How to sell dead fish
If the reforms fail, it won’t be a failure of will or intellect or effort, but communications.
There is an idea that if you win the hearts and minds of a few leaders the rest will follow like so many sheep. Keep meeting the same, tame leaders, flatter them a bit, put them in charge of a think-tank, tell them what you want them to say and send them out to spread the word to the rank and file.
Except that it doesn’t work. You don’t hand opinion formers ready-rolled opinions and then expect them to go forth and influence. They have inconvenient minds of their own, so do their victims. They all need convincing.
If you were selling cars, would you get ten of the country’s “leading” drivers in a room, suck up to them, hand them a 300 page document describing your new car then tell them to go away and tell their friends? And if you did, how many cars would you expect to sell?
You would create an advertising campaign to sell the benefits. You would get Clarkson and his motley crew of middle-aged male petrol-heads to drive it irresponsibly fast and then put it on TV so that people of a similar demographic can drool over it.
You might set up a Facebook page, get a few celebs to tweet their approval, buy some space on cool websites for teaser ads, put some never before released footage on Youtube, create a buzz and get people talking about it.
It was once said of Hewlett Packard’s marketing that if the company was selling sushi it would call it raw, dead fish.
Reading through the papers that pour out of government, professional bodies and academic institutions one can only conclude they were all on the same training course.
Involving doctors more closely in commissioning decisions, making them more accountable, giving patients choice and better services, closing the gap between health and social care where the needy and dispossessed are disappear without trace – all these are fine ambitions to which every right thinking person aspires.
Yet somehow this brilliant, handsome, vote-winning policy comes over like an awkward duffer. How did it happen?
Patients have been told that doctors would be responsible for commissioning – a completely alien concept that means nothing to them and leaves the door wide open to scaremongering about cuts and closures by the unions and the media.
Patients are also told that they will be more involved in the design of local services. Why on earth would they want to do that? Feeling poorly? Take your mind off it by co-producing an integrated care pathway with your clinical commissioning group.
Now the doctors: what’s in it for them?
They can be more accountable. They can have governance, performance management, peer review and added regulation. They can have extra homework, Saturday detention, and cross-country runs with cold showers followed by the high jump for shirkers.
There will be more prefects and more rules, fewer holidays and less play time. There will be a lot more talk of freedom but many more visits to the headmaster’s office to prevent anyone from abusing it.
Yo Sushi calls it “tasty Japanese food in a fun environment”. The same product from the NHS would be sold under the slogan “get your dead fish here”.