In support of ‘balanced argument’

Author: Carl Davies

I read with interest the blog written by Nish Manek in ‘Pulse Today.’  It was an articulate and balanced view, offering a different insight into a world (NHS England) that many readers will not have been party to.  It was a clear attempt to set aside the ‘anti-establishment’ rhetoric, that it would be easy to jump on board with, and encourage others to challenge their own beliefs about the task of policy creation and ongoing policy changes.  However, the backlash Nish has received should signal a red flag to us all about how we encourage debate of complex issues that span the entirety of the NHS.

Clearly, shaping NHS policy is a difficult and challenging task.  One would expect that all those affected by a change in policy would at least understand that.  Nobody expects ‘everybody’ to agree with changes in direction, and critical challenge and reflection is undoubtedly necessary to help shape and refine said policy.

However, the impact that changes in policy will lay at the doors of frontline services will be both correct AND distasteful for some.  Many will have to look at their own practice and ask themselves if there are things they could do better.  Indeed, many are doing just that and there are numerous examples of changes in national policy helping to shape improvements in healthcare services.  There will also be examples of where policy makers have not fully considered the impact, and so unintended consequences have led to deterioration in healthcare provision.  Again, nobody would suggest it would not be right to highlight those examples and I certainly don’t pretend that everything is rosy everywhere.  However, there are also examples of those that refuse to critically review there own practice and instead choose to ‘blame’ others for their ongoing problems.  More worrying is the percentage of health ‘professionals’ that appear to think it is ok to personally attack anybody offering an opposing argument to their own.  One browse through the comments section of Nish’s article will evidence this.

How has it become acceptable that we tolerate such personal attacks?  Why is it ok to take personal experience, look for blame, and then make enemies of those offering different perspectives?  Why are we tolerating unprofessional behaviour and passing it off as them just being “passionate about the NHS”?  We are ALL passionate about the NHS, that’s why we do what we do.  However, we all have (and are entitled to have) different views and perspectives about how and what change looks like, without fear of being labelled an “arse licker” or being told we need a “slap in the face” as Nish has received.  It is a childish and easy game to simply label anybody optimistic or pro-change as ‘anti-NHS’ and make out that they are part of is a conspiracy to privatise the NHS.  Many of those labelled as such, are the ones actually delivering the change that will benefit the NHS rather than playing a role in destroying it.

As humans, and particularly when our ‘normal’ comes under threat, we have a natural tendency to pick a ‘side’ and make an enemy of a group that have opposing views.  You only have to look at the current political landscape to see, as times get tougher, the number of people lurching to either the left or the right.  We allow the more ‘extreme’ arguments to dictate public debate, because it is easier to pick a side and blame somebody else than to accept that we could be part of the problem or that we may have to change.  Offering a balanced argument has sadly become a dangerous game – it can lead to the writer/speaker becoming an ‘enemy’ of both ‘sides’.

We must then, ask ourselves how we want to shape the debate on the NHS.  Are we willing to allow the future of the NHS to be dragged to a gutter-press style debate, where facts are second to biased anecdote and sensationalism, and personal attacks are fair game?  Or are we going to allow us all to be free to offer a different perspective, without the fear of reprisal from angry mobs?  Personally, I cling to the hope that we can remain professional and challenge critically, without the need for personal attacks.






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