In a previous existence I was healthcare scope lead for an international Quality Assurance company, working mainly in Europe and SE Asia. As you may guess I take an interest in the claims made by politicians and other spokespersons (for the associated NHS vested interests) to do with how well they would like to claim their part of the NHS is meeting its quality commitment to patients. The 'argy-bargy' about A&E in Scotland is a fascinating case in point where the argument about a whether a politically set target is being met or not, fails to reflect the real measure of quality delivered - is the service provided meeting patients' needs and expectations is the only true measure. Targets (and especially NHS targets) can be manipulated to say what ever anyone wishes them to say by setting different statistical analysis parameters; a case of you say TOmato and I say toMAto but this still does not tell us if the tomato is rotten or not.
Folk will try to tell you defining needs and expectations in health care is next to impossible but this is because folk mix up wishes with needs and dreams with expectations. For example, when I go to see a doctor it is because 'I need to find out what is wrong with me'. My expectation is if the doctor can not diagnose my problem they will carry out tests and other investigations to determine what the problem is and refer me to a specialist if it is required. I might wish the doctor would just give me some pills but my expectation 'to be made better' may require an operation to meet my need to be 'healthy'. In this way every time you see a doctor this cascade of need and expectation will be played out to a greater or lesser extent as required by 'what is wrong with you' while your 'wishes' will be managed by ensuring you are properly informed of progress. The reason the health carer / patient relationship gets such high satisfaction scores in patient surveys, even in a NHS system at breaking point, is because patient's needs and expectations are met or surpassed on a regular basis. This is the only real measure of the quality of care being provided, patient satisfaction.
If we compare the state of play in the health carer / patient relationship with the politician / electorate relationship we see a stark difference. Electorate satisfaction with politicians is low simply because the politicians are not addressing our needs and expectations, worse they are trying to impose their own dreams and wishes on the electorate - they are not listening, they are telling us what to believe.
We need our politicians to be engaged in their constituency and we expect them to have a degree of honesty and integrity. Yet we see, far too often, politicians more interested in chasing preference within their party at the expense of their constituents and happily pocketing our tax payer money in expenses scam after expenses scam. Is it any wonder that Westminster politicians, across the UK, are seen a venal and corrupt and the UK Parliament diminished as it seeks to excuse the inexcusable and protect those of its membership past and present who have carried out peadophile attacks on young men and women by misusing 'Offices of State' as part of the cover up. The product called 'Westminster Politics' is seen by an ever increasing number of its electorate as past its sell by date and unsaleable, even if heavily discounted. Yet its snake oil salesmen and women in the media still try to sell Westminster to us as as a 'quality product', the only one which can do the 'job' where as the public perception is Westminster is not up to its 'job' and no longer fit for purpose. This is the real tension in UK politics at present which is playing out in the calls for evermore decentralised, autonomous and powerful regional government in England and Full Fiscal Autonomy for Scotland.
To this highly stressed mix you now throw in a political party which has sought, as far as is ever possible, to ensure the electorate's views and the views of its party membership are heard and acted upon. A political party which is winning the trust of the electorate while every other party is losing trust. A party which seeks to address the electorates' needs and expectations and is perceived by the electorate (rightly or wrongly) as doing so to a high degree. Just how surprising is it in the current state of affairs at Westminster that such a party would be very popular and see its vote share increasing, at the expense of the other parties?
You do not have to be an expert in quality assurance and quality control to understand why such a political party would stand out, be popular and see lots of people buying into their 'product' - some 105,000 people paid up, last I looked.
This is what those in the Westminster main parties and their London media bubble do not comprehend. The projected SNP vote share, heading towards May 2015, is not a 'protest' vote, an 'anti-Labour' nor is it a 'separatist' vote, it is the voice of a large proportion of the electorate of Scotland who believe they have, at last, a party they can trust to represent their needs and expectations at Westminster.
The SNP do what it says on their tin, sadly an unusual quality in modern UK politics, and are a product folk in Scotland choose to trust. This is, in part, why the increasingly hyperbolic attacks by Labour and the Conservatives on the SNP are having little or no effect on the opinion polls in Scotland. In fact the 'Ugly Sisters' unthinking attacks have routinely boosted vote share for the SNP.
Why should any sane Scot believe the words of a Cameron or Miliband, well known for their dissembling and prevaricating, over Ms Sturgeon and the SNP in who they trust?
The quality of politics on offer is more important than Cameron and Miliband can ever comprehend in their wonk world of SPADS, media spin and Hampstead and Islington focus groups.
Folk will try to tell you defining needs and expectations in health care is next to impossible but this is because folk mix up wishes with needs and dreams with expectations. For example, when I go to see a doctor it is because 'I need to find out what is wrong with me'. My expectation is if the doctor can not diagnose my problem they will carry out tests and other investigations to determine what the problem is and refer me to a specialist if it is required. I might wish the doctor would just give me some pills but my expectation 'to be made better' may require an operation to meet my need to be 'healthy'. In this way every time you see a doctor this cascade of need and expectation will be played out to a greater or lesser extent as required by 'what is wrong with you' while your 'wishes' will be managed by ensuring you are properly informed of progress. The reason the health carer / patient relationship gets such high satisfaction scores in patient surveys, even in a NHS system at breaking point, is because patient's needs and expectations are met or surpassed on a regular basis. This is the only real measure of the quality of care being provided, patient satisfaction.
If we compare the state of play in the health carer / patient relationship with the politician / electorate relationship we see a stark difference. Electorate satisfaction with politicians is low simply because the politicians are not addressing our needs and expectations, worse they are trying to impose their own dreams and wishes on the electorate - they are not listening, they are telling us what to believe.
We need our politicians to be engaged in their constituency and we expect them to have a degree of honesty and integrity. Yet we see, far too often, politicians more interested in chasing preference within their party at the expense of their constituents and happily pocketing our tax payer money in expenses scam after expenses scam. Is it any wonder that Westminster politicians, across the UK, are seen a venal and corrupt and the UK Parliament diminished as it seeks to excuse the inexcusable and protect those of its membership past and present who have carried out peadophile attacks on young men and women by misusing 'Offices of State' as part of the cover up. The product called 'Westminster Politics' is seen by an ever increasing number of its electorate as past its sell by date and unsaleable, even if heavily discounted. Yet its snake oil salesmen and women in the media still try to sell Westminster to us as as a 'quality product', the only one which can do the 'job' where as the public perception is Westminster is not up to its 'job' and no longer fit for purpose. This is the real tension in UK politics at present which is playing out in the calls for evermore decentralised, autonomous and powerful regional government in England and Full Fiscal Autonomy for Scotland.
To this highly stressed mix you now throw in a political party which has sought, as far as is ever possible, to ensure the electorate's views and the views of its party membership are heard and acted upon. A political party which is winning the trust of the electorate while every other party is losing trust. A party which seeks to address the electorates' needs and expectations and is perceived by the electorate (rightly or wrongly) as doing so to a high degree. Just how surprising is it in the current state of affairs at Westminster that such a party would be very popular and see its vote share increasing, at the expense of the other parties?
You do not have to be an expert in quality assurance and quality control to understand why such a political party would stand out, be popular and see lots of people buying into their 'product' - some 105,000 people paid up, last I looked.
This is what those in the Westminster main parties and their London media bubble do not comprehend. The projected SNP vote share, heading towards May 2015, is not a 'protest' vote, an 'anti-Labour' nor is it a 'separatist' vote, it is the voice of a large proportion of the electorate of Scotland who believe they have, at last, a party they can trust to represent their needs and expectations at Westminster.
The SNP do what it says on their tin, sadly an unusual quality in modern UK politics, and are a product folk in Scotland choose to trust. This is, in part, why the increasingly hyperbolic attacks by Labour and the Conservatives on the SNP are having little or no effect on the opinion polls in Scotland. In fact the 'Ugly Sisters' unthinking attacks have routinely boosted vote share for the SNP.
Why should any sane Scot believe the words of a Cameron or Miliband, well known for their dissembling and prevaricating, over Ms Sturgeon and the SNP in who they trust?
The quality of politics on offer is more important than Cameron and Miliband can ever comprehend in their wonk world of SPADS, media spin and Hampstead and Islington focus groups.
Excellent Peter, a great analogy. Thank you.
ReplyDeleteExcellent Peter, a great analogy. Thank you.
ReplyDelete