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Thinking outside the tick-box

Last week’s biggest non-surprise was the disclosure via the BBC’s St David's Day poll, that health is the number one issue among the Welsh public.

Hardly earth-shattering news given that political parties seem to be talking about nothing else in the run-up to May’s Assembly elections.

Interestingly, social research says that despite politician’s best efforts, most of us base our perceptions about NHS performance upon our own personal experiences.

This in turn relies on our expectations and how reasonable or unreasonable they are. So what is an interminable wait at A&E for some is considered acceptable by others.

A common theme is that everyone thinks there’s room for improvement, including those actually providing the service. Where folks differ is over how this should happen.

I’m not sure how many users will sign up to the Welsh Conservative’s proposal made this week for hospitals to be publically ranked with one-to-five ratings - just like food hygiene in restaurants and cafes.

I understand the intention but I’m not sure if the complex range of performance indicators currently used can be reduced to a single meaningful score on the door.

I’d say that real empowerment would be about by giving communities an effective say over the things that affect them such as hospital closures or relocation of clinical services.

Police authorities were replaced not long ago by Police and Crime Commissioners in the name of greater democratic accountability. Partly or fully elected health boards could and should be the next move.

As it happens, UKIP have such a proposal as one of their manifesto pledges. I hear other parties are looking at the same option.

I’ve no patience with the argument that it can all be left to appointed officials. Whenever a target is missed or a report is published about poor care somewhere in the UK, opposition parties immediately demand a ministerial resignation. Politicians can’t have it both ways.

Hopefully this change would also move the agenda forward into an acknowledgement of what everyone already knows – which is that what we call the National Health Service is in reality a National Sickness Service.

While the main political focus stays on treating the sick and coming up with more and more ways to measure how it’s done, so we diminish the incentive to keep people healthy in the first place.

Ever since my ‘heart event’, I’ve been getting extensive NHS advice and support on lifestyle, exercise and diet. I keep thinking that if I’d been given a hefty nudge in that direction beforehand then all that expensive clinical treatment would have been unnecessary.

Maybe it’s time to start thinking outside the tick-box.


No answers over Trump

“Should we be worried about Trump” was the question posed to me the other day. I didn’t have a good answer then and I’m not sure that I have one now.

The first point I’d make is that Donald Trump’s rise to prominence has little to do with his capability. What we’re seeing is the deeply polarised nature of US politics eagerly making room on the right for his brand of populist claptrap.

Another factor is growing voter negativity towards the traditional political class; something we’ve witnessed on our own side of the Atlantic.

For a nation with a constitutional abhorrence of kings and tyrants, America goes in a lot for dynastic outcomes. However, a sizeable chunk of voters feel that having another Clinton in the Whitehouse would be no better than having another Bush.

This is where Trump wins hearts and minds. His rhetoric at the podium suggests he’s anti-politics by inclination and anti-establishment in everything else. Neither claim is true, of course.

Will he become president? Probably not, but it’s likely that other Republicans will think they should copy his outrageously confrontational style to get ahead in the polls. To me that’s just as dangerous in the end.


A sparkling awards night

It’s not often you get to hear “Uptown Funk” played by a string quartet. Yet that was only part of the package laid on to entertain the glitterati at last week’s Swansea Bay Business Awards.

I don’t think I’ve seen the Brangwyn Hall so full for a business event since former Bank of England governor Eddie George guested at an official lunch there over a decade ago.

Coincidentally, another BoE stalwart, David Blanchflower, recently described UK growth as still very weak, adding that the global economy "feels a little bit like 2008."

There wasn’t much sign of that last Thursday night. Indeed, it was an upbeat audience who listened to unpretentious guest speaker Jonathan ‘Jiffy’ Davies doing for Trimsaran’s visitor appeal what King Herod did for childcare.

As for the main event, it was great to see Marc Clement receive a lifetime achievement award. Congratulations also to all the award winners and nominees.

My view is that the presenters, sponsors and organising team can all take a bow for staging a memorable showcase evening.

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