Telehealth, & Jargon

Sometimes as you do a little research for a post you find you have hit a rich seam of material, full of new information, and unexpected connections. When I recently stumbled onto this document I did not at first see it as much more than the basis for a rant about management doublespeak and obfuscation. Persevering through the almost incomprehensible paragraphs I started to understand what it was about. And the more I read the more angry I got.

First of course it is, superficially, a prime example of management jargon. Phrases like “thought leadership, capacity building and system regulation to the NHS..........consistent with delivery of the work programme of the Long Term Conditions Healthy Ambitions Pathway and securing the regional element of the QIPP strategy.” say it all. The document goes on (and on and on) in similar vein. Einstein once said “If you can’t explain it simply you don’t know it well enough” So the author, one Professor Sue Proctor either does not know what she is talking about, or, more likely, she is trying to dress up and obscure something unsavoury.

Telehealth is supposedly a concept of delivering health care without the troublesome business of doctors actually having to see their patients in the flesh. Instead patients would have “telemonitoring, video consultations, and teleeducation”. I think most clinicians can see the flaws with this but Prof Proctor does not, though she does acknowledge the risk that, from Strategic Health Authorities down to individual clinicians there may be a lack of enthusiasm. This does not seem to deter Ms Proctor who enthuses “This is an ever developing market sector with a range of commercial providers and NHS/Foundation Trusts likely to be attracted to a business opportunity of this magnitude.”

I am deeply repelled by this idea that the NHS has come to be regarded as a “business opportunity”, a means for some to make disproportionate profit in a manner far removed from taking an honest days pay for an honest days work.

Ms Proctor also cites proof of concept from Airedale Hospital of all places, which has recently been highlighted for serious failings, leading to police involvement. Further the “workstrand” is being led by none other than Adam Cairnes, the very individual responsible for those failings, whilst CE at Airedale.

So who is Prof Susan Proctor? Her qualifications are listed as RGN, MSc PhD. That’s right, she is a nurse, removed from the one area where she might be of some use, nursing. Looking at her previous positions and relative youth it seems pretty unlikely that she has done much actual nursing.

I have the greatest of respect for my nursing colleagues, but I think the interests of patients are best served when nurses actually nurse. I believe that nursing is primarily a practical, and not an academic subject and that the change of nursing to a degree course was detrimental to the profession. I know many nurses who agree with me.

It seems to me that Ms Proctor has used nursing as nothing more than a vehicle to attain for herself a position far far beyond her intellectual capabilities, where she feels she is qualified to pontificate on how to deliver medical care.

Telehealth is in my view an abomination. It is the ultimate separation and alienation of patient from doctor. Those who advocate it seem to understand nothing about the doctor patient relationship and the importance of proximity in a consultation. The ability to physically examine patients, to make eye contact and to be able to shake or take the hand (without gloves!). As Jacob Bronowski once said “We have to touch people”