Solutions Focused Thinking in Population Health

My last blog focused on how we can think about solutions instead of problems in the NHS. Well the same is true in thinking about the health of our whole population. Yes there are some problems! We have growing health concerns with obesity and diabetes. We imageshave huge health inequalities. There are major issues with housing, economic policies that are not working for huge swathes of our population, with more people having to use food banks, struggling with fuel poverty, living in damp houses and unable to make ends meet. Yes, our kids are spending more time on screens and less time in activity. Yes, the sugar lobby, alcohol lobby and advertising giants have far too much power. Supermarkets are designed deliberately so that we buy things that are bad for us. And sometimes, we just make poor choices (if you can call them choices, which for some people, they aren’t always) – we do not all live as healthily as we could – we eat the wrong stuff, work highly stressful jobs, and exercise less than we are recommended to. Mental health issues are on the rise, especially for teenagers, due to crazy targets and league tables, with all the pressures they face. We are less happy and more separated than we ever used to be, despite the rise in social media…..(or maybe because of it……)…..Man, I can paint a negative picture – it’s like storm clouds and darkness everywhere……..

 

imagesBut what if it wasn’t that way? What if we got a bit angry about it, but instead of finding someone to blame and pointing the finger; instead of getting all tribal and throwing stones at others, we chose to use our energies creatively to find solutions, to work together and make positive changes?! Let’s put away our pointing fingers and our ranting tongues and let’s work together for a better future for everyone! Doesn’t that sound good?! It’s what we’re trying here in Morecambe Bay, and I’m hoping it spreads like wild fire so that we can become a place where health abounds and beauty surrounds (that’s the motto of this place!). That doesn’t mean we stop speaking truth to power, but we also let our actions (and maybe our votes) speak louder than ever before.

 

imgresWe’re talking together, taking time to dream about what it would be like if we were the healthiest area in the UK. We’re training up many people to host conversations, so that we break down walls and learn to collaborate for the sake of everyone. We’re not just dreaming about physical health, but mental, social and systemic health as well. We’re encouraging those who want to rise up and take some leadership, to be pioneers in the stuff they are passionate about. Even in my little town, we now have a mental health cafe that is literally saving people’s lives, because a lady called Jane wanted to make a difference. We have a cafe for all the people who have circulation problems because one of our nurses wanted to break people’s isolation and improve their healing rates at the same time. imagesWe’ve got a carers cafe, a dementia cafe and will soon have a breathing cafe for those who have severe COPD, sharing ideas and diminishing anxiety. We’ve got exercise classes to help with pain, a community choir, dog poo wardens to help us take more pride when we walk down the street and food banks to help those who can no longer afford to eat.

 

image[1]We have 2000 kids aged 4-11 running a mile a day at school with staggering results for our children here in terms of physical, mental and educational health. We’re hoping over time, this becomes the Morecambe Bay Mile, part of a cultural shift towards being more active. We are working with local chefs and supermarkets to enable people with pre-diabetes or weight struggles to eat more healthily.  We’re choosing to lead by example in the NHS to work well and flourish in our work places. We’ve made a commitment to see the 5 ways to wellbeing in every NHS organisation and we’re hoping many other systems and businesses will follow us in this. We’re finding radical ways to help people who are struggling with alcohol and drug addiction, get free and stay free with amazing results. We’re helping people live well with and beyond cancer.015c74b06779fe8d8496d585fb9865ea We’re changing the way consultations happen in the NHS to enable people to make more informed and better choices about their own health and conditions, so they feel empowered to make changes that work for them rather than beaten up when they go for an appointment! We’re launching the Morecambe Bay Poverty Truth challenge, learning from those who are lived NAWIFUexperts in poverty to help us work together and care better for those most struggling in our society. We’re having difficult conversations about death to help people be prepared for every eventuality.

 

All of this has started in the last year! What else might be possible? What other dreamsimages will be awakened? What other partnerships, collaborations and relationships might be formed? Being all tribal and accusatory of others saps our energy and stops us being creative. Mud slinging and blame will achieve little. We have to work from where we are. We have to build bridges and work together. We have to build a future of positive peace and that means binary thinking is over! The future doesn’t have to be full of doom and gloom. It is alive with hope! What resources might  we find? What talents might we discover? What might we see develop over the next 12 months/years/decades as we look for solutions together for a better future for everybody? Don’t you feel just a little bit excited?

 

 

Share This:

Share

Healthy Conversations

We live in a political climate in which it appears that those in power do not listen to the voices of the ‘multitude’ (e.g. with the current protests around the NHS and education), but press ahead with their own agendas regardless. This is not only true of the current government, but a symptom of the way in which our entire political systems are set up. Here in Morecambe Bay, we need to recover the power of people movements and decide together what kind of future we want. Here is an invitation to come and be part of the emerging conversations about health, well-being and the health system around the Bay.

 

Share This:

Share

The Junior Doctors And Lady Godiva

A few months ago I wrote a blog suggesting the right approach for the junior doctors was one of subversion and submission. But I think I was wrong. It’s not that I’ve changed my mind on the power of subversion and submission, it’s just that this entire spectacle surrounding the junior doctors, the ‘7 day NHS’, the strikes and the media reporting there of actually affects us all at a profound level.

 

bmalogo14This situation exposes something far deeper than just an argument between Jeremy Hunt and the BMA and is far more important than discovering who has the strongest will power. Infact, the BMA have made a major error in targeting Jeremy Hunt so vindictively, because in the final analysis, this isn’t about Hunt at all. Jeremy Hunt can be replaced in a moment, and is likely to be succeeded by a far more robust Jeremy Hunt nhsBoris Johnson, who will simply pound his fist more visciously. To make Hunt the scape goat narrows this debate to something far too insignificant and actually strengthens the government’s ability to do exactly as they please.

 

Sadly, however, all this proves is how defunct our current system of government has always been. What the government really want is a discussion about how we can improve patient access across the weekend timeframe. However, what they did was to decide this is necessary and went ahead to try to fix what is incredibly complex. There was no discssion, no real engagement, no conversation, no asking of the deep questions. Just because we want something, doesn’t mean we can have it! Just because we think something is a good idea, doesn’t mean everyone else will agree! The entire process of enagement and change management is not understood at all. In the first8790 place, the goverment could instead have said to all the hospital trusts across the country what their hopes and intentions were and then waited to see if this was workable, in what way and how much it would cost. But you cannot simply act like Pharoah and expect the brick makers to make ever more bricks with less and less resource available – otherwise, you face an exodus!

 

What this entire debacle demonstrates is just how far free market capitalism has gone in its use of people as biopower to drive the system. The junior doctors of the NHS are nothing more than fodder to make the machine run. It doesn’t matter at all to the government that their lovely idea of a ‘7 day NHS’ is both unaffordable (due to chronic underinvestment in the health service) and unstaffable (due to a combination of under-training of staff across the board, and free market forces which work against people remaining in the UK). What this exposes in its most blatant form, is the chronic and shocking abuse of power, because of the very structures we have in place and the foundations upon which our society is built – namely violence, debt and control. And so, we see the human being reduced to what Hardt and Negri call ‘naked life’.

 

_86375024_86375023The system, to which we must all bow doesn’t care for the needs of the people who work within it. It will force them to submit. Why should doctors (many of whom work for less than the minimum wage, when on call) be allowed time to rest at weekends? Why can’t everybody have routine care through the weekend, just as from monday to friday (even though most of our top clinicians think we need better emergency care and not routine access)? Surely our economy needs this kind of health service? And actually, whilst we’re on it, isn’t it a waste of time, allowing teachers to have weekends off as well? Don’t we need our children to work harder, or at least be given some sort of babysitting service, so we can get more for our pound of flesh from their parents? If we are to have a 24/7 health service, why not a 24/7 education service? Our shops are already open practically 24/7. In this commercial world – shouldn’t everything else follow suit? No, no and NO!!

 

SolidarityThis is why we need a revolution of solidarity and resistance. We need a people movement who will stand together and be brave enough to say that there is a different way to see the world and a new way to live within it. Our naked life itself, although currently abused, can become for us our greatest power. Our naked life can expose the truth of just how abusive our systems have become. Our naked life, when combined with the indestructable force of kenotic love, becomes the very agent of change that we need.

 

So, what next for the junior doctors? Should they strike next week, including for emergency care? Are they ready for the media (who have lost the art of journalism) to turn against them? Are they ready for the storm that will ensue? Well, lives have already very sadly been lost. How many more can stand under the strain? What if the public turn against their heros?

 

It is time for something deeper to take place. It is time for solidarity. It is time for those of us in senior positions to cover shifts and show our unreserved support. It is time for the public, not just teachers, but across the board, to stand with the juniors. As my friend, Julie Tomlin showed me, we have to learn from the arab spring that one march alone will not do it. March after march after march may be needed. And singing too!! Let songs be heard on the streets! And to Lady-Godiva_DSC_9412really demonstrate the power of naked life……how about naked marches?!! (I grew up in Coventry, and so the story of Lady Godiva is in my blood – nakedness overcame oppression once before!). Or maybe the staff of the NHS should all turn up to work with no clothes on?!! How about people stripping off at least to their underwear to expose both the fragility  and the power of naked life?!

 

There is a different way for humanity. We can free ourselves from the oppressive yolk that seeks to divide and rule us. Perhaps, the Junior Doctors could be more creative and expose the deep structures of oppression that lie beneath the calls for this ‘7 day NHS’? Now is the time for subversion, for exposing just how unjust our systems are. But subversion alone will not suffice. We need solidarity and resistance. So, who will stand and march with the Junior Doctors (naked if need be?!) for an altogether different future?

 

Share This:

Share