NHS: time to face an awkward truth

Few issues in the public sector at the moment are quite as sensitive as the reform of local health services.

You can line up as many eminent paediatricians, cardiologists and obstetricians as you like, but try saying there is a good medical reason for having fewer hospitals and the protesters will start waving placards quicker than you can say ‘reconfiguration’.

MPs, particularly those in marginal seats (and even those in government) find it very hard to resist this particular bandwagon. Last week I heard a number of MPs declare in their loudest, vote-winning voice that they would fight for their local A&E service ‘because that’s what every single member of the public I talk to wants me to do’.

And who can blame them? Campaigners might agree that their local health services are far from perfect as they are, but why should they and their MP support government proposals that they believe will simply make things worse? 

However, I’d argue that those who don’t want their health services reconfigured are resisting change for fear that change itself will cause more harm than good.

As any director of ‘change management’ will tell you, this refusal to change for fear of the new is one of the biggest challenges to overcome. It is perhaps the single biggest obstacle to achieving real improvement.

The problem for we communicators – especially in healthcare – is how far we must go to demonstrate that things can’t stay as they are. How can we prove that services really are stretched so thinly that staff are already at crisis point and (whisper it) that lives may already be at risk?

It’s a deliberate balance.  There is a tipping point in any comms project when you need to start delivering negative stories – in this case, about the extent to which the NHS is stretched, how desperate for change service providers are, and how keeping things the same will bring crisis.

One of the ways to persuade people to step outside their comfort zone is to point out that, in actual fact, they may already be outside it.

Luke Blair is a director of the London Communications Agency

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