Anyone for Cranberries?

I've just read the latest Intellect report on NHS IT - NHS Information Evolution - all 16 pages of it.  It's not quite as off the mark and wrong-headed as I'd feared when I read the headlines in E-Health Insider.  All that nonsense about learning from Lastminute.com.

But it's not great either.  The biggest problem is that it's breathtakingly superficial in its analysis and happy to make recommendations with little in the way of justification.  It's not that the ideas it puts forward are bad, they just lack logical foundations and hence coherence.

As far as I can see, the author plugs the gaps where some serious analysis and discussion ought to be with filler based on the premise 'everyone else is doing it, so why can't we?'. 

It's a good question, but a document underpinned by genuine intellect would have sought to answer it before trying to formulate recommendations rooted in that analysis.

I've never bought into the view of people like the Guardian's 'Patient From Hell' blogger Dick Vinegar that the failure of the NHS to espouse the latest technology is down to an unholy alliance of conservative doctors and bureaucrats, all too satisfied with the status quo.  That's just the simplistic narrative of journalism where some bogeyman must be to blame.

After all, the vast majority of the people busily not jumping on the new media bandwagon in their working lives are well on board at home. 

No, it must be something more far reaching to constrain progress so extensively and consistently. It must be something inherent in the way the business works, or doesn't work: in the fundamental way that things are organised and arranged.

The Intellect report fails to take the lid off any of that, presumably because the authors don't have enough knowledge or experience of the byzantine political and managerial landscape that constitute the NHS business, and which forms the essential backdrop of any serious attempt to formulate IT policy and strategy.

Obviously, that lack of knowledge didn't stop Richard Grainger, Christine Connelly or Katie Davis.  Oh, then again, perhaps that's exactly what it did.

Coats on their backs

The shabby exterior of Holbeck Working Men's Club isn't the backdrop many people would choose for their lives.  Less so the strip of rubble-strewn waste ground between the WMC and Holbeck Moor Road. Bounded by soil embankments, presumably to stop the Gypsies and travellers making it their home and overlooked by ranks of drab grey flats and mean grey houses, it looks grim on a good day.  It seems to exist in a microclimate of grainy monochrome.

I noticed them on my way back to the car during the last spell of arctic weather. Picking their way through the frozen mud, bricks, bottles, poly bags and god knows what else in the wintery afternoon light.  It was about minus 4 and I was glad to be getting out of the cold and into my car on the Moor Road.

Mum or granny - who could be sure?  But a 'grown up' and in charge, with three small children somewhere between the ages of four and seven I would guess, but roughly in the same ballpark as my own.  Maybe it was that, combined with the unrelenting bleakness of the setting that drew my attention to them as they straggled across the wasteland.  You might call it 'lunar' but I think that would be insulting the moon.

They looked poor, but that wasn't what caught my attention and after all, some of that might have been the setting.

No, what really struck me was how well wrapped up the children were: all with warm padded coats done up, hoods up, hats and gloves on, Thomas the Tank Engine or whatever rucksacks on.  These may have been poor kids straggling across some dismal waste ground between the M621 and an abandoned-looking WMC, but they were looked after; cared for; cherished, at least in terms of their immediate physical needs.  And they were together.  A tight little unit - some of the kids holding hands, pulling the smaller ones along.

Now none of this should be at all surprising, after all, the poor have never had the monopoly on neglecting their children.  And I have absolutely no idea of what their family circumstances might be, or their backgrounds or home life.  So I'm aware that any attempt to derive inferences from what these people looked like is extrapolating well beyond the data.

But that's not the point.  What struck me was the impossibility of locating these people on the current government's map of the deserving and undeserving poor.  Were they 'strivers' or parasites?  Were they what David Cameron means when in plumy tones he says 'haad warking fam-liz' or would they be one of the supposed 120,000 ‘troubled’ families that require a tougher approach to stop them drifting through a lifetime of state-funded idleness and petty criminality?

Damned if I know, because for all that the children were obviously cared for, it's quite possible that those coats and hats and bags were paid for out of benefit money or tax credits, or even from the proceeds of petty crime.  Equally, somebody might have scrimped and saved or traipsed around endless charity shops to provide them. 

The arbitrary distinctions of a government seeking to justify an unparalleled reduction in the money available to the poor seemed a long way away and somewhat divorced from the gritty immediacy of the scene.

Somewhere, far away, important decisions on ‘welfare’ and the like would be made by wealthy, expensively suited and booted, well-educated people in warm, brightly lit offices.  People confident in their own abilities; self-assured and articulate and whose memories of childhood, family and school would be a world away from Moor Road.  Nevertheless, their decisions might fall like a hammer blow on this little band, struggling across the freezing waste ground in front of the ragged façade of Holbeck Working Men’s Club.

These thoughts were little more than a gloomy embryo developing in the back of my mind as I got in my car and drove slowly away.  But the one thing that stuck there in my mind’s eye was their utter vulnerability.