Editor's blog Monday 24 January 2011: Darwin, Stalin, citizens and the service
Today's event on the involvement and engagement of patients and the public with the National Health Service and its reform was an interesting one.
Principally because whenever policy remembers that the point of healthcare is not systems or structures, but people, then it has remembered something fundamental and surprisingly easy to forget.
The conversations started, continued and reiterated might not have broken vastly new ground. That is not so much the point as the focus. The focus is of real value.
We have a lot of change coming, and not a little chaos likely.
There is also a dynamic tension on offer in health policy: SOS Lansley has spent much of last week emphasising that the Health And Social Care Bill represents "evolution".
This sits askance with Sir David Nicholson's comments to the NHS Alliance conference, Health Select Committee and the HFMA conference that the reforms are "a change programme so big you can see it from space", and with his warning to the health select committee that the next two financial years will be about "tight Stalinist controls".
Darwin's theory of evolution, outlined in On The Origin Of Species, offered a culturally, socially and religiously unacceptable challenge to the dominant narrative of intelligent design. That sounds like what a serious dose of transforming the relationship between citizens and the service would be.
If Stalin's control will let it.
So. Who's your money on: Charlie or Joe?