Kenarchy and Healthcare – Paradigm

I think a lot of the time about healthcare. I guess, it’s because it’s the arena in which I spend a huge bulk of my time. I’ve studied and worked within this sphere for nearly 14 years now and it’s something I care deeply about. I think what I will write here will be helpful and applicable to other realms of work, but this is what I know, and so this is where I start – ha! though it won’t be where I finish!!

If kenarchy is about emptying out the places of power, lives laid down in loving and serving other people, then caring about the health of others is a good place to apply it! If kenarchy can be applied to our paradigms, praxis (or politics) and person, then wherever we work, whatever we do, we can use its lens to help us get some focus in each of these areas.

Were I to try to blog all in one go on a kenarchic paradigm, politic and the personal impacts on healthcare, then this could end up being the longest blog post in all of history! So I will break it down into the three subsections, starting with a kenarchic paradigm (the way we see the world). This is big picture stuff and doesn’t massively deal with specifics! For some, these thoughts are nothing new, for others I hope they spark challenge and debate!

Paradigm (with some politics thrown in for good measure!)

These are some initial thoughts on how my thinking about health care has been shaped in terms of the big picture.

1) Great health care should be universally accessible to all, and all should have access to the same standard of excellence, love, and care. I do not see health care as something which is earned or a privilege, but something which is freely given. Of course there are economic implications here, but perhaps if we stop thinking in terms of an economy of buying and selling (trade) and rather think of services that are given and received (exchange) then this may help us. It also questions the huge drive to privatise healthcare, in which money and profit are dangerously the motivating factors, rather than equity. Many of political philosophers writing currently, are calling for a new moral foundation or frame-work from which to establish new ways of being and living. The kenarchic basis here is that God is love and God is healer. God calls us to be like him and we too are therefore to be those who primarily function out of love and to be those who bring healing. Freely you receive, freely give…..

2) As my great friend, Roger Mitchell says “all knowledge is relational”. Too often, especially with intellectual copyright laws and big pharma, knowledge is power. But it shouldn’t be. If we gain knowledge, it is for the benefit of others, for their empowerment, for their betterment. That doesn’t mean there isn’t expertise, or specialism, far from it. We need one another’s knowledge, to honour and draw on one another’s gift, but if we hide it when it could help millions of people, or focus our knowledge on helping those who can pay us most, we need to question our humanity. So much of what we do in medicine, is a symbiotic relationship of learning and teaching. ‘Knowledge power’, just like any power, is not there to be lorded over others or enslave them to us in any way, rather it is for the service of others. An uncomfortable challenge. Knowledge needs wisdom for it to be used properly. The wisdom of God is found in a cross, where the human one, Jesus, gives his life in ‘foolishness’, refusing to bow to the status quo or powers that “know what to do”….but when we keep knowledge for our selves, or use it to make ourselves look clever and wonderful in the sight of others…..we are being less than human…..

3) Health care is diverse. Health care is not just about curing people. It involves some curing, but also some discovery, some therapy and some suffering with others over long periods of time. It is mental and physical and spiritual. It is natural and supernatural. It is about helping people to live well, die well and choose well. We must be very resistant to that which commodifies it into being about cures and results. We need to ensure we honour and use the vast breadth of care available especially for those, who don’t make financial sense or produce obviously fast results!

4) Healthcare is most effective when there is collaboration in place of competition. Time and again studies show that where teams work together to bring out the best in one another and collaborate together, outcomes are far better and those working are far happier than where competition is used as the model. The Kings fund and others have done so much work into this, and there is little else to comment on.

5) Healthcare is service. It is not about profit, or glory or self promotion. It is about serving people. That’s why I love that the health system we have in the UK is called the NHS. Working in this environment should remind us what we’re here for and what our motivation is.

6) Universal healthcare is affordable. It is a complete myth and a lie that we couldn’t afford to give good health care to every one on the planet. We make ridiculous choices as humanity to destroy one another, when we could be living very differently. Healthcare for everyone does not mean poor health care for everyone. Here is a brilliant TED talk by a truly excellent thinker, Thomas Pogge.

7) Healthcare involves joined up thinking and new partnerships emerging. We are stuck in a crazy cycle of a lack of joined up thinking between so many aspects of life and the economy. Plenty of examples of this in the next blog……but for example, health, education, international development, media, sport, as a starter for 10!

My hope is to take these 7 paradigms of kenarchic healthcare and apply them politically and personally……As it says at the top of my blog, when paradigms change, the world changes with them……

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