Sunday, 13 December 2009

Understanding the Message and a Magic Malaysian Duck

I noted that whilst Twitter has triumphed in ensuring freedom of speech (for an up-to-date example, just Google Trafigura); Facebook has had its problems this week. It seems that in how we chose to communicate with others personal privacy and agency might become hareder to protect.

Who we intend to communicate with and to what end we engage in such communications, have all featured strongly in my experience of the last week.

For example, a colleague sent me an email this week (more of emails later). This particular email came complete with an attached copy of the latest policy statement released from the Department of Health setting out its vision for the future of the NHS: Prevention, Person Centred, Productive.

Interestingly this statement was released after the Pre-Budget Statement. Is the first message being communicated here that the NHS is safe in the Governments hands. Predictably, being a DoH document, it was rich in rhetoric:

Although this will be the most difficult challenge it has ever faced, we believe that the NHS can approach it with confidence, building on the major improvements of the past decade. Improving quality will continue to be at the heart of everything the NHS does. Improvements will be led by NHS clinicians at the local level, based on what is best for the public and patients in their area. There will be no ‘blueprint’ imposed by the Department of Health and no top-down reorganisations of the NHS.

Again it appears the message being sent out is about ensuring that the ontological security of the great British public is protected – the NHS will always be there for you whatever your needs. The rhetoric continues:

Our commitment to encourage and foster innovation in the NHS, and particularly the diffusion of innovation, is clear. We have created a £220 million Regional Innovation Fund to support quicker innovation and more universal diffusion of best practice across the NHS. We have developed NHS Evidence, a pioneering system to improve access to information, providing clarity on what good looks like. This will lead to better clinical and commissioning decisions and increase diffusion of best practice.

The message here perhaps, is that although other parts of the public sector may have to make massive cuts, Universities for example, who face £600 million cuts which are predicted to hit at the range and amount of research undertaken and the breadth of taught programmes, the NHS is different. Research, education and development will continue to be important and protected in the new NHS. Two and Two might not make four when added together.

And there are still further beguiling messages, including:

There should be early interventions for staff with musculo-skeletal and mental health conditions, to help minimise the time staff must spend suffering with these problems and to support early return to work.

A good sounding message, well at least in away that Talcott Parsons might have recognised.

Parsons will always have a special place in my heart. I drew on his work in constructing my PhD. For me, he successfully brought together sociology and psychoanalytical thinking in his exploration of our relationships with each other and with the institutions of the State. For Parsons, ‘being sick’ was not simply a condition, but something imbued with the customary rights and obligations based on social norms. His theory presented two rights of a sick person and two obligations:

The sick person is exempt from normal social roles
The sick person is not responsible for their condition

The sick person should try to get well
The sick person should seek technically competent help and cooperate with the medical professional

For the individual, organisation and the wider society, clearly, these rights and obligations can give rise to problems, and there are many critics who over the years have rehearsed the problematic nature of Parsons contentions. However, it seems that some 60 years after publishing his ideas, both Parson’s theories and our privacy are still in danger of being challenged by those interested in exerting social control. The effects of social control can be experienced at an individual organisational and societal level. Perhaps it is because the many new technologies, particularly ICT, allow us unprecedented opportunities for communicating that these tensions are beginning to emerge.

This week I was confronted with the tyrannical (and perhaps cynical) nature of the way we unthinkingly use email to communicate. Emails can be both anonymous and attributable, helpful or hurtful. Hence my new year’s resolution is to break the almost Pavlovian response to email requests for information, meetings, opinions, actions and so on. In future I intend to ask people to pick up the phone and talk to me and or come and have a chat, face to face. Whilst this approach might not be as Productive, it will be Person-centred, and might better Prevent misunderstandings.

That duck, well yesterday, Bernama, the Malaysian state owned news agency reported that an Imam and his wife were rendered spellbound after one of their ducks, this week, laid three black and three brown eggs. Apparently the shells of the black eggs bore an image of a man in a white robe, a pretty woman and Chinese characters. I am afraid you will have to work out for yourself what the hidden message might be here!