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Jeremy Cooper

Helter skelter! Which Beatles song best captures our relationship with the NHS?

The Beatles

A song I listened to on the radio this morning came with a dedication – not to an individual, but to the NHS. The song, a specially recorded version of With a Little Help From My Friends, features a host of stars paying homage to the NHS on its 70th birthday.

The song came on just as I was reflecting on Alex Massie’s recent thought provoking article in the Times, proclaiming the NHS to be the biggest cult of our time.

Massie’s view is that the British people have a ‘startling’ faith in the NHS.

Granting the NHS holy relic status unavoidably removes it from the arena of ordinary political debate. When the health service becomes a kind of sacred superstition it becomes something to be revered, not changed

I would certainly agree that we have had a strange, multi-dimensional relationship over the (ahem) Long and Winding Road of the last 70 years. At IMPOWER we grapple with this relationship every day, using EDGEWORK – our philosophy and approach to navigating change within complex social systems. As well as acting like cult members, we love to personify the NHS, treating it as a revered aunt, celebrating its birthday and turning up at the celebrations with a gift worth £20 billion. We are proud that it is fully tax funded, but turn a blind eye to all its real costs at the point of delivery (not to mention those of the closely linked care system), whilst simultaneously donating to it as a charity.

Going forward, how might we relate to the NHS in a more rational way? Rather irrationally, this is where John, Paul, George and Ringo come in.

I realised this morning that With a Little Help from My Friends might provide some useful guidance. It points not only to the dedication of all those formally involved in health and care, but also to the fact that involvement of friends, families and communities in delivering health outcomes is essential. Failing to properly appreciate this is one of the biggest weaknesses of an increasingly professionalised health system.

I agree with Massie that the “sappy reverence in which the NHS is held has become a block to the reform and change it needs”.

We need deep rooted cultural change in the social contract between the public and the NHS. We can start this by changing – individually, then a hundred at a time and then a thousand at a time – the millions of front line interactions between health and care professionals and individual citizens. Reimagining those interactions, so that there is greater emphasis on prevention and on patient strengths, can realign unhelpful mindsets and help to maximise patient involvement and independence.

So here’s a question – one that will result in answers which are somewhat silly but also revealing. What other Beatles songs capture our relationship with the NHS? It’s worth asking, because we can’t just Let it be!

I’m not sure that any of these really work:

  • Hello, goodbye – an example of effective demand management?
  • Come together – right now, over me . . . person centred care planning in action?
  • She’s leaving home – for residential care because the care pathways couldn’t be sorted out properly
  • Revolution – maybe this is the one!

If you’ve got any ideas that might please, please me, drop me a message. Or dare I say, Help!

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