What matters to me

‘What matters to you?’ day occurs each year at the beginning of the summer and aims to encourage and support more meaningful conversations between people who provide health and social care and the people who receive it. A reminder like this can only be a good thing but we should be careful about making claims that this idea is somehow novel.

I am an NHS doctor and an artist. I have, in the past, been a patient. I have tried to convey some of what matters to me in my writings and films.

As a doctor of more than 25 years NHS Scotland matters to me. In this short film I will express my concerns about the increasing dominance of the Institute for Healthcare Improvement (IHI) in NHS Scotland. This Boston based company celebrates Scotland to the world as the leading example in using its methodology. This methodology was developed in the engineering and manufacturing industries. It is only within the last decade that IHI has promoted this methodology as the founding basis to improving healthcare. It is thus relatively untested.

Healthcare Improvement Scotland follows the IHI “mantra”. It is to be celebrated that some aspects have gone well, such as patient safety with medicines in primary care. What is far less clear is whether the reductionist methodologies that improvement science takes, approaches which generally prioritise data over people, will be just as suitable for more complex healthcare situations.

IHI methodology has been introduced to Scotland by a very small group of Fellows of this American Institute. One of the Fellows, was formerly the Director General for NHS Scotland and is now the President and Chief Executive Officer for IHI. Two other Fellows, who have been key to the progressive dissemination of IHI methodologies in NHS Scotland, occupy the most senior positions in the Scottish Government’s Department of Health and in Healthcare Improvement Scotland.

The headlines used in this film have appeared in Scottish newspapers in the period that IHI’s influence has gathered pace in NHS Scotland.

At a time when NHS Scotland budgets are under intense pressure it is not at all clear whether the continuing involvement of IHI is providing value for money.

Improvement science is relatively untested in healthcare settings and it is therefore concerning to learn that these methodologies are currently being introduced to Scottish Schools.

It matters to me that the NHS continues to follow the vision with which it began 70 years ago and does not become subsumed by big business interests.

This is what matters to me. If it matters to you too please consider sharing this film.


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