Health Matters | Paul Corrigan's blog

Last week I posted on several occasions about the problems being caused by the Government’s failure to develop an adequate narrative to fully explain the NHS Reforms. I observed that this omission had now been noted by a wide range of different commentators both inside and outside of the NHS.

A number of people made comments – for which I am very grateful. I generally don’t pick up on what people have said – not out of rudeness but because the agenda seems to move on very quickly on to other issues.

However someone mentioned the issue of politicians and emotional intelligence and used, as an example of the problem they were elaborating upon, a quote made by Andrew Lansley to the RCN in Liverpool in 2011.

You will recall that the Secretary of State went to Liverpool where the Royal College of Nursing were holding their conference and that rather than talk to the whole conference chose instead to meet an invited audience.

The short quote from that event that provides today’s title demonstrates so many of the problems that lie at the heart of the Government’s failed reforms that it is worth deconstructing.

By last April it was obvious to David Cameron, a man who understands communication, that Andrew Lansley had failed to communicate any narrative to explain the Government’s NHS reforms.  From that time on the Prime Minister began to construct and promote his own.

As we explored last week his problem was that whilst it was a good narrative, once the pause had taken place, it no longer described what the reforms were going to achieve.

But at least he was trying.

The above quote from Andrew Lansley demonstrates the problems he has in the area of communication.

“I am sorry if what I set out to do has not communicated itself.”

At the time what he said was described as an ‘apology’.

In fact whilst it may have been an attempt at an apology what he said did not indicate that he had done anything wrong at all. He doesn’t say that he has done anything wrong. He doesn’t say “It is my fault because I haven’t communicated this well.”

That would be a normal kind of apology because it would be about something he has not done – as well as something that he should have. Some people just find it difficult to say that they have done something wrong and apologise for it.

But the quote reveals something more shocking. He has removed the human agency from communication. He believes – and this is the crux of his and the Government’s problem – that policies communicate themselves.

In this case this policy has not communicated itself well and he is saying, in effect, that in some way the policy should have done better. But in the real world abstract things are not responsible for their communication – human beings take that responsibility themselves.

And this odd belief – that policies speak for themselves – gives us a clearer understanding of why the communication of NHS reforms has been so poorly executed.

Andrew Lansley genuinely believes that it was not his responsibility to communicate his policy – he thought the policy should do this for itself.

It was he after all who wrote the White Paper and supervised the writing of a Bill to develop his policy – and that was the end of his communication task. After that it was up to the policy to communicate itself.

So later on, when the communication of the reform programme is not good (and let’s face it, for the last 20 months it has been dire), it is not the Secretary of State’s fault but the policy’s – for not communicating itself.

I am not being sarcastic here. It is what he and many others believe.

The quote in today’s title betrays a gap between, “I am sorry if what I set out to do” – words that demonstrate a human agency at work – and the language that then takes over “has not communicated itself” – where the policy takes on a ‘life’ of its own – and in this instance is not good at communication.

This helps explain why the Secretary of State, despite everyone pointing out for over a year now that he has performed poorly in developing a narrative, still hasn’t done anything about it.

Because he doesn’t see it as being his job. It’s the responsibility of the policy.

This has real implications for the future. There are those who argue that there is a strong case for keeping Andrew Lansley as Secretary of State. Their argument is based on the fact that he is the only person who understands this policy. He must therefore remain as Secretary of State because he is the only person who can explain the policy as it is being implemented.

We now know that is not the case. He may well be the only person who understands this NHS reform policy, but he is certain that it is not his fault if it has not been well communicated. It’s the fault of the policy.

It follows that in the confusion that will be the implementation of his reform Bill it will still not be his job to communicate that process.

Because the implementation process will somehow communicate itself to the nation.

My bet is that the policy will be very bad at communicating what it is trying to achieve as it is being implemented.

My advice to the Prime Minister would be to get someone in who recognises that communication requires a human agency and is not the responsibility of a White Paper.