We Need to Be Ambidextrous in Solving our Health and Social Care Conundrum

UnknownAll this week on the BBC, there has been a focus on the NHS and the crisis we are in – don’t panic Mr Mainwaring…..There is a heady mix of opinions being thrown around – Question Time became quite a furore of ideas and thoughts last night – not enough beds, not enough staff, not enough money, too much money, too many patients, too many wasted appointments, too many malingerers, too many ill people, too many old people, too many managers, too many drugs, too many drunkards, disappointed clinicians, disappointed patients, disappointed MPs, a disappointed health secretary – what are we to think and what are we to do?

 

imgresWe love the NHS because it speaks something to us about our togetherness and our commitment to health justice for all. This circular argument about money is the wrong conversation and it is beginning to have a very nasty undertone about who we might be able to blame and scapegoat in order to solve the mess we are in. Let’s be very clear. The NHS is NOT in crisis because of refugees, asylum seekers, immigrants or health tourists. I’m going to stick my neck out here – it isn’t even the fault of the current and previous health secretaries, though it would be easy to play the blame game that way too. The NHS is in crisis, because the entire Western World is in crisis! Our economic systems are broken and our political systems are pretty defunct. We have built our nation state on the foundations of empire. We have built our economy on conquest and slavery and have used debt, violence and law to keep control….but everything is shaking.

 

There are some difficult truths for us to face up to. Are we brave enough to accept that things cannot remain as they are? Are we imagesLYB84K5V.jpgbrave enough to rewire our brains, realign our values and reimagine a different way of being together? If we accept that things simply cannot remain as they are, might we instead find one another in fresh ways and discover new ways of being in which we’re not always chasing the money, with all its strings attached, but choosing something altogether more life giving?

 

images3W7WQ07WI would suggest we need two things (an ambidextrous approach) – both of which are already happening, we just need to recognise them, fan the flames and watch the new emerge, whilst Rome burns around us.

 

The first thing emerging is a grass roots people movement around health, wellbeing and a kinder society. Think of this as the left hand. We must take a left handed approach to really listen to and engage with our communities. Many people are waking up to the fact that we are eating in ways that are unnatural and completely unhealthy for the human being. Global corporations like GSK have shoved Lucozade and Ribena down our throats and then very kindly provided the medication for the diabetes we have developed. Enough! Thankfully, peopleimagesOP6FM73O.jpg are beginning to think about how we are living and making a change. It’s a tough reality, but there is personal and corporate responsibility that we need to take. We cannot keep shoving poison into our bodies or treating them badly and expect that we will be well, or that we will be able to afford the drugs to fix us. Social movements are beginning to emerge and we need to be a part of them. Together, we can! Together we can cause corporations to change their behaviour and act in accordance with what is right, true, just, kind and loving. We can also choose to take responsibility for what we buy and how much exercise we do. Here in Morecambe Bay we are launching the Morecambe Bay Mile, encouraging everyone to move a mile a day without transport! We’re also working with our communities around diet. We’re also connecting with amazing people doing amazing things and seeing just how much kindness and goodness there is in the communities around us. Our happiness is directly linked to the quality and depth of our friendships. People being together and facing up to the issues together is absolutely key to our long term health.

 

imagesBCV6CE7Y.jpgSecondly, we must stop serving the system, re-humanise it, call it in line and cause it to serve the needs of the people and the planet (the right handed approach). Those in the health and social care system must refuse to be bullied by the powers into ways of behaving, stop thinking they have the answers and therefore coming up with another new scheme to do to people and be willing to listen to and work with the emerging social movements. This will allow us to see a society that is much more well and therefore in need of less care. But where care is needed, we have to accept that we have allowed ourselves to be competitive rather than collaborative, hierarchical instead of co-operative and our own attitudes and behaviours are stopping us from giving the compassionate care we long to deliver. We cannot make excuses. We must let go of self-protectionism. We must be willing to change the way we think and behave, breaking down walls, letting go of suspicion and cutting through red tape so that we provide the care which we can. This is happening, here in Morecambe Bay – but it’s not a quick thing. We are rediscovering the power of relationship and daring to make some bold steps into delivering care very differently – but for those of you outside the system, please understand, it takes time and feels pretty scary!

 

I believe it is possible for the NHS and Social Care System to be radically transformed at this time. It might enable us to model something for the rest of the world. That in our time of crisis, we did not sell out to the lie that the only way ahead was privatisation and insurance – (in our hearts, we know this isn’t fair and it doesn’t work for everyone). No – instead we chose to work with a grass roots people movement, calling for us all to beuntitled.png more healthy and well and we changed our ways of working to be more collaborative and kind. It is this ambidextrous approach to health and wellbeing, in which a heady mix of an invigorated people movement and a reorientated system working together for the good of everyone everywhere, might breathe hope into other parts of the world that out of the old can come something new. Maybe it is just possible that healthcare can be provided for everyone everywhere when people are brave enough to let go of old ways, embrace the brokenness of our reality and find a new way through together.

 

untitled.pngI’m telling you – it is nearly Spring time and the bulbs are beginning to break through. Can you smell the scent of something new emerging? Those rhizomal roots of the snowdrops – that interconnected underground network that shoots up its flowers, is telling us the winter of discontent is over. It’s time to turn off the radio, dial down the meta narrative of fear and instead, put on love, hope and faith, find each other, change our ways of working and step into the future we know our hearts yearn for.

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Time to Face the Music

UnknownWe have yet to really face up to the crisis we are in. We keep on pretending that by making a few alterations here and some adjustments there to how we deliver health and social care, we might be able to save the NHS. But this simply isn’t true. Last weekend saw a crisis conference for GPs nationally as 38% think they will be forced to leave the profession in the next 5 years due to severe under-resourcing and increased stress (that would be a loss of 10000 GPs throughout England, with government plans to recruit only 5000 by 2020). Yet again our Emergency Departments are at breaking point, Junior Doctors are staging further strikes, Public Health Services have been decimated and although new partnerships are being forged with social services and (to some extent) the education system, deep cuts in both those areas mean there is little time or energy left to find new ways of working for the future health of our population. Throw into the mix a need to save £22 billion through “efficiencies” and couple that with the crippling debt caused through programs like PFIs in our acute hospital trusts and we really do have a problem.

 

Complicating this picture is the stark reality that 1 in every 5 pounds spent in the NHS is as a direct result of our current lifestyle choices and we have images-2believed a lie that the NHS is “free” and therefore we can treat it however we like and live however we want and it will somehow magically sort us out. On top of this we have an ageing population with increasingly complex health needs and an ongoing under funding of the entire system (only 8.9% of GDP).

 

And we cannot we forget the financial crash of a few years ago which was a major warning sign to us that we are living in a broken system and the god that is
imagesthe Nation State is beginning to crumble all around us. Let me just repeat that difficult statement in another way. The grandfather that is the Nation State is now utterly riddled with a cancer and it is dying. The cancer, like all cancers needs ever increasing growth in order to sustain it’s life and our economy is set up to feed it, but even built on the pyramid of power, control and debt, it can no longer survive. Like any dying man, it is holding on for dear life and as it does so, it puts the squeeze ever tighter on to health, education and other public services, pretending it is still powerful, controlling public services through the slashing of budgets and ever tighter and undeliverable targets whilst not actually dealing with it’s debt issue at all, but telling us all a story that it is. And the mouth of Unknownthis dying beast, the media that has become utterly complicit with it all, spouts out tale upon tale of how mighty the State remains, “punching above it’s weight” on an International scale (using violence and threat where necessary to do so), but tightening it’s belt to ensure economic sustainability. Am I being dramatic? Listen, when 85 people now have more accumulative wealth than half the world and when the 50 richest global corporations are richer than the 50 richest Nation States (and are therefore powerful enough to tell them what to do), the facades must come down. The Emperor has no clothes on.

 

images-1And so it is time to face the music. Once we realize that the centre cannot hold, we can permission ourselves to find new ways of being. There really are alternatives to what we have now. there are other ways of being. Life will go on. We can learn to dance to a different tune, we can sing a new song and begin to reimagine a different kind of future. We can learn to live differently. There are some tough conversations to be had. But, as the old systems begin to pass away, what might emerge instead? What brave or holy experiments might we try without letting go of the wisdom we have learned? What might it be like if politics and economics were just part of a collaborative and cooperative world rather than assuming the role of dominant sovereignty over every other sphere of society? What if we can’t have everything we want right now, learning some new and more effective boundaries around the ways we live? What might we prioritise? How might we move towards a more peaceful world? How are we going to live in a way that is sustainable and leaves the environment as a gift rather than a burden for the generations to come? How might we develop an economics of equilibrium (the state of a healthy body) rather than one of continual growth which requires us to feed its ever hungry belly with our own lives? What might we recover in education? How could we shape regional wellness services? How might cities and regions gift their expertise to one another? How might we choose to protect the most vulnerable in society and provide for the most deprived, keeping love at our core over self-preservation, greed, fear or hate?

 

Unknown-1Truthfully, we can no longer afford to avoid these conversations or hide away in our business. If we want things to remain exactly as they are, then so be it, but what will we leave for our children’s children? In the NHS we spend our lives trying to preserve and prolong life at all costs. But we must learn to face death, because there is life the other side of it. There is life the other side of the Nation State as we have known it. There is still ethical, free, safe, sustainable and accessible healthcare for all the other side of the NHS in its current form. It might become a National Wellbeing Service. Or it might be more regional and cooperative. It will mean some different lifestyle choices and some more effective partnerships. It will mean changing our attitude towards how and where care is provided. But I’m sorry to say that unless we make some radical choices to either pay a lot more tax or not renew trident and spend all of that money on healthcare, there are some deep cuts to be made in the mean time. It is going to be a very painful few years ahead. We must not imbibe ideologies that protect the rich and punish the poor. But we have to be brave enough to let go of the good we have known in order to embrace a future that is better for everybody together.

 

Unknown-2And that calls for a different kind of kenarchic leadership. We need leaders who will serve and collaborate with communities in open and honest conversations, so that cuts do not happen in an isolated boardroom, but witUnknown-3h and among the communities most affected. Leaders must learn to ‘hold the space open’ for the new to emerge. It will mean understanding that we must make choices about which targets we do and don’t decide to meet, prioritising some services over others and taking better care of ourselves individually and in community. But it is not a time to lose hope! There is much goodness to come, much rediscovering to take place. Much creative reimagining to enjoy. Many songs to be sung. So, let’s face the music and dance.

 

 

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