Out of office, governments extol the virtue of low taxes and smaller government yet spend most of their time, in office, raising taxes and growing the size of government.
Technology may well be able to provide them some solutions to their growing pains but why is it, rarely, governments make it their first-choice?
Generally, governments start with analogue solutions, only later do they look for a digital answer, by which time the transition between the two becomes a huge heave-ho, that generally ends in tears, along with a shed-load of public money down the tubes.
Government is analogue because it is grounded in an analogue tradition. Senior people are, mostly, from an analogue generation, with an analogue education and an analogue career. They make it difficult for transition for fear of loss of influence and control.
Making the transition from analogue to digital requires a language that is not spoken across public services and a willingness to change that is disruptive of… ‘the way we do things’.
No more is it true than in the NHS.
Today’s technologies, never mind what’s around the corner, would enable much of the routine of healthcare to be done or assisted by technologies.
Dare I say, there is a strong likelihood a significant ‘some-of-what-is-done’ could be done more accurately and more reliably by the application of technologies.
Sticking with analogue impedes public access, security, safety, economies and the headroom to spend more time with people who need our help the most.
No better example than the video consultation technology provided by Babylon. The argument about the reliability of diagnoses is a side-show, as we have no measure of how reliable GP, face-2-face, diagnoses are.
The real issue are the reimbursement mechanisms. To accommodate Babylon, and the likes, requires a switch to a, technology underpinned, fee for service. Far too disruptive.
The ball and chain of analogue is no more pronounced than by the way the NHS and its people are regulated.
Regulation happens when politicians are spooked by the public’s reaction to events. For example…
The Bristol Baby horrors gave rise to the CQC. The political knee-jerk was analogue… inspection. At that time, all we had was clip-boards and flat caps.
The result, a comedy of hundreds of inspectors arriving by the coach-load, block-booking local hotels, and a farce; poking around, trying to find as much as possible wrong with a GP practice, hospital, or care home, or whatever.
A million miles away from the causes of Bristol and millions of pounds of public money wasted.
The CQC hasn’t worked for the NHS and it doesn’t work for the public. Providers no more reliable and the public no safer.
To make it work; the technology exists to use data to create a performance algorithm, to look for outliers, forecast Trust performance, spot problems in the making and plug in help and support.
It would be even easier with GPs as, generally, their technologies are better.
The profession’s regulators, born of a quill pen era, never mind analogue, have grown fat on the fees health professionals are obliged to pay… for what?
To preserve the regulator’s reputation they treat their ‘customers‘, for that is what their registrants are, with little more than contempt.
Left hanging for months for hearings and enquiries. Crumbling registration procedures.
They embellishing their roles by publishing duplications of guidance, best practice and blurb, few have the time to read.
Are the public any safer for regulation? Read the newspapers, patently not.
Governments have no idea how to regulate. FaceBook, Twitter and the likes, are a case in point. These companies are fast becoming public utilities, with the power to do great good and inconceivable bad.
Government’s response is analogue. Framed in the ‘don’t do this, or that‘. It’s the wrong answer. It should be framed in the ‘what can we achieve together’.
Regulation, stuck in the role of dust-cart, sweeping up after life’s accidents, failures and fraud, is of little use.
Regulation, has to become a detector-van and for that to happen government has to redefine its relationship with technology.
Analogue doesn’t scale, doesn’t integrate, doesn’t forecast and can’t accelerate, or connect.
Government needs to do all of that and so does the NHS.
Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.