There is no real crisis worthy of the name in our Scottish NHS. It is largely a bonfire of mass hysteria originating in media misreading or distortion of statistics, fuelled by public servants and trades union leaders with a vested interest in starting the fire and danced around by politicians who hope to benefit from the aftermath at the expense of their rivals in this 21st Century tribal community. If ‘mass hysteria’ offends your sensibilities, you can use the more gentile term ‘cultural performance’ but the point is the same in that the human behaviour being described is essentially ritualistic rather than rational.
I know and regret that people have died needlessly and others are waiting longer than is often bearable for them. NHS Scotland is not perfect but it’s a damn sight better than virtually any other public health service on the planet. The demand for more and better service is insatiable. No service feasible or affordable could ever meet all of the demands that a modern population might expect of it. No one ever feels 100% fit. If they thought there was treatment for it, no matter how trivial others might think the complaint was, people in this affluent caring society would expect it and now. The evidence is clear and present. I keep posting this. I know it’s getting dated after only a few months. I know some of the evidence might be open to argument but, taken together and accepting the limits of all statistics, it suggests a national health service of incomparable quality and in rude good health:
Take just one example:
‘Scotland has the best and still improving A&E performance in the World’
Those are the words of the Royal College of Emergency Medicine this year. There are many other objective indicators of high quality in NHS Scotland yet our media insist on acting as if it were not so:
‘Outrage after Scottish NHS misses targets in over two thirds of Government standards’
The Daily Record shouts the above as it too dances round the bonfire of mass hysteria without ever telling us how high the targets are, how narrow the misses were and how proud we should be that we have such a system managed by such a government that is prepared to set them and to use them to help it improve even further. What kind of culture rewards high aspirations with such derision? These are achievement NHS England could only dream of and which for most of the planet would only be a crazy wonderful dream. Imagine the situation were the other political parties to return to rule? They’re even less confidence-inspiring now than they were when they were doing their best to destroy it all via privatisation only a decade ago.
Let me show how mass hysteria can be a fact of life in modern Scotland just as easily it can be in pacific island tribal communities. I stole the impressive headline from a great Scottish academic, Ian Stronach, who wrote ‘Shouting Theatre in a Crowded Fire’ about the endless panics and ritualistic cycles of change in school-level education in response to international evidence that other country’s children (Germany, Japan etc) were doing better at something (Literacy, Numeracy especially) than ours. Opposition politicians responded opportunistically to this very limited evidence of what was at most a challenge and with the help of the media turned it into a ‘crisis’ which was then presented to the wider population in terms which trigger a further panic and crucially encouraged a few disgruntled parents to come forward and to report excitably on how a school had failed their child. The media also sought out a few disgruntled employers to support the notion that job applicants could not spell or count properly. Before you knew it, the flames were roaring and the government of the day was forced into a new programme of reform. Extra staffing, resources and the excitement generated among the children ‘getting’ the ‘new’ education lead to some improvement, at first. As time passed, however, the novelty factor wore off for the kids and for the teachers and the extra funds began to fade away. A few years later and nothing much had changed. Five to ten years later and some new international comparative research reported that our kids were failing again, relatively. Media reported it, some opposition politicians spotted the career opportunities and we were off again. Teachers groaned, ‘Not again FFS!’ Any readers who have worked in Scottish schools over the last 40 years or less will have seen this before, perhaps more than once, and know just how much this is really a ‘cultural performance’ to satisfy the hysterical reactions of a new generation of parents and politicians. Crucially, these new parents and politicians had forgotten the previous cycle of ritualistic behaviour. In particular, if you were a teacher, you might remember the dances of those close to the tribe’s chief, Her Majesty’s Inspectors of Schools’ as they came to your school, fully-feathered and carrying sharp sticks to prod you into making the decreed changes. Anecdotally, allegedly, those same scary individuals drove Stronach out of Scotland to work somewhere more modern like, I think, Manchester! I can’t find the source for this but I’m sure I’ve read of an American Educational Psychologist (Ralph Tyler?), speaking in the 1940s and saying of a new curriculum strategy then: ‘Oh no, not those fucking competences again!?’
Here’s how Professor Stronach himself, put it in the abstract to the full paper (url below) which I really recommend:
‘This article offers a deconstruction of global evaluative discourses concerning school effectiveness and improvement. It portrays these discourses in anthropological terms, as ‘cultural performances’, and examines the ways in which technical discourses obscure elements of ritual, philosophy, myth and shamanism. The author concludes that such discourses, especially in their mediatized forms – as league tables – are a form of contemporary ‘spectacle’. They are our Olympic Games.’
Are we agreed then you can have mass hysteria or a cultural performance with no really scientific basis in modern Scotland? If it is possible in one system such as Education, then why is it not likely in another of a similar nature in the same society, in Health Care? Next time you’re watching Ruth Davidson shouting ‘Scandal!’ at the First Minister, imagine feathers, a skimpy animal skin, face-paint and a sharp stick. See what I mean?
- ‘Shouting fire in a crowded theater’is a popular metaphor for speech or actions made for the principal purpose of creating unnecessary panic. The paraphrasing does not generally include (but does usually imply) the word “falsely”, i.e., “falsely shouting fire in a crowded theater.’ https://en.wikipedia.org/wiki/Shouting_fire_in_a_crowded_theater
- ‘Insociology and psychology, mass hysteria (also known as collective hysteria, group hysteria, or collective obsessional behavior) is a phenomenon that transmits collective allusions of threats etc., whether real or imaginary, through a population in society as a result of rumors and fear (memory acknowledgment).’
Stronach: Shouting Theatre in a Crowded Fire: ‘Educational Effectiveness’ as Cultural Performance http://evi.sagepub.com/content/5/2/173.short