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Alice through the glass ceiling or Tweedledum Tweedledee and Tweedledem

May 8, 2010

As we suspected a hung parliament which means a period of negotiation starting with the Conservative Cameron and the Liberal King maker Clegg (or Tweedledum and Tweedledem as some wag has called them), there is much confidence that they will find a workable deal not least because, contrary to expectations, the Liberals did not do as well as polls suggested, in fact they lost seats; but neither did Cameron so he needs them to get a majority. If these negotiations fail Mr Browns Labour will need not just the Liberals but many of the other minor parties to get a majority.

Making sense of all this may prove difficult and relatively short lived which is why the markets have reacted badly but it also tells us that the electorate has faith and trust in no one. It seems unlikely that this will be restored any time soon, given the need to address the economic issues that can no longer be avoided. What it may do in fact is ensure that the worst excesses of any political party proposals are tempered which may be a very good thing if it can ensure we get out of the recession; meanwhile the cold winds continue to blow in London as a metaphor of the period we now enter. Perhaps the most surprising and disturbing thing that happened in the election was that many polling stations could not cope with the numbers turning up and so many people did not get to vote causing various degrees of chaos depending on the local response which ranged from the illegal (keeping the polling station open till 10.30) to the immoral (denying individuals the right to drop their votes in the box in the polling station becasue it was 10pm).

So you may be wondering what has all this to do with healthcare organisation that is the focus of my day job, well quite a lot as the outcome of the election will dictate exactly which form of chaos policy in UK healthcare will have to deal with. Contrary to what politicians and indeed the institutions of health would like to believe healthcare is not just a complicated space but a complex and sometimes chaotic one but the rhetoric of the rational fix is seductive and fits with the positivist paradigm at the heart of the science of medicine and economics which dominate the policy and practice agenda.......until we really engage with what this means in misinterpreting the space and its possible solutions we will not resolve the dilemmas which are posed.

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