Power to the Proles: why Orwell got it wrong
In George Orwell’s novel Nineteen Eighty-Four, Big Brother and the members of the ruling elite, the Inner Party, monitor the population by telescreen, a surveillance device in every home, public space and place of work.
The logical problem with this concept is that Big Brother could not possibly watch everyone all of the time, even if he had an army of monitors.
Orwell died 25 years before the first personal computer and 40 years before the web revolution. The first commercially successful computer appeared in 1951, a year after his death.
Written in 1948, the year the NHS was created, Nineteen Eighty-Four accurately predicted a world dominated by information technology. But it got one thing critically wrong. IT is not a tool for state control but for the empowerment of the Proles.
Sixty years on, everyone owns their own telescreen and Big Brother and the Inner Party are quaking in their boots.
You can rate the service you receive from your local hospital or general practice on NHS Choices. Other websites allow you to go further. The iWantGreatCare website encourages patients to rate their doctors and dentists, praising the good ones and naming and shaming the bad.
Sites like this create a dangerous illusion of democratic legitimacy but actually achieve little more than a paralysing atmosphere of scrutiny and blame.
The idea is that everyone has a say and that the collective weight of opinion makes us all better informed, better able to exercise “choice” as we trundle down the health aisle of Tesco and Asda.
But everyone doesn’t have a say. Five people express their indignation and another five express vacuous gratitude for a “great service” or a “brilliant doctor”. Even if there is a clear verdict it will have been delivered by a jury representing a tiny proportion of the population. In a practice with 10,000 patients, 10 voices equate to just 0.1%. And in matters of health, every negative opinion, every bad experience will outweigh a bland expression of satisfaction by a factor of thousands to one.
If Harold Shipman’s patients had been given the opportunity to tweet their views, he would have had a five-star rating. The “not sures” were too dead to vote. (Local knowledge – Harold Shipman was incredibly popular with his patients, and that probably included the ones he murdered – LGF)
The experience of patients is important, but experience is a slippery commodity, which has very little to do with health outcomes and everything to do with rude staff, bad hospital food and an exaggerated sense of entitlement inflated by the media.
If we ever reach the point where everyone expresses a view, what do we do with all the “information”? Direct representation only works at a small scale. The Greeks, who invented democracy, could only make it work for 5000 people before it got out of hand, but then they didn’t have Facebook.
Now that there is no limit to our ability to build a bigger amphitheatre we like to think we are better informed and have more choice; in practice we are more baffled than ever.