head mate!!! Absolutely agree with others too, this is a total whitewash. The 'listening excercise' will be filled with yes men and nodding dogs! Not real experts!!!

    Oh, and when I was 11, I wanted to be a spaceman too, or Indiana Jones! I still do in fact. Does this mean we never really grow up?

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  • This is the problem with the NHS being in the hands of the Government. It will always be used as a political football and that is why we have constant change forced on us year after year. The NHS needs to be removed from the control of politicians as the Bank of England was.

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  • I'm with you Sarah! Been saying it for ages, take the Politics out of the NHS and we may begin to establish some stability in its organisation.

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