Harry Blair and the Magic Wand

'Harry' Blair has a new wand. His last one - the 'target' wand didn't work so he's got the latest model - the 'choice' wand. Michael Malfoy is so jealous he's bought the same model.

It is disturbing that both major political parties have begun to believe in magic to solve major problems. I've yet to hear any member of either party give a coherent account of how the magic of choice is supposed to work. One minister so help me, live on air, tried this: if a hospital has a bad record on MRSA control then patients will consequently choose to go to another hospital. (You bet). This vote of no confidence we are asked to believe then provides the necessary 'incentive' for the poor hospital to improve. Are we supposed to take this idiotic rubbish seriously? Does a hospital with a serious MRSA problem actually have to wait until it loses 'customers' to another hospital, to realise that it must do something about it? If so I'd choose another hospital on the grounds of stupidity not medical weakness. One would have thought that losing customers to the graveyard might be a little hint. This is patronising nonsense masquerading as a policy and insults every nurse, doctor and administrator struggling to deal with a serious problem in a real world.

If you are going to pin your faith on an incoherent idea you might ensure that the other inhabitants of Hogwarts can at least fake a meaningful rationale for it. As for MRSA we are lost as poor old Dumbell d'or, Dr (sic) Reid only has last year's 'target' wand to magic it away. And what 'two-broomsticks' Prescott is up to I dare not hazard a guess.

The battle against MRSA will be won when everyone in a hospital 'owns' its cleanliness and hygiene. This is not one functional objective among others to be delegated, contracted out or targeted; it is a pre-condition for any form of satisfactory operation in the first place. To achieve an absolute commitment to cleanliness from everyone who enters the hospital requires rigorous, committed, ever vigilant management with zero tolerance of anything but impeccable hygiene. Sounds like we need a 'matron' magic wand: except it's unremitting hard work - not magic. And the motivation is professional pride not fatuous 'incentives' or the contrived pressure of phoney competition.

"Examples!" I hear my old professor of philosophy cry. So here's another one and this one's a real doozie. In a recent radio interview, the head of OFCOM said "Providing the consumer with choice must be good." This was in the context of the farcical state of Directory Enquiry services. At the time of the interview, the single service we knew had become 124 separate 'services'. Every one of these now has different, usually hidden or cleverly opaque, charges etc. Since the spirit of Lewis Carroll took over this minuscule element in our lives we are all paying more for a worse service that half of us are too confused to even use.

All the houses in Hogwarts seem to have bought into this empirically idiotic, pragmatically nonsensical and morally disreputable mystical belief. The guy from OFCOM also said "customers must be given information in order to make an informed choice." To make an 'informed' choice today's customer (and voter now it seems) would need a PhD in semantics, a Mastermind-winning stock of general knowledge and about 3 hours a day to examine forensically every piece of devious small print, intentionally confusing product labelling, and cleverly wrapped-up package of 'free' or highly 'advantageous' benefits that obscure the supply of worse goods and services at a higher price. Add to the 3 hours, the time spent trying to weave your way through the arcane mysteries of voice mail systems and deleting unsolicited mobile phone offers and with luck, there might be a little time left to do something useful before falling into bed in despair.

Even mystical beliefs have to come from somewhere so lets look a bit more closely at what has put the political wizards in Hogwarts into such a tiz. As ever, for groups dominated by lawyers (Slitherins to a man) who've never run anything but a clever argument, the paradigm is the world of corporate business. We know this must be the source of holy writ for successful outcomes as this is the world led by Grand Wizards who don't get out of bed for less that £2 million a year and who to wave their wands seriously, need the occasional incentive of the odd £1 million here and there. These magicians make Hogwarts alumni look like beginners; for whether they win, lose, or draw, they still walk off with the supposedly results-based rewards. Now that's some magic.

Let's look at the choice-magic philosophy. It’s supposed to work like this: companies supplying similar products or services compete by persuading us to choose one over another. The theory is that this motivates them to continuously improve the product or service so we pick theirs. But even in this simple paradigm is this what actually happens? If sales of a particular branded product or service fall, which option is most common: serious improvement in the product, or a bigger ad campaign, re-packaging or a marketing push to persuade us that essentially the same product has improved?

So even in this simplistic application, the beneficial force of choice is illusory. Then we extrapolate a false assumption to inappropriate contexts. As an ex-school governor I know that as LEA’s now rely almost exclusively on geographical criteria for most non-sibling entry, ‘choice’ of school becomes choice of house. Thus choice of school becomes an illusion founded on a lie. Choice of house is not an educational criterion at all, it is a function of income.

Choice in transport will give me 3 or 4 ways to travel major profitable routes and none at all to the smaller, diverse places where I actually want to go. Postal choice will give guaranteed fast delivery to some in prime locations and no universal, cheap access to a comprehensive, whole country, essential form of social interaction for all, especially the elderly and the disabled. How do I ‘choose’ between hospital consultants, or hospitals? Do I want to? A rational choice between consultants would require expertise I don’t have to discriminate between qualities they would not be allowed to advertise anyway. This is third rate thinking serving second rate ideals.

I want to know that the hospital closest to me is working to high professional standards attained by committed, well managed staff, self-motivated by personal and professional pride in individual and team performance. The idea that this can't be achieved until they are brought to their senses by carelessly knocking off a few patients and once word gets round, losing their local 'customers' to a hospital down the road, only needs to be stated to be seen as the half-baked idiocy it is. What I believe does, as it should, motivate our doctors and nurses is the desire to help, cure, alleviate pain and suffering, and support their fellow human beings unfortunate enough to be afflicted by illness and injury. The idea that they can only do this by 'competing' for custom with another hospital with identical ideals is as insulting as it is fatuous.

‘Choice’ in these critical social contexts is, and will always be, financial privilege masquerading as social equality. Mickey Malfoy and his Slitherins have always supported this idea. But for Harry Blair, and his chums Ron Brown, Hermione Hewett, Dumbell d'or Reid and Hagrid Prescott to buy into such tosh is very bad magic indeed.

Zettel

Look out for the upcoming 'Harry Blair and the Secret of the Third Way'.