George Orwell and the decoding of the Local Involvement Networks

By Cath Arakelian

In 1946, George Orwell said that writing consisted “less and less of words chosen for the sake of meaning, and more of phrases tacked together like the sections of a pre-fabricated henhouse”. To him, that was “sheer humbug” – he was was concerned that language should be “an instrument for expressing and not concealing or preventing thought.”

While Local Involvement Networks (LINks) are meant to foster public engagement, there is a danger that through such humbug, the people in them become co-opted into the very system they are meant to monitor. I am on the stewardship group of my local LINks and received a report that seemed to illustrate this collusion. The closer you get to powerful interests the more they try either to co-opt you in their own plans so that you become collusive in your own powerlessness, or to deflect you from their real ideas by creating imaginary barriers, disguised as “for your own good”.

We need to be able to decode what public servants mean by words like “commissioning” or “involvement” so that the public are not bamboozled. Becoming fluent in the language of our public services can mean that you uncritically accept their definitions, their conceptual boundaries and biases. I do not believe this is how you increase public involvement, but how you become a gatekeeper, preventing the public influencing their own services.

So here is the report to LINks decoded:

“I met this morning with Dr X, who is leading on the NHS Alliance’s “Involvement” thinking.”
I met Dr X. He is a top dog in the NHS – that is the employers’ man – on how we get ordinary people talking about and with the people who provide public services. I was impressed.

“The NHS Alliance’s Chair, Dr Y, had ‘brokered’ the meeting.”
The even more top top-dog on the employers’ side had a word with him over a game of golf and they agreed (if they really had to) to see representatives of the public – so long as they gave up a day to come to London, and didn’t stay too long.

“To clarify – the NHS Alliance is a national body which was set up when the Conservative Government legislated to give GPs their own budgets, in the early 1990s and is made up of those who work exclusively within the broad range of the Primary Care sector in England.”
Yada yada yada. This is an employer’s quango costing a bomb and I expect paying out around £80K per officer so costing us, the taxpayer, a fortune.

“We spent a good morning’s session at the King’s Fund HQ in London, engaged in an extremely thought-provoking discussion about opportunities for what is, we both believe, potentially a constructively fruitful relationship between LINks nationally and the Alliance.“
They allowed me to meet them in their swanky London offices and I was impressed. It’s amazing what we have in common – we all love talking through our bottoms.

“We agreed that approximately 90% of the commitment for both LINks and the NHS Alliance has to concern monitoring of work in Primary Care, Community Mental Health Care and Local Authority Directorates for Social Care – rather than in the Secondary Care sector.“
They told me that the public had no business looking at what happens in hospitals.

“We reflected on the necessity to explore the often missed opportunities which limited practice-based commissioning offers to communities, and acknowledged the need to be aware of conflicts of interests and of the essential duty of LINks to remain independent in their search for evidence that there is both appropriate commissioning and provision of services which adequately serve the needs of the community.“
Wow – get the Plain English brigade out! I’ll break it down into easy chunks:
* We reflected on the necessity to explore = we talked aimlessly for a long time until the tea came.
* The often missed opportunities = things which we didn’t spot until they hit us in the solar plexus.
* Which limited practice-based commissioning offers to communities = which got in our way of making our shopping list of what we think are best for the rest of you.
* And acknowledged the need to be aware of conflicts of interests = we know what we want and what the public wants are not the same.
* And of the essential duty of LINks to remain independent in their search for evidence = we won’t help you in any way to find out anything about anything we are doing or planning – because that would be compromising your independence.
* Appropriate = what we think is ok given our budgets which have to cover our enormous public salaries before anything else
* Community = any group of people who live together in houses along roads and rely on public services
* The needs of the community = what we think you deserve

“We reflected on the difficulties arising from the “lack of interconnectedness” between the DoH and the DCLG.”
We talked pointlessly about nothing except how gorgeous those acronyms sound rolling around in the mouth, until the afternoon coffee came.

“We especially focused on areas of formative training and development for both LINks’ members.”
We think you lot are pig ignorant.

“And the wide range of workers in the Primary Care sector, who are often fearful of, and negative about, the “Duty to Involve” agenda.”
Our own staff who quite reasonably loathe the public, and are also pig ignorant.

“We reflected on the difficulties arising from the “lack of interconnectedness” between the DoH and the DCLG.”
We talked pointlessly about nothing except how gorgeous those acronyms sound rolling around in the mouth, until the afternoon coffee came.

“As well as issues of accountability.”
How we will make sure you volunteers don’t dare move an inch to check out your own situations because of the paperwork.

“Across adult health care and social care.“
Especially where old or vulnerable people are involved – which doesn’t of course mean children, who are a different species and don’t need to be involved in their services, becasuse they by definition are pig ignorant.

If Local Involvement Networks are intended to empower people who use public services to influence the people who make the spending decisions, then please, let’s avoid the humbug.