Liam Farrell: Big Brother is watching over NHS 'newspeak'

In George Orwell's '1984', language is reduced and brutalised as a means of curtailing thought.

Words are simplified and negatives are discouraged; bad becomes 'notgood', great becomes 'plusgood', excellent becomes 'doubleplusgood'.

More nuanced words are disparaged as 'oldspeak', which is considered evidence of political unreliability and likely to attract the attention of Big Brother.

Restricting freedom of expression enables restricting freedom of thought (it wasn't all bad, apparently newspeak for health service bureaucrat was 'bonehead').

Not that the NHS has anything to learn from George Orwell; we've had the spin inflicted on us for years now. Which political party is actually in charge seems to be irrelevant; Tories, Old Labour, New Labour, (oops, almost forgot the Lib Dems, how did I make that mistake, they are so powerful and influential, when Nick Clegg says: 'Jump', we all ask: 'How high?'), they all come out with the same plausible gibberish.

Health trajectories, re-ablement (used to be known as rehabilitation), foundation hospitals, ShiftLeft (which, believe it or not, means moving from secondary to primary care) and Gonad Reorganisation (OK, I made that last one up). The latest jewel was the phrase that they were 'retiring' QOF points. 'Retiring', how sweet, how soft, like the murmuring of flies on summer eves. It paints a picture as if QOF points had been a dear, much-loved family friend, a faithful old retainer, to whom we would sadly wave goodbye as he rode off into the sunset and who would see out his days playing golf, pottering around the allotment, Googling porn and blackmailing gay farmers.

The truth is rather different, of course. Most QOF points were chosen because health service managers just adore things they can count, especially on their fingers and toes. QOF points, targets, protocols, algorithms, they all coarsen the nature of medical practice and ignore the need for thoughtfulness and intuition. That patients are individuals and that each patient demands care specific to their individual needs is much too disorganised and chaotic for the boneheads. If they can't pigeon-hole it, it's not important.

What goes around, comes around; 2012, 1984, individuals are inconvenient.

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