Heroes Not Zombies

Health is not a THING.

Health is not an entity or a product.

Health is more than the sum of the set of “normal” measurements.

Health is a lived experience.

As an experience, health is a characteristic described by the experiencing person, by the subject. Without a person to experience health, there is no health.

So, why do we deliver health care by treating diseases and people as objects, or by processing people to reach pre-determined targets, which might have precious little to do with the experience of health?

The shocking report on Stafford Hospital, suggesting between 400 and 1200 patients might have died due to the way they were treated in the hospital concludes that

“There was a lack of care, compassion, humanity and leadership,” he said. “The most basic standards of care were not observed and fundamental rights to dignity were not respected.”

Chris Ham of the Kings fund says

The priority must be to shift from a culture in which the behaviour of staff is driven by compliance with targets to one in which there is a real commitment to patient-centred care in every hospital and surgery

But so far the government’s response seems to be to drive towards greater compliance with tougher regulation and inspections.

The problem isn’t one of control, it’s one of “care, compassion and humanity”. How did the Health Service come to this?

Increasingly we treat health care delivery in the same way we treat a business or a factory, by measuring, standardising, and enforcing compliance. None of that seems to be improving the experience of health care because none of that is based on the fact that health is a lived experience, not a product.

Every single human being is unique.

Every life is unpredictable.

A truly patient-centred care will consider the uniqueness of the individual at all stages in the health care journey, and will require imagination – the imagination needed to enable health care workers and managers to imagine what it would be like to experience what the patients are experiencing.It will also take a lot of non-judgemental listening. Without really hearing a person’s story, we fail to know their uniqueness, fail to comprehend or consider their beliefs, values or wishes.

The Stafford story is not the end of the story. It’s probably the tip of an iceberg. Maybe now is a wake up call for all of health care. Maybe now is the time to reconsider the commodified, reductionist, materialistic basis of the current model which pushes more and more drugs into more and more people every single year, and processes more and more people through hospital beds ever more quickly.

After all, if health is an experience, we should design health care around making personal experiences better.

Check out the manifesto for slow medicine.