Sunday, 30 January 2011

Equalities Stakeholders. Yes, they're out there messing up your health service again!


My meanderings brought me to this blog post entitled, "Where do equality stakeholders fit in the new NHS Landscape." Not sure whether it should have had a question mark at the end or not but it reminded me just how distant from normal understanding of common sense the 'diversity' and 'equalities' agenda has got:

According to Minister, Andrew Lansley, the changes he proposes to bring about in the NHS will put patients at the centre of everything the NHS does.

That's a bold claim, which should be seen in the context that NHS organisations like the 152 Primary Care Trusts (PCTs) and the ten (regional) Strategic Health Authorities (SHAs) have specific statutory obligations to consult with the public, plus obligations (as public sector bodies) under the past and future Public Sector Equality Duties.

This is followed by a jolly diagram showing us how the new system operates - with different colours, arrows and fine names. But - so far as anything within this jargon-laden and confusing little piece is clear - the writer's argument is that "equalities stakeholders" (creatures the writer doesn't describe or define) are pushed to the edges of the current system because we've scrapped PCTs and SHAs thereby removing all the equalities and diversity monitoring that's going on in the NHS at the moment.

And the new system won't be accountable "to local stakeholders" - as if the current NHS organisation is remotely accountable to anyone locally! Or rather it is but in a different way from the way we - as ordinary folk - understand. The accountability - a cosy, all-mates-together kind of accountability - exists between those who the government fund to provide 'voice' and 'advocacy' and the agents of the NHS itself. What the writer is bemoaning isn't that the result will be a less "fair" NHS but that these mostly self-appointed representatives of "equalities groups" will be pushed to the margins.

I welcome this as a very positive step - hopefully to be replaced by the development of personalised service for individuals, as individuals. The present 'equalities' arrangement single out specific groups as worthy of 'representation' and fail to see real people with real concerns about the health support they receive. Although we seem lumbered with the Equalities Act - with all its basis in groupthink and special pleading - making sure that our care systems respond to individual need rather that meaningless group needs moderated by professional advocates must be a positive step.

Patients are now put at the centre of the NHS by employing professional "equalities stakeholders" to moderate the interface between the individual and health providers - that's what we have now. We get to the heart of the NHS by being given power - and power over suppliers comes from choice not the bureaucracy of equalities and diversity.


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