Category Archives: Healthcare

Healthcare Politics 2b

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2b) I do believe “all knowledge is relational”. On a completely separate tack, I am passionate to see the hierarchy created by knowledge within the NHS broken down. The managment restructuring within the NHS had some great potential to create a more level paying field. But it has amazed me to see the CCG’s in England created with a dominance from doctors, only one nurse on the panel and no other therapists…..

Within general practice, it is rare to find practices where all the partners are not doctors, or if there are others, it is usually senior nurses or practice mangers. There are some exciting models where all members of a practice are partners (Bolton/Tower Hamlets in East London). Such models break down the hierarchies of money and knowledge as power and recognise the amazing contributions and to be made from across a team. Not only so, but data from these places indicates high staff morale, high patient satisfaction rates and good clinical results – a pretty awesome combination! This can work in hospital settings also and gives the hospital team and potentially the wider community the chance to participate in their workplace/heath service more holistically. It brings the possibility of participatory budgeting to the fore which is really exciting model for budgeting and corporate financial responsibility.

To flip power on its head and make it that which allows the mountains to be made low and the valleys to be raised up is at the very heart of kenarchy. Level playing fields – make for a better game!

Healthcare Politics 2a

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2) I do believe “all knowledge is relational”. I wrote to the secretary of state for health in the last government and suggested that we coud join up some thinking between the dept of health and the dept for international development. How often do we hear that the money given through aid has been squandered, wasted or siphoned off into some terrible and corrupt dictator’s pocket? And this then gives UKIP or the Tories scope to try and slash our aid budgets to the developing world. But, we also have a surplus of trainee doctors…..

My idea was this – instead of giving money into situations to help with health, we could give our doctors, nurses and midwives to work on an optional (rolling) basis as part of their training. We have loads of GP, surgical, medical, paediatric, anaethetistic, emergency, nursing and midwifery specialist trainees (to name but a few), who finish their training, or who get to a certain level and then cannot progress further due to a bottle neck in the system. We have some the best trained medical professionals in the world waiting for jobs. We also have, for example, the same population as South Africa, and ten times the number of doctors…….

What about piloting some schemes, where we allow relationships toimgres develop between partner hospitals and communities? We can send some of our best trained people into the developing world, paid for by a joint arrangement between the DoH and DfID. Our trainees would get some of the best experience, with on the job training available and return with richer and more diverse skills. They would build friendships and receive as much as they would give, learning about communication skills in difficult circumstances, reaching through cultural barriers and expanding their knowledge base. The host hospitals/clinics would also benefit from the sharing of knowledge and skills and therefore an increased level of expertise with which to help their communities. There would also be fresh supplies and medicines, homeprovided, for example, by the incredible work of the International Healthcare Partners or the Health Impact Fund. It is vital that such partnerships include community medicine as well as hospitals, because we need a sustainable model for the future. Plus we need to breakdown traditional views of who is ‘qualified’ to be a healthcare professional! Basic signs of illness could be taught to community members, so that the right treatment is given for the right condition. There has been some fascinating work, of late, in helping communities recognise when something is malaria and when it is not – the results have been staggering. It’s a scheme which involves partnership, honesty, sharing resources, using aid budgets in a relational and focussed way and could, I think, be really transformational! Aid that is relational and reciprocal – breaks down some of the power dynamics and utilises resource as gift. Sounds like good stewardship. The british government didn’t think so and were rude and dismissive in their reply!!

Healthcare Politics 1

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1) Great health care should be universally accessible to all. I tweeted recently that I was pleased that Obama was re-elected, not because I think his politics are particularly more radical or really that different from those of Romney, but so that Obama Care could have a chance. A chap from the states tweeted back that nothing in life is free, it’s just not the ‘American Way’. The politics of Jesus is clear. He goes to the poor, the marginalised, the rejects and the outcasts. He never creates loopholes to exclude them! He treats the foreigner with dignity and cares for the unlovely. His politics are far more challenging that we would ever allow ourselves to believe! There is no toxic distinction made between the ‘deserving’ and ‘undeserving’ poor. That is a repulsive notion that we must not allow ourselves to be aligned with.

Homeless ManWhere the rich can access better healthcare more easily in the ‘christianised’ west, we need to ask ourselves how and why on earth we have let this happen – the answer is not a comfortable one. When 50 million americans cannot access health care, and a black man living in New York has a life expectancy of just over 40, also true of a homeless person living in London, we have to wonder about our priorities. You are far more likely to die young in an inner city estate from chronic disease than if you live in a middle class suburb. And that is only the health injustice in the west.

We bury our heads when we begin to think of the life expectancy of our brothers and sisters in Africa, in South America, in parts of Asia.kevin-carter-vulture We focus on increasing the life expectancy of the rich (white) ones in the UK to 85 or more, and feel a deep sense of achievement, while all the time, children die of diarrhoea (can you imagine if that happened here?), starvation, malaria, things that are genuinely and inexpensively preventable?! I don’t come at this naively. I don’t think the answer is a quick fix, but there is a kenarchic challenge – to those whom much is given, much is required. So often we hang on to human rights, and make them about me and my rights. We want to become our own mini emperors, where we demand the best for ourselves and the self protectionism sadly drowns out the cry of others. The truth is, we don’t need to make healthcare everywhere worse for good health care to happen everywhere for everyone.

However, we need to allow ourselves to be uncomfortable about the amount that is currently spent per head on healthcare for a wealthy child compared to a poor one…….we need to find new ways to protest, new ways to give, new ways to redistribute resource. But we cannot remain silent and we cannot do nothing. We cannot be like the fat cats who sing our happy songs and forget about justice for the poor. The millenium development goals are now, sadly, a total joke, and yet we could have gone further…….we blame, amongst other things the banking crisis. This is plainly a lie. If we want to live in a way that is like God, and really see justice and mercy filling the earth we live in, then we must learn to prioritise those He prioritises.